Midwifery and culture: future directions
This paper discusses findings from a study undertaken to explore how midwives provide culturally sensitive care for women from culturally and linguistically diverse (CALD) backgrounds, particularly focusing on the care provided to Australian Indigenous women. Following ethics approval, a qualitative study was undertaken, utilising a modified grounded theory approach for the data collection and analysis. Thirty two midwives were interviewed in the different geographical locations within New South Wales, Australia. The study used insights from colonial and postcolonial discourse theory to explore and interpret the perspectives of the participants. When discussing the concept of most participants referred to customs and traditions, a perspective which tends to see culture as static and unchanging. They had been encouraged to view culture in this way by their educational preparation, reinforced by much of the nursing literature. As a result, participants tended to expect CALD women to conform to what they themselves believed were cultural norms. Some were challenged in this view during their practice with CALD women but, for many, the routines of busy hospitals allowed little time for reflection. More recent approaches in the literature have emphasized, which advocates being aware of the social, political and economic factors which impact on clients, but it is still unclear how this concept may be operationalised in practice. These findings question the utility of using the concept of culture in midwifery education. The challenge is to encourage midwives to value the uniqueness of each individual woman, appreciating broader factors which impact on her life, but not stereotyping. Is culture the right concept for the job? If we decide it is, perhaps we can learn from other disciplines such as anthropology and cultural studies to take a more nuanced and insightful view than this study suggests is presently the case.