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Dr Karaponi Okesene-Gafa, Obstetrician & Gynaecologist, Counties-Manukau District Health Board
Dr Kara is currently working as a consultant Gynaecologist/Obstetrics specialist serving the South Auckland community through her role at Counties Manukau District Health Board. She graduated from Otago University and studied a Diploma in Obstetrics and Gynaecology at Auckland University followed by Obstetrics and Gynaecology Specialist training in National Women’s Hospital, Auckland. Kara has worked in National Women’s, North Shore, and Wellington Women’s Hospitals.
In 2006, Kara was appointed as Director of Health for Niue to support the establishment of the new Hospital and to work with CMDHB to strengthen health services. After two years, she returned to Middlemore Hospital in January 2008. Kara is the clinical Obstetrics Lead for Diabetes in Pregnancy at CMDHB and also has Public Health interests related to nutrition, obesity and diabetes. With Dr Sara Corbett, Kara conducted research investigating “Barriers to Initiation of Antenatal Care Amongst Pregnant Women at CMDHB” and identified a range of factors preventing Pacific women from accessing health care.
A recent report released by CMDHB found that while the total number of deliveries (8,500) and the number and proportion of deliveries by over the last six years has remained fairly constant, the number of deliveries for CMDHB women identified with GDM has almost doubled over the six years from 2006/07 (225) to 2011/12 (407). Many Pacific pregnant women are also presenting daily with hypertension during pregnancy and pre-eclampsia.
Mothers may be considered as “number one” however, she often puts her needs aside to fulfil her responsibilities and needs of others in the family. There are many challenges Pacific mothers face. Their experiences during their young lives may impact on the way they think and perceive pregnancy. It may influence her behaviour and attitudes during pregnancy.
For all these reasons, the work required to improve the health of Pacific pregnant women and their babies needs to start before they become pregnant. Improving outcomes for Pacific pregnant women and their babies no doubt calls for multi-faceted, joined up approaches, but ultimately Pacific mothers ‘don’t know, what they don’t know’ so having a greater understanding of what constitutes a healthy pregnancy is paramount. We also need to address the issues of poverty and socioeconomic factors which are consistently found to be significant determinants in the health of Pacific pregnant women and infants.
Dr Alec Ekeroma is the Head of the Pacific Women's Health Research and Development Unit, which he established in 2006 at the Department of Obstetrics & Gynaecology, University of Auckland. He is also the President of the Pacific Society for Reproductive Health Charitable Trust, a regional non-governmental organisation (NGO) of doctors and midwives. He is in the second year of his PhD, which is trialling interventions that has the potential to increase research and clinical audit activity by clinicians in six Pacific Islands countries.
The social, political and economic circumstances of women in the Pacific, in addition to the lack of accessible essential health services, results in significant adverse outcomes for women and their families. The lack of an essential and skilled health workforce compounds problems of access to basic health care or health services and policies that have been informed by research evidence. The work of regional advocacy groups, non-governmental organisations, training institutions and funding agencies are important in lobbying governments, informing policies, developing the workforce, setting professional standards and improve practice. This presentation highlights some of the interventions in reproductive health that can make a difference and the importance of collaboration in addressing workforce needs in the region. His presentation is based on his work governance experience of regional professional organisations and his research work in the Pacific.
Paul is an Associate Professor and Paediatric Endocrinologist who divides his time between clinical work at the Starship Children Hospital and research at the Liggins Institute. His research has focussed primarily on the developmental origins of adult disease, especially pertaining to an adverse in utero environment. He is also involved in a wide range of other research topics, especially exercise, cardiovascular function in diabetes and new born screening.
Paul has senior roles in their two largest regional endocrine societies (President of the Australasian Paediatric Endocrine Group and President Elect of the Asia Pacific Paediatric Society). He has developed research links in Australia, India and Asia and is attempting the same in the South Pacific. Since 2006 he has also been the principal or associate investigator on grants worth more than $4,400,000 and supervised 7 PhD (4 completed), 3 MSc (all completed) and 4 clinical fellows. He serves on several national committees including the Growth Hormone Committee and the National New Born Screening Advisory Board.
