How do midwives learn about, understand, and integrate Cultural Safety into their care of First Nations women and families? A qualitative exploration

Problem: Midwives are required to provide care based on Cultural Safety for First Nations women and families. Recent literature has suggested that midwives’ understanding of Cultural Safety and how it translates into their practice differs widely. This disparity requires further exploration. Background: The Australian professional midwifery codes and standards state that there is a requirement to provide care based on Cultural Safety. It is critical to understand how First Nations people’s history and culture impacts their health and wellbeing, requiring midwives to recognise how this may impact care. Aim: To determine Australian midwives’ knowledge and understanding of Cultural Safety and how this translates into their practice when caring for First Nations women and families. Methods: A qualitative study was undertaken. Data were collected via semi-structured interviews with 12 midwives practicing in Australia. Data were transcribed and thematically analysed. Findings: Three themes were identified: ‘Society and Systems’, ‘Knowingness versus Understanding’, and ‘Personal Qualities, Engagement and Partnerships’ which highlight the strengths and deficits of Cultural Safety education and its integration into midwifery practice in Australia. Discussion: Health systems providing maternity care remain rooted in Western biomedical philosophies, which influences the practice of Cultural Safety at all levels. Midwives are beginning to understand the ongoing impact of colonisation on the health and wellbeing of First Nations families, but still face challenges when striving to provide culturally safe care. Conclusion: Cultural Safety must be valued at an organisational level, in which midwives can engage in authentic, maternity-based educational programs led by suitably prepared educators. *