How is cultural safety understood and translated into midwifery practice? A scoping review and thematic analysis

Journal article


Capper, Tanya S., Williamson, Moira and Chee, Rachelle. (2023). How is cultural safety understood and translated into midwifery practice? A scoping review and thematic analysis. Nurse Education in Practice. 66, p. Article 103507. https://doi.org/10.1016/j.nepr.2022.103507
AuthorsCapper, Tanya S., Williamson, Moira and Chee, Rachelle
Abstract

Aim
To identify and understand the scope of the literature published since January 2008 that explored Australian midwives understanding of cultural safety and how this is translated into their practice when caring for First Nations women and families.

Background
Recognition and understanding of First Nations peoples history and culture and the impact this has on the health and wellbeing of women and their families is essential if the midwife is to promote culturally safe and respectful maternity care. The role and responsibilities of the midwife in ensuring that their practice is culturally safe are now reflected in the Australian professional midwifery codes and standards. Whilst midwifery academics’ awareness of cultural safety and how it is taught within midwifery education programs have previously been explored, at present, little is known about midwives’ understanding of cultural safety, and how this translates into their clinical practice.

Methods
A Scoping Review was undertaken following Arksey and O’Malley’s five step process. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses – Scoping Review extension checklist. Twelve studies met the criteria for inclusion. Thematic analysis was used to analyse the data and organise the results.

Results
Thematic analysis, guided by two predetermined review questions led to the identification of six overarching themes: ‘Awareness of deficiencies’, ‘The importance of meeting women’s diverse needs’, ‘Understanding relationships as a foundation for culturally safe care’, ‘Working in partnership with others’, ‘Providing individualised care’ and ‘Fostering effective relationships and communication’. One sub-theme of the first theme was identified, this was named ‘Seeking an understanding of culture’.

Conclusion
Australian midwives’ level of understanding of cultural safety and how it is translated into their midwifery practice when caring for First Nations women and their families differ widely. Midwives across Australia require increased and equitable access to appropriate opportunities to improve their knowledge and understanding of cultural safety. Whilst theoretical learning on cultural safety has a place in all midwives annual mandatory training requirements, this should ideally be supplemented, where possible, with opportunities for immersive practice in communities. Immersion was considered the optimal way to gain rich knowledge and understanding to strengthen culturally safe midwifery practice. Continuity models of midwifery care which incorporate the principles of cultural safety should be consistently implemented across Australia. These models enable midwives, women, families, communities, and Aboriginal Support Workers to work in collaboration towards achieving optimal outcomes for mothers and babies.

Keywordscultural safety; midwifery practice; Australia; scoping review; education; midwives; First Nations
Year2023
JournalNurse Education in Practice
Journal citation66, p. Article 103507
PublisherElsevier Ltd
ISSN1471-5953
Digital Object Identifier (DOI)https://doi.org/10.1016/j.nepr.2022.103507
PubMed ID36410133
Scopus EID2-s2.0-85142137476
Page range1-12
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online16 Nov 2022
Publication process dates
Accepted14 Nov 2022
Deposited09 Nov 2023
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