Obesity is a major problem affecting all New Zealanders but is especially prevalent in Maori and Pacific Island Peoples and is a fundamental factor in causing many adult diseases. While the increasing obesity rate is multifactorial there has been a growing awareness of the importance of prenatal and early life environment. An obesity cycle has now been described whereby obese mothers have larger babies who are more likely to become obese children. Obese children become obese adults and if they are women they will also be likely to have large babies thus perpetuating this cycle. Fetal over nutrition, reflected by larger birth weight, appears to be an important risk factor for the risk of later obesity. There is evidence that interventions such as exercise in the latter half of pregnancy reduce birth weight and reduce the risk of obesity postnatally in the children. This talk will expand on the evidence linking prenatal and early life environment and the risk of later obesity. Moreover recent data on the use of maternal exercise during pregnancy in limiting fetal growth and potentially reducing post natal obesity will be presented.
Lesley McCowan is a Professor and Head of the Academic Department of Obstetrics and Gynaecology at the University of Auckland. She is a sub-specialist in maternal- fetal medicine and her main clinical interest is in management of high risk pregnancies especially those with fetal growth restriction and preeclampsia. She has chaired the perinatal mortality review process at National Women’s for many years and was a founding member of the national Perinatal & Maternal Mortality Review Committee (PMMRC) which reviews deaths of babies and mothers nationally.
Lesley is actively involved in medical research which aims to improve the health outcomes for mothers and babies. She is the Auckland principal investigator on the international SCOPE (Screening for pregnancy Endpoints) Study which aims to identify women early in their first pregnancy who will later develop preeclampsia, preterm birth or have a growth restricted baby . The overarching goal of SCOPE is to develop reliable early pregnancy predictive tests for these serious pregnancy complications, as preventative treatments are available which can reduce the risk in high risk women. The SCOPE study has a very high quality early pregnancy bio bank which is being used for prediction of these late pregnancy complications.
Another key research project aims to identify modifiable risk factors for stillbirth in late pregnancy. Three in every one thousand New Zealand pregnant women will lose a baby after 28 weeks of pregnancy. She is leading a multi-centre New Zealand case control study, funded by HRC and Curekids. Her research team is particularly interested in the role of the mother’s sleep and whether this influences stillbirth risk. The goal is to reduce the rate of stillbirth in New Zealand. Her other current major research interest is the influence of the mother being overweight on the risk of complications for mother and child. She hopes to develop an intervention study aimed at reducing the risk of gestational diabetes and excessive pregnancy weight gain in overweight mothers.
The global obesity epidemic affecting women of reproductive age is a major contributor to adverse pregnancy and infant outcomes. In New Zealand 64% of Pacific and 45% of Maori women are estimated to have a BMI≥30, 51% of Pacific and 43% of Maori 2-14 year old children are overweight or obese and these children have a high probability of becoming obese adults. Excessive gestational weight gain (GWG) with postpartum weight retention is an important contributing factor to the obesity epidemic in women and is independently associated with a range of pregnancy complications including large for gestational age infants, increased Caesarean delivery, hypertensive disorders of pregnancy and possibly diabetes in pregnancy. The Institute of Medicine (IOM) guidelines on GWG were revised in 2009 to recommend reduced weight gain for obese pregnant women. The adverse effects of obesity on pregnancy cannot be reversed after conception but interventions which improve maternal nutrition and limit gestational weight gain been shown improve outcomes for mothers and babies.
A recent meta-analysis of randomised dietary and lifestyle interventions in pregnancy demonstrated that nutritional interventions reduced gestational weight gain by approximately 4kgs, substantially reduced the risk gestational diabetes and preeclampsia and were associated with a trend to reduced stillbirths. Exercise interventions alone reduced weight gain by approximately 1kg and were associated with small reductions in birthweight. Results of 2 large international randomised studies of lifestyle interventions in obese pregnant women are awaited. Interventions which are successful in other settings may not be transferable to our multicultural community in South Auckland. To this end we are trying to obtain funding for a large randomised controlled trial of a culturally appropriate, affordable and sustainable nutritional intervention in overweight and obese pregnant women in Counties Manukau. If successful we may be able to reduce the vicious cycle of obesity on the unborn baby.
“South-Pacific Teenage Births in New Zealand” BY Seini Taufa
(co-investigators: Dr. Elizabeth Craig, Prof. Diana Lennon, Dr. Melani Anae)
Background: In New Zealand following the mass migration in the 1970’s a young urbanised Pacific population has emerged. New Zealand teenage births (33.4 per 1,000) are second only to the U.S.A (55.6 per 1000) in the OECD. Pacific teenage pregnancy rates are three times higher than for European/Pakeha teenage pregnancy, however little is known about the differences between Pacific groups or if there are differences within Pacific groups.
