All parents need someone in their corner like we had. But for First Nations parents, having an Aboriginal midwife is essential

The Guardian

4 days ago

When we first shared our pregnancy news with friends, the advice from those who had been through birth was to get into a midwifery program. But the midwifery programs at our local hospital were full – or so we thought.
When we were offered a place in an Aboriginal midwifery program, we declined. Narelda, a Whadjuk Noongar woman, was not the birth parent – Karina was – and we didn't want to take the place of someone who might need it more than us. We knew the healthcare system is notoriously culturally unsafe and this racism and discrimination is contributing to the shocking statistic of Indigenous women being three times more likely to die during childbirth.
But one of the midwives was in the room before we knew what was happening, explaining how the program is for families and by helping provide a culturally safe environment for Narelda during our pregnancy and birth, it would benefit all of us. Tears of deep appreciation rolled down Narelda's cheeks.
Unfortunately, the midwives in our program don't work on weekends – which is when we went into labour. We were lucky to have other wonderful midwives help us deliver our baby, Sanna, but it was after the birth that we found ourselves saying things like: 'Thank goodness we are in the Aboriginal midwifery program', and': 'How would more vulnerable parents cope or get the medical care they need?'
Sanna was born on a Sunday morning and, because of a third-degree tear, Karina required surgery. By Monday morning, Karina was distressed; no one had explained to her what had happened, warned her how severe the swelling might be, talked to her about pain management, given her food, said she could shower or explained how to empty the catheter.
Karina's breasts were also engorging and nipples blistering, which was painful, and she was feeding for durations well beyond what a newborn needed.
Thankfully, in rolled our midwife. 'Have you been given ice? Has anyone looked at you?', she asked. It turned out just up the hall was a fridge full of ice specifically for the tear and the breasts – no one had mentioned it, despite icing a third-degree tear being standard practice. There was also a kitchen where food could be made outside service times, which Karina had missed due to multiple visits to the NICU.
Our midwife had a look at the stitching and checked Karina's abdomen for hernias; she also sorted out painkillers, because despite asking for something stronger than paracetamol, there was a reluctance to give it and she was suffering unnecessarily. Our midwife told Karina she didn't have to leave the baby on the breast so long and gave her permission to shower.
If our midwife wasn't there, it seemed like no one would have done any of this, and the result would have been an increasingly traumatic birthing experience.
All parents need a person in their corner like our midwife was, but for Aboriginal parents we believe it is absolutely essential. We experienced this first-hand when Narelda raised what became a very serious issue with the cannula in Sanna's arm. Her concerns were dismissed every time, but she was devastatingly vindicated when an incident report over the damage to Sanna's arm was made several days later.
On another occasion unrelated to the cannula, an interaction with a staff member left her feeling shamed, belittled and embarrassed. Some would say the colour of Narelda's skin had nothing to do with it – plenty of parents are ignored by medical practitioners when they shouldn't be. But the evidence is that racism is rife, and for those who experience it, you know it when you feel it.
That's also true of homophobia. We felt despite all the rainbow lanyards, there is a long way to go for queer families in hospitals. Being in an Aboriginal midwifery program meant we not only had a culturally safe experience during the pregnancy with the midwives from a First Nations perspective, but also an LGBTIQA+ one.
There is clearly a need for greater investment in all nurses and midwives, but states and territories must adequately fund and expand Aboriginal midwifery programs. The reported experiences of racism, inadequate care, and lack of consent in maternity wards are shocking and cannot be ignored.
If we, a non-Indigenous birth mother and two people who have some confidence speaking up, needed an Aboriginal midwife to advocate for us and for culturally safe care, then you can imagine just how much they are needed by younger, more vulnerable Aboriginal parents and babies. As the reporting in the Birth Rights series shows, Aboriginal midwives save lives, and, we have no doubt they help keep First Nations families together.
Where an opportunity exists to reduce trauma, why wouldn't you take it?
Narelda Jacobs is a journalist and presenter for 10 News First. Karina Natt is a political and communications adviser. Their book, If Queers Weren't Meant to Have Kids … is out 4 November.