To support First Nations mothers, we need to let them take the lead

Lise Bosch

Lise is a South African-born and Aussie-raised creative working as Kiindred's in-house writer and editor. With a journalism degree and experience in the beauty industry, she has a passion for family and lifestyle content. On her days off, she’s finding the latest and greatest brunch spots and trying to work through the longest TBR list known to humankind. It’s a work in...

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Updated on Jul 15, 2024 · 6 mins read

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To support First Nations mothers, we need to let them take the lead

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You should be able to give birth in a place that feels safe. You should be empowered to give birth in a way that aligns with your values and culture. First Nations mothers are being denied this basic right, and it’s proving detrimental.

In Australia, First Nations women are almost twice as likely to have a preterm birth and nearly four times as likely to die during childbirth than non-Indigenous women.

For centuries, the response from non-Indigenous Australians has been to find cracks in First Nations communities to point the blame. What is it they’re doing wrong?

In truth, the culprit is closer to home.

Our healthcare system still bears the gnarled roots of colonisation’s paternalism. To truly support First Nations mothers, we need to start there.

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Indigenous birthing practice versus paternalistic healthcare

Amnesty International defines paternalism as, “a father-child relationship between governments and Indigenous people, where governments act on their view of what is ‘best’ for Indigenous people.”

In healthcare systems, this can manifest as placing a higher value on Western perspectives of birthing practice than that of Indigenous patients.

First Nations communities across Australia articulate well-being through a holistic and collectivist lens. They wrap it in their connection to self and Country; their identity, culture, art, family, spirituality, and kin.

Before settler interruption, Indigenous mothers would give birth on the land of their mothers, grandmothers, and great-grandmothers. Grandmothers and aunties take on midwifery roles (providing warmth, safety, and comfort), and the birth itself was seen as a responsibility of the whole community.

Culturally safe birthing has carried First Nations families for over 80,000 years, but this changed drastically with colonisation. Indigenous Australians were forced to abandon these pillars, that nourish and sustain their communities, to adopt a ‘better way’ – the Western way, which often sees birth as individualistic, clinical, and transactional.

This ‘better way’ is far from better; the health outcomes prove it.

Studies have identified that birthing statistics in Indigenous communities are driven by poor access to culturally appropriate health services, sustained institutional racism, lower educational attainment, poverty, remoteness, and continuing effects of colonisation.

If First Nations mothers do make it to a hospital, it can be hard to understand what the midwives are saying, what the procedures are, and what they need to do.

And on top of all that, trauma from the Stolen Generations has meant that First Nations families have little trust in the medical system itself. A 2014 study found that this was largely why Indigenous mothers felt safer and were more likely to access maternal care when cared for by Indigenous midwives.

But currently, there are shockingly few First Nations midwives.

Every birthing mother should have access to local healthcare that’s culturally safe, prepared for language barriers, and staffed with suitably trained and qualified professionals. It’s a human right. And when they have it, their health outcomes improve significantly.

That’s what motivates the social justice movement, ‘Birthing on Country.’

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Understanding ‘Birthing on Country’

We’ve long spoken of ‘closing the gap’ initiatives pursued by the Australian Government and First Nations peoples. These are intended to bridge disparities between Indigenous and non-Indigenous Australians, whether it be the overrepresentation in the criminal justice system or employment outcomes.

Many of these policies have a history of working against Indigenous Australians instead of with them. But we know that to truly support First Nations peoples, we need to let them take the lead.

The National Agreement on Closing the Gap explains, “Closing the Gap is underpinned by the belief that when Aboriginal and Torres Strait Islander people have a genuine say in the design and delivery of policies, programs and services that affect them, better life outcomes are achieved.”

Birthing on Country is a movement that seeks to close the gap in the health of mums and babies by returning childbirth services to First Nations communities.

It creates a culturally safe birthing experience for Indigenous women, where they feel trust and ownership over that space.

Under this initiative, maternity services are designed, developed and delivered to:

Be community-based and governed
Include traditional practices
Involve connections with land and Country
Respect women’s choice
Incorporate a holistic definition of health
Value First Nation ways of knowing and learning
Be culturally competent and collaborate with women and their community

This model of care can and should be woven into any setting; both in big city hospitals and remote communities.

Birthing on Country works. One study in an urban setting found it led to a 38% reduction in preterm babies, showing just how critical the movement is.

Melanie Briggs, NSW’s first endorsed Aboriginal midwife, has said “Birthing on Country means our mums and our babies can have the best start in life by having a birthing place that is sacred, that is theirs and that is safe. It’s about building on womens’ strength.”

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Birthing on Country gets a five-million-dollar boost

Charles Darwin University’s (CDU) Molly Wardaguga Research Centre, established to support women’s cultural and birthing aspirations, has received nearly $5 million in funding to expand Birthing on Country services.

The CDU’s Birthing on Country program is well-known for cultivating better birth and infant outcomes. They actively support Aboriginal Community Controlled Health Services and other partners in establishing and evaluating three Birthing on Country services in Nowra (NSW), Alice Springs, and Galiwin’ku (NT).

Yvette Roe, the research centre’s director and a proud Njikena Jawuru woman, says “The Birthing on Country program is informed by First Nations knowledge and at its core it is about maternal health justice. It supports a First Nations workforce trained to care for mothers and babies and focuses on improving the two-way cultural knowledge transfer in the birthing system.”

The funding comes as part of the Federal Government’s Medical Research Future Fund – a long-term investment to support Australian health and medical research.

It means that the program’s potential-filled research findings can convert into action; training frontline workers and improving services dedicated to caring for First Nations mothers and babies.

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Looking forward

We’re failing First Nations mothers and families. We’ve been failing them for a long time.

When every expert, every research piece, and every conversation with Indigenous communities points to self-determination and cultural safety as the way forward, there’s little excuse for the lack of it.

Birthing on Country embodies the idea of Indigenous-led care. It’s shaping a more empowering birthing experience for First Nation mothers and a better start to life for their children.

And it’s our opportunity to do things differently.

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