Aim: To explore the demography of Pacific teenage births using a variety of different ethnicity classifications, and to understand the experiences faced by Tongan teenage mothers leading up to, and after the birth of their child.
Method: De-identified birth registration data from 44,768 teenage mothers were analysed for 1996-2011. The outcome of interest was teenage birth, with explanatory variables including maternal ethnicity Prioritised Level One ethnicity (Maori, Pacific Island, Asian, Other, European), and the Level 2 Sole Pacific (belonging solely to one Pacific Group) and Any Pacific (belonging to a Pacific group, alongside other ethnic groups) classification systems) and socioeconomic deprivation (using the NZ Deprivation Index). Qualitative analysis was undertaken during 2008. This involved 21 semi-structured face-to-face interviews with Tongan Teenage mothers in New Zealand and Tonga.
Results: When prioritised ethnicity was used, Pacific teenage birth rates were intermediate between those of Maori and European women. When the Sole / Any Pacific classification was used, teenage births were significantly higher for the Any Pacific category, than the Sole Pacific Category. By Island group, teenage birth rates were also significantly higher for Cook Island Maori and Niuean women, than for Samoan or Tongan women. For all Pacific groups, teenage birth rates were higher for those living in the most deprived areas. Themes that emerged from the qualitative analysis highlight the importance of family support and the lack of awareness of services available for Teenage mothers.
Conclusions: Pacific women in New Zealand are a heterogeneous group, with significant differences in teenage birth rates being evident for different Pacific groups. Despite this, a unifying theme within the quantitative analysis was exposure to significant socioeconomic deprivation, a finding which has significant policy implications, if the ongoing wellbeing of these young mothers and their babies is to be ensured. In addition, the qualitative analysis aspires to understand attitudes towards teenage pregnancy using poetry as a means to highlight different perspectives of Tongan women, in the aim of illustrating what teenage pregnancy means to prospective and current young Tongan mothers.
“Smoking During Pregnancy: New Zealand Distribution and Relevance for SUDI Prevention” BY Dr Liz Craig
Dr Liz Craig, is the Director of the NZ Child and Youth Epidemiology Service, a research group at the Dunedin School of Medicine, who produce annual child and youth health reports for the Ministry of Health and DHBs. A public health physician by training, Dr Craig’s interests are in using routinely collected data to monitor child and youth health inequalities, and the impact (both positive and negative) of Government policies on the health of children and young people.
Background: Smoking during pregnancy is an important risk factor for Sudden Unexpected Death in Infancy (SUDI), with New Zealand research also suggesting that in-utero smoke exposure interacts with the shared sleep environment to significantly increase an infant’s risk of SUDI postnatally.
Methods: Data from the National Maternity Collection were used to explore maternal smoking status at first registration with a Lead Maternity Carer (LMC) for the cohort of New Zealand babies born during 2009-2010.
Results: Of the 129,635 New Zealand babies born during 2009-2010, information on maternal smoking status at first LMC registration was available for 84.5%. Amongst these babies, the highest maternal smoking rates were seen for the babies of teenage mothers (38.5%), for Māori babies (38.1%) and for babies born in the most deprived (NZDep 9-10) areas (27.0%).
Discussion: These findings suggest that any initiatives aimed at reducing smoking in pregnancy, and its later impact on SUDI, will specifically need to meet the needs of younger pregnant women (particularly teenagers), Māori women and those living in the most deprived (NZDep decile 9-10) areas.
Ed qualified at St Georges Hospital Medical School in London and has worked in the UK, Zambia and New Zealand.
He completed his paediatric training in New Zealand. From 2001 he has been the Cure Kids Professor of Child Health Research at the University of Auckland. He has published over 350 original papers, particularly on the epidemiology of asthma and sudden infant death syndrome (SIDS). In 1996 the University of London awarded him a Doctor of Science for his work on “The Epidemiology and Prevention of SIDS”. He has received several awards for his landmark study of SIDS. He is married to Hilary and they have two grown-up children, one a doctor too. If you don’t find him in the office he’ll be either sailing or tramping.
GUEST OF HONOUR - Launch of Tapuaki
With a career in health that spans 30 years, the recently appointed National Clinical Director for Pacific Health, Hilda Fa’asalele, has a lifetime of experience to draw on in undertaking her day-to-day role at the Ministry of Health. An Aniva alumna of 10 years, Hilda took up the Wellington-based role in November 2012 after finishing up as General Manager at the Auckland District Health Board.
