Antenatal care assessing and addressing alcohol consumption during pregnancy: A qualitative study of Aboriginal women’s experiences and strategies for culturally appropriate care in an Australian local health district

Abstract

Purpose

Pregnancy care guidelines in many countries recommend that alcohol consumption is addressed for all women as part of routine antenatal care. Considerations should be given to providing culturally appropriate care for First Nations women. Limited studies have explored the perceptions of Aboriginal and Torres Strait Islander women in Australia regarding such care. This study aimed to explore Aboriginal and Torres Strait Islander women’s experiences and acceptance of receiving antenatal care addressing alcohol consumption from maternity services, as well as their suggestions for culturally appropriate strategies for positive care experiences.

Methods

Nine yarning groups were conducted across a large local health district in New South Wales, Australia, between November 2017 and October 2018. Aboriginal and Torres Strait Islander women who had attended a maternity service within the last two years were purposively recruited through existing networks. An Aboriginal-led Indigenist and community-based participatory action research approach and yarning were used to explore the women’s experiences and suggestions for culturally appropriate care. Three Aboriginal researchers facilitated the yarning groups. Yarning groups were transcribed and analysed using thematic analysis.

Main findings

Thirty-nine Aboriginal and Torres Strait Islander women participated in the yarning groups. The women reported mixed experiences of antenatal care regarding alcohol consumption during pregnancy; however, they were largely accepting of receiving such care from their antenatal providers. Two main themes that centred around empowerment and safety were identified. The women suggested that these could be addressed with the following approaches: i) all pregnant women should be asked and informed about the risks of alcohol; ii) continuity of care models should be used; iii) holistic approaches should be used; and iv) support should be given without judgement and fear of reporting.

Principal conclusions

Aboriginal and Torres Strait Islander women want and expect to receive antenatal care around alcohol consumption during pregnancy. To inform their receipt of culturally appropriate care, Aboriginal and Torres Strait Islander women need to be engaged in decision-making about the implementation of pregnancy guidelines in maternity services.