During the 1960s there was a period of increased political activity within Indigenous communities. This led to the development of Community controlled services, in particular in the Northern Territory and Queensland. The movement that pushed for these services (including maternity services) grew from the push against racist policies such as protectionism and segregation which occurred from the 1890s to the 1950s (approx). The first Aboriginal community controlled health service was established by the local Aboriginal community in Redfern in July 1971.
Community controlled services were, and still are, vital for Aboriginal and Torres Strait Islander people to be able to participate in decisions and have overall control over all aspects of an organisation that serves them. At this time, the self-determination of the Indigenous population – which is where people have the right to freely determine their own social, cultural, economic and political views – was beginning to be understood.
Some Aboriginal and Torres Strait Islander women had access to small local hospitals – but services were limited, and in particular maternity services, that may have had non-Indigenous nurses (who may or may not have had midwifery experience/training), were in short supply. Often, Aboriginal and Torres Strait Islander people were denied access to these services, and women often felt safer to give birth in their own communities without accessing this care. Historically, traditional birthing practices were clan-based, and passed down between the generations of Indigenous women. Given the historical removal of children an dislocation of families instigated by the government at the time, many Aboriginal and Torres Strait Islander women and their families were suspicious of the maternity services, even if they did have access to them.
Community controlled health services are those where the Aboriginal and Torres Strait Islander people have ownership of the services, in a framework of self-determination, reconciliation, cultural safety and identity. Local communities have control of decision making, administration and service provision, control their own destiny, and exercise responsibility within the context of their broader community: the services are planned, managed, and controlled by the communities they serve. Like any large health care service they employ a large number and wide range of health care practitioners in multi-disciplinary teams, including midwives.
What does birthing on Country mean to you?
Featuring interviews filmed during the Best Start to Life 2022 National Gathering at Mparntwe (Alice Springs) alongside breath-taking Australian landscapes, this educational documentary explores the many meanings of Birthing on Country.
Co-production Molly Wardaguga Research Centre, Central Australian Aboriginal Congress & Charles Darwin University
© One20 Productions 2022
The face of birth
Watch the 2012 video “The Face Of Birth” chapter 10, to hear young Aboriginal mum, Tanya Kunoth, from the remote community Utopia in central Australia who had two babies in hospital and two babies on country. She shares why it’s so important for her to be able to birth on country, and why home felt safer than hospital.
Directors & Researchers Kate Gorman, Gavin Banks
Producers Alexandra Vasilijevic, Kate Gorman, Gavin Banks
Writer Kate Gorman
Birthing on Country
Molly Wardaguga Research CentreBirthing on Country
Birthing on Country is a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies and their families, an appropriate transition to motherhood and parenting for women and an integrated, holistic and culturally appropriate model of care for all.
The Molly Wardaguga Research Centre is an initiative of the Charles Darwin University. It was established in April 2019 and is dedicated to the late Molly Wardaguga, Burarra Elder, Aboriginal Midwife, Senior Aboriginal Health Worker and founding member of the Malabam Health Board in Maningrida, Arnhem Land.
PHOTO CREDIT Image by Bobbi-Lee Hille, © the Milyali Art project. Bobbi-lee Hille is a newborn photographer and mother of three. She is a Ngarluma Kariyarra (Pilbara), Nyul Nyul and Yaw-uru (The Kimberley) woman. See more of her beautiful artwork here.
Waiting for baby...
Every year, hundreds of pregnant women from remote Northern Territory communities give birth in Darwin as part of a scarcely known and divisive health policy.Waiting for baby by Emilia Terzon for ABC News
This ABC News article explores the impact of a lack of self-determination and community controlled resources.
“Few people know much about a Northern Territory health policy that sees hundreds of pregnant women travel to Darwin, Nhulunbuy, Alice Springs and Katherine to give birth every year.
Officially, this NT Department of Health policy only recommends that rural and remote-based women leave home a few weeks before 40 weeks’ gestation — baby time — to await the birth of their child in big towns with hospitals.
But sparse remote health services, restrictions on home birthing, and the reality of medical risk means that, for most women, there is no other choice…”
First posted Updated
Growing Deadly Families
Growing Deadly Families: Aboriginal and Torres Strait Islander Maternity Services Strategy 2019 – 2025 (Qld)Aboriginal and Torres Strait Islander Maternity Services Strategy 2019 – 2025 (Qld)
“Every Aboriginal and Torres Strait Islander baby and their mother in Queensland has the right to safe, culturally appropriate care… but more needs to be done to close the gap in maternal health outcomes for Aboriginal and Torres Strait Islander babies and their mums. To get there we must take a woman-centred approach that meets the cultural, spiritual, physical, and emotional needs of every mum, every bub and every family. The voices of Aboriginal and Torres Strait Islander mothers guided the development of the Growing Deadly Families Aboriginal and Torres Strait Islander Maternity Services Strategy 2019–2025, and we will continue to work closely with Aboriginal and Torres Strait Islander communities to implement the Strategy. Aboriginal and Torres Strait Islander people must be equal partners in decision-making, planning, delivery and governance of maternity services across Queensland.
Nothing is more important than ensuring our future generations have the best start to life. That’s why child and maternal health is so important…”
ARTWORK: Elaine Chambers-Hegarty of Cultural Edge Designs.
