Communal to Individual Midwifery Care: Cultural Practices and the Maternity Journey of Sub-Saharan African Women in New Zealand

Abstract

Maternal health disparities persist globally, including among Sub-Saharan African immigrant women in high-income countries. Many come from contexts where pregnancy, childbirth, and the postpartum period are embedded in communal traditions. In Aotearoa New Zealand, the birthplace of cultural safety, limited research has examined African women’s maternity experiences. This study forms part of a midwife-led qualitative exploration of the maternity journeys of women from Sub-Saharan Africa in New Zealand, using interpretive description informed by cultural safety and structural competency. Semi-structured interviews were conducted with eleven women between July 2024 and January 2025. Data were analysed inductively using Braun and Clarke’s reflexive thematic analysis. Participants described a repertoire of cultural practices, including herbal and dietary remedies, postpartum rituals, and newborn care customs. Herbal medicine was used to ease labour and promote physiological birth, while cultural nutrition supported recovery and breastfeeding. The extended family played a vital role in postpartum recovery and breastfeeding support. Migration, however, disrupted this communal model, leaving women socially isolated in New Zealand. Participants reported loneliness, lack of family care, and, in some cases, a history of postpartum depression. Despite these challenges, women demonstrated resilience, adapting practices and advocating through transnational family ties and community networks. Participants' cultural practices strongly shape maternity expectations yet often conflict with New Zealand’s individualised model of care. Addressing these gaps requires culturally safe, structurally competent maternity models that integrate positive cultural traditions and reduce the risk of isolation. The next phase of this project describes women’s clinical maternity care experiences, highlights how structural barriers, misdiagnoses rooted in cultural assumptions, and limited recognition of traditional practices further compromise the delivery of woman-centred care.