Mā te wāhine, mā te whenua, ka ngaro te tangata. Wāhine and whānau experiences informing the maternal-infant health care system

Abstract

Māori (Indigenous people of Aotearoa New Zealand) whānau (family) are experiencing the harm or loss of their baby more often than Pākehā (non-Māori) whānau. Compared to Pākehā babies, Māori babies are twice as likely to have a potentially preventable death. In addition to death, Māori babies are admitted to a neonatal intensive care unit or special care neonatal unit more often. Arguably, these health disparities are a manifestation of how the current maternal-infant health care system is failing Māori whānau.

This research aimed to address this failure and questioned whether or not the maternal-infant health care system was delivering culturally responsive care for whānau following the harm or loss of their baby; and if not, can we learn from the lived realities of whānau and mātauranga Māori (Māori knowledge) to propose positive, culturally responsive systemic change(s). To carry out the research, a Kaupapa Māori (by Māori, for Māori) methodology, named Te Pūkenga Mātauranga, was developed following a consultation journey with key informants. Ten whānau who had experienced the harm or loss of their baby shared their stories through kōrero (conversational interview).

The shared stories and experiences were collated and the findings are expressed as a journey through the maternal-infant health care system: beginning from hapūtanga (pregnancy) to whānautanga (labour and delivery) to piripoho (immediately following birth), and onāianei (current time). All ten whānau entered the maternal-infant health care system at an unexpected time, and under unanticipated circumstances. It was found that when they were made to enter in this manner, the system was incompatible in delivering culturally responsive care. To offer a solution, a nuanced framework of health care, named Te Hā o Whānau, is suggested. The name was chosen to mean whānau voices leading maternity care in Aotearoa New Zealand. Thus, the framework builds upon the whānau experiences and Te Tiriti o Waitangi/the Treaty of Waitangi to offer tikanga Māori (Māori cultural practices) guidelines that could enable the maternal-infant health care system facilitating a culturally responsive environment that allows whānau to thrive as Māori following the harm of loss of their baby.