Listening to First Nations women's voices, hearing requests for continuity of carer, trusted knowledge and family involvement: A qualitative study in urban Darwin

Abstract

Problem: Australian First Nations women are more likely to commence care later in pregnancy and underutilise maternal health services than non-First Nations women.

Background: Disrespectful maternity care is a major barrier to care-seeking in pregnancy, often resulting in later commencement and underutilisation of care.

Aim: We aimed to identify barriers and enablers to pregnancy-related care-seeking for Australian First Nations women living in the Darwin region through yarning about their experiences of pregnancy care.

Methods: Ten Australian First Nations women shared stories about their pregnancy care journeys. Yarns took place at a time and location determined by the women, with recruitment continuing until saturation was reached.

Findings: Emerging themes included a desire for continuity of carer, particularly with midwives; access to trustworthy information, enabling informed decision-making; and a need to have family involved in all aspects of care. No specific barriers were identified within this cohort DISCUSSION: Universal access to continuity of carer models would provide women with the relational care they are asking for as well as address other identified needs, such as a desire for information relevant to their pregnancy; and space for partners/family members to be involved. The themes that emerged provide a picture of what a positive, respectful pregnancy care experience could be for First Nations women within the Darwin Region, thus enabling care-seeking in pregnancy.

Conclusion: Although the public sector and Aboriginal Controlled Community Health Organisations currently provide continuity of carer models, robust systems ensuring these models are made available to all women are lacking.

Keywords: Continuity of carer; Family involvement; First Nations; Midwives; Respectful maternity care; Trusted knowledge.