The artwork I created shows the centre area using the symbol of the start of life and the baby in the mother’s belly, with symbols around representing ancestors and extended family, because family is integral to Aboriginal and Torres Strait Islander people. READ MORE about this artwork in the Growing-Deadly-Families-Strategy
Cultural Birthing Kits
The Mungabareena Aboriginal Corporation and Albury Wodonga Health Birthing Suite ProjectCultural Birthing Kits: The Mungabareena Aboriginal Corp & Albury Wodonga Health Birthing Suite Project
CATSINaM
Congress of Aboriginal and Torres Strait Islander Nurses and MidwivesCATSINaM
The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) is the peak advocacy body for Aboriginal and Torres Strait Islander Nurses and Midwives in Australia.
CATSINaM’s vision is that Aboriginal and/or Torres Strait Islander Nurses and Midwives play a pivotal and respected role in achieving health equality across the Australian health system for Aboriginal and/or Torres Strait Islander Peoples and communities.
ARTWORK: Logo © CATSINaM
NACCHO
National Aboriginal Community Controlled Health OrganisationNACCHO - National Aboriginal Community Controlled Health Organisation
“Aboriginal health in Aboriginal hands”
“Aboriginal and Torres Strait Islander people enjoy quality of life through whole-of-community self-determination and individual spiritual, cultural, physical, social and emotional well-being.
The National Aboriginal Community Controlled Health Organisation (NACCHO) is the national leadership body for Aboriginal and Torres Strait Islander health in Australia. Our organisation provides advice and guidance to the Australian Government on policy and budget matters while advocating for community-developed health solutions that contribute to the quality of life and improved health outcomes for Aboriginal and Torres Strait Islander people.
We represent our members – 143 Aboriginal Community Controlled Health Organisations (ACCHOs) that operate in over 300 clinics across Australia, delivering holistic, comprehensive and culturally competent primary healthcare services. These ACCHOs are initiated and operated by local Aboriginal and Torres Strait Islander communities. The sector is the largest employer of Aboriginal and Torres Strait Islander people across Australia, with well over half of its 6,000 staff being Aboriginal and Torres Strait Islander.”
ARTWORK: Logo © NACCHO
Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care
Best, Odette, & Fredericks, Bronwyn. (2021). Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care (3rd ed.), Cambridge University Press.Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care
Joint statement on culturally safe care
Nursing and Midwifery Board of Australia (NMBA) and Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM)NMBA and CATSINaM joint statement on culturally safe care
Racial discrimination is well documented as a contributing factor to poor health outcomes for Aboriginal and Torres Strait Islander Australians1. The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) and the Nursing and Midwifery Board of Australia (NMBA) are committed to addressing racism and demonstrating leadership to nurses and midwives to ensure they value the needs of Aboriginal and/or Torres Strait Islander peoples, and promote and provide culturally safe care. In order to effect change CATSINaM and the NMBA know that regulations and codes establishing health professional standards must clearly communicate the requirement for cultural safety… CATSINaM and the NMBA believe that cultural safety and respectfulness is the responsibility of all nurses and midwives. By embracing this principle nurses and midwives provide leadership in building a health system free of racism and inequality, that is accessible for all.
Pregnancy care for Aboriginal and Torres Strait Islander women
Clinical Practice Guidelines: Pregnancy CareClinical Practice Guidelines: Pregnancy Care - Pregnancy care for Aboriginal and Torres Strait Islander women
Improving maternity services for Indigenous women in Australia: moving from policy to practice
Sue Kildea, Sally Tracy, Juanita Sherwood, Fleur Magick-Dennis and Lesley BarclayImproving maternity services for Indigenous women in Australia: moving from policy to practice
DJÄKAMIRR
Caretaker of pregnancy and birth
Follow Ḻäwurrpa and Sarah, on their journey through ancestral time, country and culture to empower community and reclaim childbirth.
Filmed in remote Arnhem Land, DJÄKAMIRR follows Ḻäwurrpa and Sarah on a unique journey through ancestral time, country and culture. As mutual trust develops between the two women, they hope to empower Yolŋu and reclaim 60,000 years of birthing culture from the stronghold of Western medicine. This is their story of working with community to pilot the training of djäkamirr– the caretakers of pregnancy and birth.
© One20 Productions 2022
For over 60,000 years Yolŋu childbirth happened on-country with skilled djäkamirr – midwifery caretakers -using ancestral wisdom and bush technologies to support women and babies. Yolŋu flourished.
Since the recent arrival of Western missionaries in the 1920s and the removal of childbirth to hospital, Yolŋu have been suffering. Women are now disconnected from their support systems and the region has profound health inequities including the highest rate of preterm birth in Australia.
DJÄKAMIRR is a privileged insight into the aspirations of remote First Nations communities to reclaim their birthing culture from the stronghold of Western medicine; and be part of the solutions to improve health. Filmed over a two year period on-country in Arnhem Land, the documentary is a rare invitation to experience Yolŋu women’s culture and hear their aspirations for maternity services. This is a journey of hope, demonstrating that when Yolŋu and Balanda (non-Yolŋu) Australians work together, positive change and community empowerment is possible.
The documentary is a creative output from the Caring for Mum on Country project.
Directors Statement