Most Aboriginal and/or Torres Strait Islander women give birth in a hospital or birthing centre, which is often not on their ancestral lands (country). This is despite the cultural and spiritual significance of doing so, and national recommendations[1] that emphasise the importance of maintaining cultural values and norms around pregnancy and birth[2].
Aboriginal and Torres Strait Islander women have been advocating for many years that ‘Birthing on Country’ (BoC) will improve maternal and infant outcomes because of the integral connection between birthing, country, and place of belonging[3]. Birthing on country occurred for many thousands of years before women were removed to birth in other settings, hence, from a historical perspective it is a relatively new phenomenon to not birth on country.
The term ‘Birthing on Country’ and BoC Models are generally not well understood. BoC Models can be described as maternity services that are designed, developed, delivered and evaluated for and with Aboriginal and Torres Strait Islander women that are community based and governed, provide for inclusion of traditional practices, involve connections with land and country, incorporate a holistic definition of health, value Aboriginal and/or Torres Strait Islander as well as other ways of knowing and learning, encompass risk assessment and service delivery, and are culturally competent[4].
For others BoC ‘is understood as a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies and their families, [it provides] an appropriate transition to motherhood and parenting…and an integrated, holistic and culturally appropriate model of care for all’[5].
Accordingly, BoC Models can be incorporated in any setting and it is important that wherever an Aboriginal and/or Torres Strait Islander baby is born, his or her mother and family are encouraged, supported and enabled to incorporate relevant cultural aspects within that place or service.
This aim was reflected in the National Maternity Services Plan[6], which highlighted the development of a BoC framework and the establishment of BoC programs.
To this end, CATSINaM partnered with the ACM and CRANAplus to develop a position paper with calls to governments for action in this important area.