Sociologising Maternity Care to Inform Workforce Capability Investment and Maximize Health Gains for Urban Indigenous Families

Clinical and cultural safety of health workforce is vital to accelerating health gains for Indigenous peoples. Maternal and infant health has been identified as a key area where preventative intervention can make lasting improvements to one’s life trajectory. While there was been some investment in Australia, there have been minimal gains in Indigenous maternal and infant health outcomes nationally. In Brisbane, Birthing in Our Community program was a local response to rising preterm birth rates for Indigenous babies was the partnering of a large tertiary based hospital with two local Indigenous community controlled health services to provide specialist wrap-around care for women having Indigenous babies and their families. Four years on this has proved a successful investment with families developing trusting relationships with their known midwife and Indigenous health worker, reducing preterm birth and increasing engagement with the broader health system. While 100% of women accessing the program felt their needs were met and they were understood and treated respectfully due to their cultural background, these same women reported feeling less cultural safe as they accessed mainstream maternal and infant health care within the hospital. This correlates with a lack of professional development opportunities for mainstream hospital staff to improve their cultural capabilities. Specialised services are important to having healthy and engaged Indigenous families but also requires cultural and clinical safety of mainstream tertiary services as clients navigate the broader health system. This involves reflection of the responsibilities of the health system, and its institutionalized power dynamics of professions, race, class, gender and intersectionality. This paper interrogates our responsibility as sociologists to understand ways of improving health systems within a social justice agenda, and explores our role in the newly emerging field of Indigenous midwifery research.