Donna - although I have no experience of intrapartum care in the community,
I have had experience in community antenatal care and hospital birth with
traditional Aboriginal women. I can't say that I used any different model
of care either but the principles which seemed to be useful were the same
as those which are for white women- ie
Ask the women what are the priorities for them, what are the most important
issues in birthing in the community, when would they rather be elsewhere?
Be honest with them in how you are feeling about issues.
Involve women in their care by giving them the information to be able to
make decisions about their options - this may involve translating the
information via healthworkers.
Continuity of care and trust and relationship building.
If you are really serious about the cultural "stuff" be prepared to hand
back/let go of the responsibility/power to the women - particularly the
older ones. This would probably be one of the hardest steps i think. (I
don't think i have expressed that very well- do you understand what i
mean?)
I should think the women in the community will have the answers as to the
type of care they want if you sit down and talk for long enough. I would
expect that this would be a lengthy process.
There may be useful information for you in the NT Birthing Services Review(
?1993) -i'm not sure where you could get a copy - contact NT Dept of
Health.
Also perhaps the program Strong Mothers, Strong Babies, Strong Culture - a
Top End NT antenatal program incorporating traditional values may have
useful info - again contact NT Health in Darwin - Lorna Fejo was heading
that previously ( i may not be entirely up to date).
Also another thought but again I may be out of date - Congress Alukra in
Alice Springs may have info that is useful.
I don't know if i have been of any help here - i hope i haven't been
telling you how to suck eggs! Please keep us informed as to how things are
going - I know the women in the community I worked in (Yirrkala) had very
strong feelings about community birthing when it was discussed during the
Birthing Services Review. They were also quite suprised when i talked to
them about how birthing at home was an important and political issue for
white women also.
Cheers - Maxine
Maxine Wilson
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