Woman-centred care and Birthing on Country
Culturally safe maternity services are fundamental to improving outcomes and experiences for Aboriginal and Torres Strait Islander mothers and babies (Kildea et al. 2016). Supportive policies, applying the principles of woman-centred care (see Box 1 and Figure 1) and Birthing on Country models of care may address many elements of cultural safety for Aboriginal and Torres Strait Islander women.
Box 1: Principles of woman-centred care
Woman-centred care is care which:
- recognises the woman’s baby or babies, partner, family, kin and community
- respects cultural and religious diversity as defined by the woman herself
- considers the woman’s individual circumstances, and aims to meet the woman’s physical, emotional, psychosocial, spiritual and cultural needs
- is built on a reciprocal partnership through effective communication
- enables individual decision-making and self-determination for the woman to care for herself and her family
- respects the woman’s ownership of her health information, rights and preferences while protecting her dignity and empowering her choices (DoHAC 2019).
Figure 1: Key values and principles of woman-centred care
Source: adapted from DoHAC 2019.
Key policies relating to delivery of care to Aboriginal and Torres Strait Islander mothers and babies are the:
- National Women’s Health Strategy 2020-2030: identifies pregnant women and their children and Aboriginal and Torres Strait Islander women and girls as priority populations, and maternal, sexual and reproductive health as a priority area (DoHAC 2018).
- Woman-centred care: Strategic directions for Australian maternity services: purpose is to ensure Australian maternity services are equitable, safe, woman-centred, informed and evidence-based, that women are the decision-makers in their care and maternity care reflects their individual needs. This strategy identifies cultural safety as a principle for woman-centred maternity care for Aboriginal and Torres Strait Islander women, and Birthing on Country as a key enabler for culturally safe care (DoHAC 2019).
Birthing on Country refers to maternity services which are developed and delivered in partnership with Aboriginal and Torres Strait Islander women and communities (Kildea et al. 2016). The aim of Birthing on Country maternity services is to improve outcomes for Aboriginal and Torres Strait Islander mothers and babies by developing programs which strengthen connection to culture and Country – regardless of geographical location – during birthing and acknowledge the cultural risk of not birthing on Country (Kildea et al. 2016).
The aim of Birthing on Country is to improve outcomes for Aboriginal and Torres Strait Islander mothers and babies by developing programs which strengthen connection to culture and Country – regardless of geographical location – during birthing, and acknowledge the cultural risk of not birthing on Country (Kildea et al. 2016).
Guiding principles for a Birthing on Country program are:
- respect for, and incorporation of, Aboriginal and Torres Strait Islander knowledge and traditional practice
- respect for family and men’s involvement
- partnership approach
- women’s business
- continuity of carer
- connection with Country
- capacity building approach (training and education)
- holistic definition of health
- choice
- evidenced based clinical practice
- social model of health and wellbeing (Kildea et al. 2016).
It should be noted that Birthing on Country does not refer purely to geographic location, it is the provision of cultural safe continuity of care to women pregnant with an Aboriginal and Torres Strait Islander baby, wherever maternal health services are sought.
References
Department of Health and Aged Care (2018) National Women’s Health Strategy, 2020-2030. Canberra: Australian Government Department of Health and Aged Care.
Department of Health and Aged Care (2019) Woman-centred care: Strategic directions for Australian maternity services. Canberra: Australian Government Department of Health and Aged Care.
Kildea S, Lockey R, Roberts J, Magick Dennis, F (2016) Guiding Principles for Developing a Birthing on Country Service Model and Evaluation Framework, Phase 1 Canberra: Mater Medical Research Unit and the University of Queensland on behalf of the Maternity Services Inter-Jurisdictional Committee for the Australian Health Minister’s Advisory Council.