“Counties Manukau District Health Board Maternity Review”
BY Margie Apa – Director, Strategic Development, Counties Manukau Health
Margie’s immediate past role was Deputy Secretary, Sector Capability and implementation at the Ministry of Health. She has also held roles at the Health Funding Authority, Capital & Coast DHB, the Labour Market Policy Group at the Department of Labour and the State Services Commission. In her current role as Director Strategic Development Margie is tasked with strategic planning and programme management, Maaori and Pacific Health, organisation communication and human resources. She is also responsible for coordinating Counties Manukau Health’s response to the maternity review.
Dr Sara Weeks is a psychiatrist specialising in perinatal conditions. She works in both the private and public sectors in New Zealand, and is Lead Clinician for Lotofale Pacific Island Mental Health Service with the Auckland District Health Board. She is also involved in research on postnatal depression in Pacific Island women, and teaches perinatal psychiatry for the post-graduate diploma in Obstetrics and Gynaecology.
Since 2011, Sara has been a member of the Pacific Society for Reproductive Health, and she has previously been an executive member of the Australasian branch of the Marcé Society – an international society for the promotion of mental health in women and families in relation to childbearing.
“Early days, Early weeks – What your Pepe can tell you” BY Natalie Leger and Dr Denise Guy
Natalie Leger is of Tongan, Maaori and Pakeha decent and is a Registered Nurse who has worked within the Pacific Mental Health and Addictions sector for nearly 20 years. Currently, Natalie is the Manager of Faleola which is the Adult Community Mental Health Service in Counties Manukau Health and is also Pacific Advisor for the Mental Health Division. Within her advisor role, Natalie is engaged in a variety of projects which includes the development of the Counties Manukau Health “Look at You, Aroha Atu, Aroha Mai” DVD projects for parents, whānau and professionals regarding the social and emotional needs of babies in the first three months of life.
Denise Guy is a Child Psychiatrist who has worked in Infant Mental Health [IMH] in Australia and New Zealand for almost three decades. Currently Denise has a variety of roles including; supervision of clinicians and IMH services, Vice President of the NZ IMH Association [IMHAANZ] and co-coordinating the training and supervision in Australasia of the Watch, Wait and Wonder® Intervention for families with infants from 4 months. She is Clinical Advisor to the Counties Manukau DHB “Look at You, Aroha Atu, Aroha Mai” DVD projects for parents, whānau and professionals regarding the social and emotional needs of babies in the first three months of life. Denise is a Trustee of the Incredible Families Charitable Trust which focuses on the early years with the delivery of evidence based interventions and training.
Presenters: Moka Tamapeau, Anna Tom & Pele Head-Tuariki
The Royal New Zealand Plunket Society is the largest provider of free support services for the development, health and well-being of children under five, seeing more than 90 percent of all newborns each year. A significant number of Pacific families are enrolled in its services.
Plunket’s vision is “Together the Best Start for Every Child, Ma te Mahi ngatahi, e puawai ai a tatou tamariki.” and for Pacific families, its approach is that “It takes a Village to Raise a Child”. The Pacific work in Plunket is around supporting Plunket to be more responsive to our families, that Pacific peoples are not a homogenous unit with a one size fits all approach, that within the name Pacific are in fact groups with their own uniqueness requiring approaches that best fit that Pacific culture. The aim is to engage enrolled Pacific families with the wider services Plunket provides and to support families to have the confidence to access the services they need.
Falenaoti Mokalagi Tamapeau
Falenaoti Mokalagi is the National Pacific Services Development Manager with Plunket. She is of Niuean and Samoan descent, with three children who are also of Fijian descent. Falenaoti Mokalagi has a background in parenting support, family therapy, probation, and community work.
Ana Tom is a Plunket Clinical Leader in Otara, of Cook Islands descent. She worked initially as a Plunket Nurse and has worked in Clinical leadership for the past 7 years. She is inspired and passionate about working with families and communities, particularly Pacific, and is committed to using her skills to make a difference for Plunket families.
Pele Head-Tuariki is the Auckland Pacific Regional Advisor at Plunket. Pele is of Niuean descent and was a high school English teacher in New Zealand and Niue where she held senior roles in teaching and administration. Pele worked as the Waitakere Community Injury Prevention Coordinator for Pacific Peoples where she found a passion and focus to work for greater health outcomes for Pacific communities here in New Zealand.
