Introduction
A midwife has to understand the state of health care for mothers and children in the community. To ensure this understanding, it is necessary to use sources that study existing problems and try to resolve them. The article Historical Account of Maternity Care in a Remote Australian Aboriginal Town by Ireland et al. aims to develop effective maternity care practices based on prior documented methods (2015). Birth as a Country by Fleur Magic Dennis and Hazel Keedle concludes that maternity care in Australia’s remote Northern Territory is limited to antenatal and postnatal care only, with women typically being evacuated to the hospital for delivery (2019). The article Impact of Country Service Redesign on Childbirth and Newborn Health Outcomes for Indigenous Australians, written by Kildea Sue et al., calls for urgent redress of unacceptable health outcomes for First Nations mothers and their children (2021). Thus, the problem of insufficient medical care for some Australian populations becomes apparent. The article Birthing as Country was chosen to explore the impact of scientific papers on the perception of a midwife because it evokes the maximum emotional response since it is built on personal experience.
Description
In Australia’s Northern Territory, Indigenous women make up more than a third of all mothers. Of these, the majority live in remote rural areas, unlike non-Australian mothers. Women from rural areas are the least likely of all Australian women to choose and control pregnancy care; the choice of care provider and planned birth location is limited (Ireland et al., 2015). Telematernity services currently recommend that all pregnant women should be scheduled to give birth in a hospital, with only antenatal and postnatal care being offered in the woman’s hometown. Sometimes, women cannot leave a remote region and have to give birth in clinics without obstetric, anesthetic, laboratory, or pediatric support on-site. Properly conducted childbirth is hampered by the inaccessibility of medical services and the reluctance of Aboriginal women to give birth in a hospital. Because of the desire to comply with cultural rites, women endanger the child’s life and their own.
Feelings
The general problem of the inaccessibility of obstetric care for Aboriginal women seems to be serious. Based on good intentions, innovative Western midwifery practices have turned out to have a negative effect. The imposition of Western experience was expressed as a tool of colonization, not assistance, ignoring the ideas of aboriginal women about the correct birth (Ireland et al., 2015). Spiritual and cultural beliefs are essential for the woman’s well-being and must be ensured.
Although many Aboriginal women refuse medical care at birth, there are assistance programs for those who wish to give birth in a hospital. A study by Sue Kildea shows that new programs to help Aboriginal pregnant women have an excellent effect on children’s and mothers’ conditions (2021). New methods of assisting Indigenous Australian women need to be introduced. However, they must be ethical and consistent with their cultural and religious beliefs about reproduction. Dennis’s experience shows the plight of pregnant Aboriginal women in Australia (2019). The woman points out that she wanted to resolve all her four pregnancies following spiritual and religious practices, not within the walls of a medical institution (Dennis & Keedle, 2019). However, such beliefs could be influenced not by her genuine desire but by her cultural background.
First, Dennis’s upbringing in a traditional culture could not have allowed her to think otherwise. Secondly, she sincerely says that she did not have the funds for a professional midwife during her second pregnancy (Dennis & Keedle, 2019). All four children were born alive and healthy, and it is pure coincidence and luck. Midwives should promote successful childbirth and raise awareness of the need for medical care. Any midwife must provide care for mother and child, which she cannot guarantee outside of a hospital setting.
Evaluation
The assessment of the existing problem was correctly carried out in the studies. Ireland’s research included fieldwork, interviews with Aboriginal women and health professionals, and an archival collection of documents. A collaborative paper by Dennis and Keedle examines the experience of four pregnancies in Aboriginal traditions (2019). Dennis provides a personal account of her pregnancies and relates them to the socio-cultural issues surrounding her life at the time. A study by Kildea et al. suggested that pregnant women attending the Mater Mothers State Hospital who was pregnant with an Indigenous child were invited to receive the BiOC service (2021). Women underwent several examinations throughout pregnancy; all the data were recorded. The work of Dennis and Keedle makes the most sense of the seriousness of the problem of inaccessibility of medical services for pregnant Aboriginal women.
Analysis
Birthing as Country by Dennis & Keedle provides insight into the lack of access to midwifery services for Indigenous Australian women, especially those living in remote areas. The midwife practitioner must be aware of the problems of underserved populations to meet the ethical requirements of the profession. Studying the article is helpful for the midwife to form the correct personal values, which should be the desire to help any woman in a difficult situation. At the moment, there may be a lack of awareness in the midwifery community about the issue of Aboriginal women. The new assistance programs should have a positive effect, but, unfortunately, this is not the case. Aboriginal women may be hostile to childbirth assistance programs that go against their cultural and religious beliefs. Midwives must provide an individual approach to each woman during and after pregnancy.
Action Plan
An effective way to address the lack of access to competent obstetric care for Aboriginal women could be to expand the new health care program. The Birthing in Our Community program is effective because there has been a decrease in premature births since its introduction. However, women may be afraid to apply to this program, still fearing intervention in the process of childbirth, which is unacceptable to them religiously and culturally. It is necessary to raise women’s awareness that the program aims specifically at helping the indigenous population and considers cultural characteristics. In addition, ensuring the availability of midwives in remote areas and local clinics to avoid the forced relocation of women can be an intelligent temporary measure.
Conclusion
The problem of insufficient care during and after pregnancy for Aboriginal women is severe. Many women are deprived of competent medical care and are forced to give birth without anesthesia and the help of professional midwives. Dennis’s experience proves that Indigenous Australian women face barriers and often cannot afford to give birth in a hospital. Programs to help Aboriginal women are already in place, but they may not fit their cultural understanding of the birth process. New methods of supporting women in childbirth ethically, considering their beliefs, must be created.
References
Dennis, F. M., & Keedle, H. (2019). Birthing as country.Women and Birth, 32(5), 383-390.
Ireland, S., Belton, S., McGrath, A., Saggers, S., & Narjic, C. W. (2015). Paperbark and Pinard: A historical account of maternity care in one remote Australian Aboriginal town.Women and Birth, 28(4), 293-302.
Kildea, S., Gao, Y., Hickey, S., Nelson, C., Kruske, S., Carson, A., Currie, J., Reynolds, M., Wilson, K., Watego, K., Costello, J. & Roe, Y. (2021). Effect of a birthing on country service redesign on maternal and neonatal health outcomes for First Nations Australians: a prospective, non-randomized, interventional trial.The Lancet Global Health, 9(5), 651-659.