Pasifika women's choice of birthplace

Abstract

A Corresponding Author: jmcaraco@ aut.ac.nz B Auckland University of Technology, Auckland C Midwife, Auckland Background: Birth is a socially constructed experience for Pasifika living in New Zealand that is shaped by their community and maternity provider’s influences. Pasifika women in the Counties Manukau region predominantly choose to birth in a tertiary facility despite there being primary facilities available. Aim: This study asked Pasifika women about their choices for place of birth within the Counties Manukau District Health Board region. Method: Six healthy, low risk Pasifika women, who had given birth in the Counties Manukau District Health Board region, participated in this study. All women were interviewed individually and conversations were analysed using thematic analysis, followed by a hermeneutic interpretation. Findings: The women shared a culture of “we birth at Middlemore [Hospital] and that is where you have babies”. Their data surprised us as researchers. Those who had been transferred postnatally to primary units tended to still prefer Middlemore. We use the word “prejudice” in recognising that we thought (backed by research evidence) that they would be more likely to have a normal birth in a primary unit, and would prefer that experience. They told us that Middlemore Hospital was close to home; it was a place they knew; and it was where they preferred to give birth. The Pasifika women’s understanding of choice of birthplace was influenced by their community and, perhaps, by their midwife. While they seemed to have minimal understanding of why they would choose to birth at a primary birthing unit, there was a sense that even if they had this knowledge, they would not have changed their minds. They had a trust of, and familiarity with, Middlemore Hospital that held firm. They had their prejudice; we had ours. Recognising these different views offers a different space for conversation. Conclusion: It is important that any new or re-designed birthing unit be planned in collaboration with Pasifika women if it is intended for their use. Further, it is important that midwives take the time to listen to Pasifika women, and those from other cultures, to understand their point of view.