Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Western Australia, Australia.
WA Government Department of Health, Child and Adolescent Health Service, Community Health, Perth, Western Australia, Australia.
Birth. 2021 Mar;48(1):132-138. doi: 10.1111/birt.12525. Epub 2020 Dec 30.
The Birthing on Noongar Boodjar project (NHMRC Partnership Project #GNT1076873) investigated Australian Aboriginal women and midwives' views of culturally safe care during childbearing. This paper reports on midwifery knowledge of Aboriginal women's cultural needs, their perceptions of health systems issues, and their ability to provide equitable and culturally safe care.
A qualitative study framed by an Indigenous methodology and methods which supported inductive, multilayered analyses and consensus-driven interpretations for two clinical midwife data groups (n = 61) drawn from a larger project data set (n = 145) comprising Aboriginal women and midwives.
Midwives demonstrated limited knowledge of Aboriginal women's cultural childbearing requirements, reported inadequate access to cultural education, substituted references to women-centered care in the absence of culturally relevant knowledge and consistently expressed racialized assumptions. Factors identified by midwives as likely to influence the midwifery workforce enabling them to provide culturally safe care for Aboriginal women included more professional development focused on improving understandings of cultural birth practices and health system changes which create safer maternal health care environments for Aboriginal women.
Individual, workforce, and health systems issues impact midwives' capability to meet Aboriginal women's cultural needs. An imperative exists for effective cultural education and improved professional accountability regarding Aboriginal women's perinatal requirements and significant changes in health systems to embed culturally safe woman-centered care models as a means of addressing racism in health care.
生育在努冈博迪加尔项目（NHMRC 合作项目 #GNT1076873）调查了澳大利亚原住民妇女和助产士在生育过程中对文化安全护理的看法。本文报告了助产士对土著妇女文化需求的了解、他们对卫生系统问题的看法，以及他们提供公平和文化安全护理的能力。
一项以土著方法学为框架的定性研究，并采用了支持归纳、多层次分析和共识驱动解释的方法，对来自更大项目数据集（n=145）的两个临床助产士数据组（n=61）进行分析，该数据集包括土著妇女和助产士。
助产士对土著妇女文化生育需求的知识有限，报告称获得文化教育的机会不足，在缺乏文化相关知识的情况下，用以妇女为中心的护理替代参考，并且始终表现出种族化的假设。助产士认为可能影响助产士提供文化安全护理的因素包括更多以提高对文化分娩实践和卫生系统变化的理解为重点的专业发展，这些变化为土著妇女创造了更安全的孕产妇保健环境。
个人、劳动力和卫生系统问题影响了助产士满足土著妇女文化需求的能力。迫切需要有效的文化教育和提高对土著妇女围产期需求的专业问责制，以及对卫生系统进行重大改革，以嵌入文化安全的以妇女为中心的护理模式，作为解决医疗保健中的种族主义问题的一种手段。
