Meredith Cara, Haitana Tracy, McKerchar Christina, Pitama Suzanne
Department of Māori and Indigenous Health Innovation, University of Otago | Ōtākou Whakaihu Waka, 45 Cambridge Terrace, Christchurch, NZ 8013, New Zealand.
Department of Population Health, University of Otago, Christchurch| Ōtākou Whakaihu Waka, Christchurch, New Zealand.
Int J Equity Health. 2025 Aug 21;24(1):226. doi: 10.1186/s12939-025-02592-2.
Clinicians can mitigate the impact of invalidating or traumatic clinical experiences by actively working to ensure that the clinical interface is a space that is safe, inclusive, and responsive. In Aotearoa, New Zealand (NZ) the cumulative and ongoing effects of colonisation drive significant health inequities experienced by the Indigenous Māori population. Systemic health inequities extend across the perinatal period for Māori mothers and birthing parents with mental health outcomes being particularly poor. Previous invalidating or traumatic experiences at the clinical interface may impact a person's ability to trust or feel safe with clinicians.
The aim of this paper is to explore Māori mothers' and birthing parents' experiences of clinical interactions during the perinatal period to guide clinicians in providing high-quality, culturally safe perinatal mental health care.
This qualitative study was guided and informed by Kaupapa Māori methodology. Semi-structured interviews were undertaken with 19 Māori mothers and birthing parents.
Participants described the challenges they experienced at the clinical interface and also offered insights around positive interactions they encountered with clinicians. Three themes predominated the analysis of Māori mothers and birthing parents: whakawhanaungatanga (relationships, building connections); kaitiakitanga (guardianship and protection); and mana (prestige, dignity).
Themes from the clinical experiences of Māori mothers and birthing parents when seeking perinatal healthcare outline important dimensions of positive clinical encounters. During the perinatal period these dimensions were promoted through continuity of care and the inclusion and centring of whānau (family, wider support network).
Quality clinical care occurs within a system, and structural components of the health system can influence practice and impact provision of care. It is systemic changes that will facilitate clinicians' contribution to equitable outcomes for Māori, through the creation of services that support clinicians to prioritise working with whānau, engage in culturally safe practice, and address the barriers that prevent Māori from accessing evidence-based healthcare. Whakawhanaungatanga, kaitiakitanga and mana are essential to enhancing clinician-patient/whānau interactions in perinatal mental health care. To facilitate these relational values and practices, healthcare organisations must adapt health system structures to support whānau-centred practices. Recommendations from participants within this study provide important directions to guide clinical practice.
临床医生可以通过积极努力确保临床环境是一个安全、包容且有回应性的空间，来减轻无效或创伤性临床经历的影响。在新西兰的奥特亚罗瓦，殖民化的累积和持续影响导致了原住民毛利人口面临严重的健康不平等。系统性的健康不平等在毛利母亲和生育父母的围产期普遍存在，心理健康状况尤其糟糕。先前在临床环境中经历的无效或创伤性经历可能会影响一个人对临床医生的信任或安全感。
本文旨在探讨毛利母亲和生育父母在围产期的临床互动经历，以指导临床医生提供高质量、具有文化安全性的围产期心理健康护理。
本定性研究以毛利方法学为指导并受其影响。对19位毛利母亲和生育父母进行了半结构化访谈。
参与者描述了他们在临床环境中遇到的挑战，并分享了他们与临床医生积极互动的见解。对毛利母亲和生育父母的分析主要有三个主题：whakawhanaungatanga（关系，建立联系）；kaitiakitanga（监护与保护）；以及mana（威望、尊严）。
毛利母亲和生育父母在寻求围产期医疗保健时的临床经历主题勾勒出了积极临床接触的重要方面。在围产期，这些方面通过持续护理以及家庭（家庭、更广泛的支持网络）的纳入和以其为中心得以促进。
高质量的临床护理发生在一个系统之中，卫生系统的结构组成部分会影响实践并对护理提供产生影响。正是系统性变革将促进临床医生为毛利人实现公平结果做出贡献，通过创建支持临床医生优先与家庭合作、开展具有文化安全性的实践并消除阻碍毛利人获得循证医疗保健的障碍的服务。Whakawhanaungatanga、kaitiakitanga和mana对于加强围产期心理健康护理中的医患/家庭互动至关重要。为了促进这些关系价值观和实践，医疗保健组织必须调整卫生系统结构以支持以家庭为中心的实践。本研究中参与者提出的建议为指导临床实践提供了重要方向。
