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Migrant I-Kiribati Women's Experience of Childbirth in New Zealand

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McAra-Couper, Judith
Smythe, Liz

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Doctor of Health Science

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Auckland University of Technology

Abstract

I-Kiribati are among an increasing number of migrants to New Zealand. They are grouped with Pacific peoples, for whom health outcomes are poorer than for the majority of the population. Limited research exists about I-Kiribati experiences or health outcomes. This research uncovers meaning within migrant I-Kiribati women’s New Zealand experience of childbirth (taken as pregnancy, birth, and the postnatal period) and enables midwives to better understand the challenges I-Kiribati face through the participants’ stories. Hermeneutic phenomenology methodology drew out meaning from unstructured interviews with nine migrant I-Kiribati women who had birthed in New Zealand or who had supported other I-Kiribati to do so. Guidance was sought from I-Kiribati Advisors regarding culturally appropriate methods. Four midwives who had cared for I-Kiribati were also interviewed. Data analysis of crafted stories from interview transcripts was carried out via reflexive thinking, and engaging in a process of reflecting, writing, and re-writing. Findings, firstly, showed I-Kiribati women experience tension, from a feeling of unfamiliarity, equating to not feeling ‘at home’. This came from challenges and changes to relationships, lack of support, unmet expectations, being torn between two cultures, not being understood or not understanding, and from everything being unfamiliar. Findings, secondly, showed the experience of silence, which can mask anxiety, uncertainty, pain, or disagreement, but it can also show cultural shyness and respect for others; silence always has meaning. The third findings theme showed relationships, care-connections, to be important to I-Kiribati and that relationships with family are central. The widespread nature of relationships supports literature showing the holistic nature of the I-Kiribati view of health and wellbeing. I-Kiribati women bring their other relationships or care-connections, their context, to their childbirth experience. Midwives have potential to build trust for positive care by taking time to get to know I-Kiribati women by asking about, recognizing, including, and facilitating their other relationships. In this way, I-Kiribati women’s holistic context of family and wider culture is taken into account. Such new understanding brings familiarity to an I-Kiribati woman and supports her to speak up about her concerns. The research findings encourage midwives to ‘see’ the holistic context in which I-Kiribati women are embedded. To build relationships opens the way to ‘hear’ what matters to ‘this’ woman to feel ‘safe’ and ‘at home’.

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