Australia National Data show First Nations women are at almost twice the risk of stillbirth or “sorry business kids”in comparison with non-First Nations women.
To address this inequality, Australia National Action Plan on Stillbirths focuses on providing culturally secure stillbirth prevention and care to First Nations women.
But first we need to know the underlying causes of the persistent disparities in stillbirths and other pregnancy related results.
We argue that much of this inequality can be traced to the continuing impact of colonization on First Nations women and childbearing. Here’s why.
Ongoing intergenerational trauma
First Nations people have lived in Australia for at least 65,000 years. Before Invasion and European settlement in 1788Over 2,000 generations of Native Americans have lived connected to family, community, country and their ancestors.
Colonization has led to First Nations women being stripped of their traditional practices related to pregnancy and childbirthincluding the use of medicinal plants, lively labor and pain relief techniques, and songs about childbirth.
From the mid-1800s to the Nineteen Seventies, First Nations infants and children were forcibly removed from their communities and placed with non-First Nations families.
Land loss, violence and abuse, medical experimentation, cultural suppression, and other systemic injustices have led to widespread intergenerational trauma that contributes to poorer health outcomes today.
Maternity services are not intended for First Nations women
Historical violence and exclusion have led to intergenerational distrust of colonial systems, services, and spaces amongst First Nations people. There has been an expectation that First Nations people will adapt to Western health services, relatively than those services adapting to First Nations people. ways of knowing, being and acting.
It can be First Nations medical expert shortageThis further limits indigenous people’s access to culturally sensitive care.
Recognition of importance Birth within the Countryside has led to the creation of services comparable to Flap AND Birth in our community.
But there are not enough of these services for all First Nations women. And barriers to establishing services to last.
Resources are not intended for First Nations women
Pregnancy information resources have historically been designed for a colonial audience. These resources are not directed at First Nations women and have rarely been developed by and with First Nations people.
More contemporary initiatives are increasingly involving First Nations people in resource development or placing them in leadership positions.
This Center of Excellence in Stillbirth ResearchThe Indigenous Peoples Advisory Group recently led the event of Stronger Bubba Born pregnancy information and resources website for First Nations women. The information is similar as that provided to non-First Nations women as part of Safer Child Packagebut it has been culturally adapted to the goal group.
Racism and Discrimination in Maternity Services
While some First Nations women face overt racism in maternity services, many more experience discrimination through hidden prejudicesThis is where caregivers’ unconscious beliefs about Native Americans influence their judgments and interactions with pregnant Native Americans.
Active stereotypes commonly used about pregnant First Nations women include: assuming drug and alcohol use AND perceived inability to motherThis is resulting from the historical marginalization of First Nations peoples.
But implicit bias shouldn’t be the one source. Institutional racism also contributes to poorer health outcomes amongst First Nations women. This is because of built-in structures or policies that perpetuate racial disparities and often goes unnoticed by non-First Nations midwivesInstitutional racism manifests itself in a spread of ways, including: numerical limitations family/supporters who can visit.
All of this results in an imbalance of power and the exclusion of First Nations women. less prone to participate prenatal visits.
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Suppliers do not understand First Nations health issues
This Australian First Nations Views on Health differs from the Western view. Connection to family, country and community defines the health of First Nations people, not disease, illness and notions of “risk.”
Physical, spiritual, cultural, social, emotional and mental health are interconnected, and the land is a source of strength, identity and healing.
These concepts form the premise Birth within the Countryside and emphasize the importance self-determination in providing culturally sensitive perinatal care.
However, perinatal care providers have limited knowledge cultural needs of First Nations women and the low level of education and training on this area.
What’s next?
To eliminate racial disparities in stillbirth rates in Australia, our health system and society as a complete must acknowledge the results of colonisation and the structural forces that proceed to affect the health of Indigenous people on this country.
This requires acknowledging Australia’s history and understanding its discomfort.
The Guide to Healthy Spinning is workshop based on two-way learning and experience sharing for non-First Nations perinatal care providers and maternity service administrators.
The workshop goals to enable people to debate stillbirth prevention with First Nations women in a sensitive manner. Participants will learn about the history of Australia and the results of colonisation on First Nations women and childbirth, in addition to what culturally sensitive care looks like for First Nations families.
We have an extended option to go to supply high-quality, culturally sensitive perinatal care to First Nations women and families. However, formal education inside perinatal services is a critical place to begin.