'Walking the journey' with pregnant and birthing women from remote Australian First Nations communities: A qualitative study in the Top End of the Northern Territory

Problem/background: Australian First Nations people experience disproportionate burdens of poor outcomes compared to non-First Nations people. Further, women living in remote communities face more barriers to care-seeking in pregnancy. Despite work being done in some remote communities, there is limited data exploring women's experiences of pregnancy care, thus a limited understanding of specific barriers and enablers to care-seeking for these women.

Aim: This study aimed to identify barriers and enablers to care-seeking during pregnancy for Australian First Nations women living in several remote communities in the Northern Territory, by listening to their stories.

Methods: Yarning, highly regarded and rigorous qualitative approach developed by and for First Nations peoples, was undertaken in several settings with women living in remote First Nations communities. Using purposive sampling, nine women participated.

Findings: Two themes emerged: (1) the importance of family and community for women's emotional wellbeing; (2). ways healthcare providers and services build trust with pregnant women.

Discussion: Women identified various family and community members as significant sources of support in community and while hospitalised, including having companions while away from home. Further, reduced access to community life impacted emotional wellbeing. Continuity-of-care throughout pregnancy was essential for building trust, as was responsive, clear communication. Intentional connection building by care providers enabled development of trust.

Conclusion: Providing culturally safe care will likely facilitate enablers and reduce barriers to care-seeking in pregnancy in remote communities. It requires ongoing and sustained efforts to ensure true partnership and collaboration between First Nations peoples and health services.