Presenters: Mary Matagi – Pacific Midwives Group
Although in Samoan, this phrase in its simplest term depicts the journey the Pasifika midwives have forayed into since its ratification as the Pasifika arm of the New Zealand College of midwives (NZCOM) on the 24th August 2012. Much has happened since then with our current focus primarily on succession planning and growing the Pasifika midwifery workforce. We are a very small collective however have Pasifika representations from Tonga, Fiji, Niue, Tuvalu, Tokelau, the Cook Islands and Samoa. With diverse perspectives and approaches in servicing our vast Pasifika communities, we believe that through a shared-vision and common goal, anything is possible in ensuring better health outcomes for all the Pasifika women, babies and families we serve. We certainly don’t have the answers, recognising the many challenges to overcome. However, dialogue must start somewhere and where better than to walk alongside like-minded people, sharing resources and perspectives collectively? This presentation seeks to highlight the importance of walking together, side by side in harmony and with one voice…moving forward synergistically as one.
Mary Matagi currently works as a midwife servicing Pasifika families within the Auckland Central region. She is also one of two Pasifika representatives on the NZ College of Midwives’ National Committee.
“Continuity of care and carer: What is it about my model of continuity of midwifery care that supports safe and positive birthing journeys for Pacifica women?”
Presenters: Adrienne Priday – Bader Drive Healthcare & Adrienne Samuelu
Continuity of care and carer with the support and integration of the pregnant woman’s Family Health Practice I believe enhances health outcomes and satisfaction for Pacifica women during their birthing journey. I will describe four elements of my midwifery care which strengthens a safe and satisfying health care relationship for both the woman and her family and myself the provider of a health service.
The presentation will conclude with Adrienne Samuelu, Student Midwife, describing how continuity of care has enhanced the birthing journeys for Pacifica families while on clinical placement in my practice.
Adrienne (Ady) Priday. RM BASocSci RcompN
I am a Self Employed Midwife working for 18 years in Counties Manukau Health region with midwifery clinics in Mangere and Otara. These two clinics are integrated within Family Health Practices where I work with a collegial team approach with GP’s, Practice Nurses and Community Health advocates ensuring a holistic family health focus to my midwifery care.
I enjoy mentoring new graduate midwives and often have students working with me. I also work for CM Health as a midwife establishing self employed midwifery practices integrated with Family Health Practices, supporting new graduate midwives and new midwives to work in the Counties Manukau region.
I am a member of the Auckland region NZCOM committee and I am a director on the Midwifery and Maternity Provider Organisation Board. I represent the NZ College of Midwives on the HIV advisory group to the MOH.
I am passionate about ensuring quality midwifery care is accessible to all women in my work communities.
I am a proud aunt, a crazy sister, a busy wife, and a dutiful daughter. When I dont have my head stuck in Midwifery textbooks I also like to be a friend, a cell sister and cousin as well. I am a New Zealand born Samoan who from the villages of Tufulele and Levi, Saleimoa. It has been a priviledge to be involved in the TAHA Working Group who contributed to Tapuaki. My experiences have given me a deep desire to see that ALL women recieve adequate health care in pregnancy and birth. I am a product of His grace, His mercy and the earnest prayers of my grandparents.
“Reaching the hard to reach”
Presenters: Julia Areaiiti & Ingrid Minett - Otara Health
Otara Health Charitable Trust re-focused its work in July 2012. The new focus is to build in Otara a child-centred community. Our aim is to ensure each of the estimated 850 babies that are born into Otara each year have the best start to life.
A key characteristic of “hard to reach” groups is their isolation and their limited access to appropriate services. Research suggests that it may not be the people that are hard to reach but the services. Accessibility, affordability, approach, cultural awareness and community involvement all play key roles in service reach.
Otara Health provides a range of services that will meet the needs of the groups labelled “hard to reach”. Our approach is educative and empowering. It aims also at working not just with individuals and the families but also with the communities in which the families live to change attitudes and increase understanding of good parenting. Using community development principles we also aim to enrich connections within communities, further supporting individuals and their families.
Our presentation will focus on our approach and our connected range of services. We will discuss how we are ensuring we are easy to reach and how we see it making a difference.
