Current Day

Aboriginal women reportedly have: Difficult pregnancies Adolescent pregnancies Grand multiparity Low and high birth weight Greater infant mortality (McHugh, 2011). Inadequate nutrition, gestational diabetes, high blood pressure, and antepartum bleeding are also risk factors (Mottola, 2011). There is a gap that exists between Aboriginal cultural needs and mainstream medical services. Many Aboriginal cultures dont view pregnancy as a sickness and therefore, do not seek medical involvement. It is important for healthcare providers to be aware of this belief and to encourage prenatal care in these patients.

References
Australian law reform commission (ALRC) (2012). Traditional Hunting, Fishing and Gathering in Australia. Retrieved from: http://www.alrc.gov.au/publications/33.%20Tradi tional%20Hunting,%20Fishing%20and%20Gatheri ng%20Practices/traditional-hunting-fishing-an Birch, B.A., Ruttan, L., Muth, T., & Baydala, L. (2009). Culturally Competent Care for Aboriginal Women: A Case for Culturally Competent Care for Aboriginal Women Giving Birth in Hospital Settings. Retrieved from: http://www.naho.ca/jah/english/jah04_02/03_V4_ I2_Competent03.pdf Jones, J. (2011). Birthing: aboriginal women. Retrieved from: http://www.aiatsis.gov.au/ntru/documents/Jones_ Jilpia.pdf McHugh, A., Hornbuckle, J. (2011). Maternal and child health model of care in the aboriginal community controlled health. Retrieved from: http://kemh.health.wa.gov.au/services/amssu/doc s/AHCWA_Model_of_Care.pdf Mottola, M. F. , Sopper, M. M. , Doxtator, L. , Big-Canoe, K. , Prapavessis, H. , Harris, S. , Hanley, A. (2011). Capacity-building and Participatory Research Development of a Community-based Nutrition and Exercise Lifestyle Intervention Program (NELIP) for Pregnant and Postpartum Aboriginal Women: Information Gathered from Talking Circles.. The International Indigenous Policy Journal, 2(1) . Retrieved from: http://ir.lib.uwo.ca/iipj/vol2/iss1/8 Queensland studies authority (2008). Birth ceremonies, totems and rites in aboriginal society. Retrieved from: http://www.qsa.qld.edu.au/downloads/approach/i ndigenous_res012_0804.pdf Skye, Amber (2010). Aboriginal midwifery: a model for change. Retrieved from: http://www.naho.ca/jah/english/jah06_01/v6_I1_ Aboriginal_Midwifery.pdf

Native Aboriginals:
Providing culturally competent care

Barriers to prenatal care include: Lack of information and counseling Transportation Language barriers Prejudicial attitudes of health care workers (Birch et al, 2009) The Aboriginal holistic view of spirituality, emotional, cultural, and historical issues should be addressed along with physical needs (Mottola, 2011). Today, Aboriginal women give birth in a more modernized fashion- often in hospital settings (Birch et al., 2009). It is important to respect any safe cultural aspects of care that the Aboriginal woman may want to include in her plan of care. There are numerous traditional beliefs and health disparities that exist amongst native aboriginal women. By being aware of these beliefs, issues in healthcare, and prejudices, we can begin to break down these barriers and provide culturally competent care.

By: Shy Wegiel N320- Health and Illness II October 14, 2013

Native Aboriginals
Native Aboriginals believe that birth is a powerful time when spirits find their way into the world (Queensland, 2008). The traditional Aboriginal culture views pregnancy and childbirth as a natural, sacred period that does not require medical interventions (Skye, 2010). There are several customs, beliefs, and practices held throughout pregnancy and after birth in native Aboriginal culture. Tribal groups were often isolated from one another, resulting in about 250 language around the time of European settlement (Rowntree et al., 2011). There are a diverse range of Aboriginal birth ceremonies, cultural practices, and traditions that are unique to each language group (Queensland, 2008).

The Dreaming
The Dreaming (creation time) affects the relationships people have with their environment, each other, and their totems (Queensland, 2008). It links together the past, present, and future (2008). It is believed that the spirit-child exists in the Dreaming and is born through a mother.

Womens business
The pregnant woman would leave with her mother and a midwife to give birth in a different location from the tribe. Men were forbidden from the location where birth occurred. The childbirth ritual was secretive. Aboriginals believe that blood from female genitals is dangerous to men (2011). During labor, songs were sung to facilitate delivery and prevent hemorrhage (Skye, 2010). Most women give birth squatting or kneeling over a prepared hole in the ground covered with grass and leaves (Jones, 2011). Some native Aborigines believe that the placenta should be buried secretly and that the child may sicken if the placenta is found by the men. Mother and child were isolated and it was believed that they may be harmed if they have contact with men before 5 days (2011).

Totems
At the time of birth or near birth, a child is appointed a totem. This totem links the person directly with the creation time and the spiritual world (The Dreaming). Totems define relationships and provides a person with particular rights and roles within the community (2008). Totems are linked to the spirit of the ancestor the totem represents. For example, a Goanna- a type of carnivorous reptile, may cross the mothers path during her pregnancy (Queensland, 2008). The child is then seen to be linked to the Goanna Dreaming or the ancestor Uudinaddalli. The child will have a special relationship with the Goanna and the location where the mother saw it (2008). Totems can be birds, animals, rocks, landscapes, or flora species (2008).

Culturally competent care

Since men are believed to be harmed by pregnancy-related participation, Aborigine women prefer older women physicians (Birch et al, 2009). The mother may also want a midwife or birth assistant to attend the birth. Birthing positions tend to be kneeling or squatting and avoid back laying positions (Jones, 2011). Offer the woman her placenta, traditional aboriginal beliefs involve burying the placenta.

Food
There are strict rules governing the consumption and distribution of food based on age, status, and sex (ARLC, 2012). A person cannot eat an animal, fruit or vegetable of their own totem. Food taboos or restrictions were observed during menstruation and pregnancy. Pregnant women and young women must eat the right food as directed by elders (2012). Diet during pregnancy was strict containing no red meat, only fish and non-meat products (Jones, 2011).