Community perspectives on delivering trauma-aware and culturally safe perinatal care for Aboriginal and Torres Strait Islander parents

Renee Fiolet; Cindy Woods; Anni Hine Moana; Rachel Reilly; Helen Herrman; Helen McLachlan; Jane Fisher; Johanna Lynch; Catherine Chamberlain

doi:10.1016/j.wombi.2022.07.174

Community perspectives on delivering trauma-aware and culturally safe perinatal care for Aboriginal and Torres Strait Islander parents

Women Birth. 2023 Mar;36(2):e254-e262. doi: 10.1016/j.wombi.2022.07.174. Epub 2022 Aug 5.

Authors

Renee Fiolet¹, Cindy Woods², Anni Hine Moana³, Rachel Reilly⁴, Helen Herrman⁵, Helen McLachlan⁶, Jane Fisher⁷, Johanna Lynch⁸, Catherine Chamberlain⁹

Affiliations

¹ Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Victoria, Australia. Electronic address: renee.fiolet@unimelb.edu.au.
² Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, Australia.
³ Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia.
⁴ South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁵ Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia.
⁷ School of Public Health and Preventative Medicine, Turning Point Monash University, Melbourne, Victoria, Australia.
⁸ Integrated Place, Birkdale, Queensland, Australia.
⁹ Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Victoria, Australia; Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia; NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia,; The Lowitja Institute, Melbourne, Victoria, Australia.

PMID: 35934615
DOI: 10.1016/j.wombi.2022.07.174

Abstract

Background: Since colonisation, Aboriginal and Torres Strait Islander peoples have experienced violence, loss of land, ongoing discrimination and increased exposure to traumatic events. These include adverse childhood experiences which can lead to complex trauma, and are associated with increased incidence of high-risk pregnancies, birth complications and emergence of post-traumatic symptoms during the perinatal period, potentially impacting parenting and leading to intergenerational trauma. The perinatal period offers unique opportunities for processing experiences of trauma and healing yet can also be a time when parents experience complex trauma-related distress. Therefore, it is essential that trauma-aware culturally safe perinatal care is accessible to Aboriginal and Torres Strait Islander parents.

Aim: This study aimed to understand community perspectives of what 'trauma-aware culturally safe perinatal care' would look like for Aboriginal and Torres Strait Islander parents.

Methods: Data were collected during a workshop held with predominantly Aboriginal and Torres Strait Islander key stakeholders to co-design strategies to foster trauma-aware culturally safe perinatal care. Data were thematically analysed.

Findings: Four overarching themes represent proposed goals for trauma-aware culturally safe care: Authentic partnerships that are nurtured and invested in to provide the foundations of care; a skilled workforce educated in trauma awareness; empowering and compassionate care for building trust; and safe and accessible environments to facilitate parent engagement.

Conclusions: Provision of trauma-aware culturally safe care achieving these goals is likely to enable parents experiencing complex trauma to access appropriate support and care to foster healing in the critical perinatal period.

Keywords: Aboriginal; Complex trauma; Cultural safety; Perinatal; Trauma-aware; Trauma-informed.

MeSH terms

Australian Aboriginal and Torres Strait Islander Peoples
Culturally Competent Care*
Female
Health Services, Indigenous*
Humans
Infant, Newborn
Parents
Perinatal Care*
Pregnancy