Indigenous Women's Perspectives on Birth Care and Preferred Alternatives Globally

Pregnancy and childbirth are deeply meaningful experiences for families worldwide, with many valuing safe and trusting maternity services. However, research indicates that Indigenous families often encounter discrimination and cultural insensitivity within mainstream healthcare systems. Evidence shows that these families face challenges such as racism, neglect of cultural practices, and poorly designed health services that do not cater to their specific needs. Studies involving over 1,400 Indigenous women, elders, fathers, family members, and healthcare workers across regions including Australia, New Zealand, Canada, the United States, Greenland, and Sápmi reveal widespread feelings of disrespect and misunderstandings from hospital staff. Many Indigenous families report not being listened to, excluded from decision-making, or denied informed consent, leading to hesitations about seeking institutional care. Some women have expressed fears about birthing within these systems, citing a lack of cultural safety.

Addressing these issues requires improving healthcare environments to respect Indigenous beliefs, practices, and traditions. For example, accommodating extended family support during childbirth, which is culturally significant for many Indigenous communities, is often restricted by hospital policies. More culturally safe care involves staffing with individuals who possess cultural knowledge and are trained to support families respectfully. Continuity of care models—where the same midwife or small team supports a family throughout pregnancy—are particularly valued, especially when led by Indigenous midwives or those trained to provide culturally safe care.

For women in rural and remote communities, the challenge of being evacuated to distant city hospitals for birth can be traumatic. This displacement often results in separation from family and community support, making it harder to bond with the baby and initiate breastfeeding. A promising alternative is the concept of "birthing on Country," which emphasizes culturally rooted, midwife-led care that respects Indigenous traditions and strengthens community ties. This model can be adapted to urban settings as well and involves continuous support from familiar healthcare providers.

Increasing the representation of Indigenous healthcare workers is crucial, but Indigenous staff constitute only about 3.1% of the Australian health workforce. Therefore, it is also essential to train and engage non-Indigenous staff in culturally competent care—learning when to speak up against discriminatory behaviors and how to foster respectful relationships. Creating a healthcare system where everyone feels safe and respected benefits the entire community by encouraging timely care and preventing adverse outcomes.

Ultimately, transforming maternity services to be culturally safe and inclusive is a shared responsibility. It ensures that Indigenous women and families receive the respectful, supportive care they deserve, leading to better health outcomes and strengthened cultural identity.

source: https://medicalxpress.com/news/2025-06-indigenous-women-globally-birth-theyd.html