Julia joined Otara Health Charitable Trust in 2010. She was initially employed as a Community Health Worker for the Kaitohutohu service, providing intensive home based support to families who were referred through a variety of agencies and who were experiencing complex health and social issues. In June 2012 Julia became the Co-ordinator for the Kaitohutohu and Parenting services. She now oversees and supports the staff and volunteers working within the variety of services provided under Kaitohutohu, including the intensive home visiting outreach service, the SUDI education and Pepi pod service, and the Better Breathing Project in collaboration with Counties Manukau District Health Board. Under the Parenting services Julia also works hands on with the Teen Parenting programme and supports the Incredible Years Programme, Triple P Parenting, and HIPPY.
Julia is of Maori and Cook Island descent. She has four teenaged children and lives with her partner in Otara. She says that supporting families has been a humbling experience for her and has given her an appreciation for the small things in life.
Presenters: Metua Bates – Health Promotion Agency
Born in the village of Amuri, Aitutaki in the Cook Islands, migrated to and raised in NZ from 4 years of age, Metua currently works for the Health Promotion Agency (HPA) as Senior Advisor Pacific in a national role, based in Auckland. Her focus on the impacts of alcohol on Pacific populations now extends to the HPA’s other areas of focus: tobacco, gambling, rheumatic fever, immunization, mental health, flu vaccinations, heart and diabetes checks. She is a (NZ) registered Nurse (NSW trained) with a Masters in Business Administration (MBA-Otago). She has held a number of executive posts in community organizations such as Pacific Health & Welfare, P.A.C.I.F.I.C.A. and Cook Islands Health Network Association (NZ) Inc – CIHNA. She is a founding member of the Cook Islands Nurses Assn (NZ) and CIHNA. Metua is proud of her Cook Islands-Tahitian-Papaa heritage and honours her parents Teina and Martha (Verotia) Bates (nee Turia). She has two children, Merrilyn and Christopher and is the proud nana of 3 young grandsons, Dartagnan, Aramis and Dante and her little princess Annalangi-Gabriella.
“When things don’t go according to plan – A Pacifica perspective”
Presenters: Josie Apelu – SANDS Manukau
Josie Apelu graduated from Whitecliffe College of Art & Design in 2002 with a Fine Arts Degree, followed by a Graduate Diploma in Teaching Secondary in 2010. She also works & lives with her partner & 2 sons in South Auckland and is currently teaching as Head of Department for Food Technology & Hospitality at De La Salle College, Mangere East. Josie has lost both a Son & Daughter through Intro-uterine death & is serving her 4th year as a committee member for Sands Manukau as a volunteer & has assisted in facilitation, helping to train those within the organization to increase cultural awareness especially for the support of Pacifica parents & families.
Sands are a registered charity organisation that is currently in its 26th year of operation. It has support groups all over New Zealand for parents & families that have experienced the death of a baby during pregnancy, at birth or up to a year following a full term birth. Sands also support parents following a poor prognosis during pregnancy.
Parents universally say that when their child dies, a part of them dies. A child is a symbol of the future and losing that child represents a loss of hopes and dreams. In the time since burying my children I have faced many experiences both psychologically, spiritually and emotionally. Like many people I have thrown myself into doing things that try to honor my children both publically and privately. I have been an advocate for those around me that have not had the strength to talk about losing children. I have worked hard to be the best person I can be so that all my children can be proud of their mum.
As a bereaved parent my birthing experiences were quite traumatic, As a Pacifica mother first and foremost I do not want others to experience what I went through. But the sad reality is – even today, as a support worker I am still seeing and hearing stories about other Pacifica women having bad birthing experiences & not getting the necessary support from everyone around them at the time their child dies.
My mother & I gave birth under the same circumstances & although our experiences are almost 30 years apart, and at the very same hospital. There are still obvious disparities between the care given & received for us as Pacifica women. My mother & I are very strong willed, and yet we both experienced the same sense of helplessness & despair in that we put our lives in the hands of health professionals that did not fully cater for our cultural needs. Was this because of our own lack of understanding or maternal education? Were there avoidable factors at play that could have prevented these things happening to us when in the care of others?
Genetic testing has determined the medical reasons behind our babies passing away and that has not been disputed, but the quality of care afforded to my mother and I have been. Maternal health education for Pacifica people is necessary as a preventative for things going wrong before, during and after child birth. But when things do not go according to plan there is a definite need for Cultural awareness and Cultural competency by support people across the board to better serve the needs of our Pacifica parents and families.
The question is where and how do we start?