PUBH 1402: Healthcare Reflection on Pregnancy & Indigenous Health

This essay reflects on personal healthcare experiences related to pregnancy, healthcare education, and child health, using Gibb's reflective model. It explores the author's privileges and the impact of social determinants on healthcare access, contrasting them with the experiences of Indigenous Australians. The reflection highlights historical and socio-political factors contributing to health inequities faced by Indigenous communities, emphasizing the importance of culturally competent care and addressing systemic disadvantages. The author acknowledges the vast differences in healthcare opportunities and access compared to Indigenous populations, stemming from historical injustices and ongoing disparities in social determinants like education, employment, and income. The essay underscores the need for continued efforts to improve Indigenous health outcomes through culturally sensitive policies and equitable resource allocation. Desklib provides access to similar essays and study resources for students.

Running head: HEALTHCARE REFLECTION: PHOTO ESSAY
HEALTHCARE REFLECTION: PHOTO ESSAY
Name of the Student:
Name of the University:
Author note:

1HEALTHCARE REFLECTION: PHOTO ESSAY
Introduction
Reflection is the process of contemplating and evaluating personally upon one’s actions,
experiences and future hopes and dreams. Reflective practice provides scope of identification of
one’s strengths and limitations as well as the scope of future improvement (Cox, 2016). Cultural
proficiency and competency implies the practice of empathizing and understanding the needs,
opinions and experiences of culturally diverse communities, in this case, Indigenous
communities of Australia (Betancourt et al., 2016).
The following paper will associate important historical developments underlying three
important moments of life, that is, pregnancy, healthcare education and child care, within the
context of my own community as well as Indigenous Australian communities. Indigenous
Australians or Torres Strait Islander populations are recognized as the ‘First Peoples’ or natives
of Australia. However, after immigration by Europeans, Indigenous Australians suffered from a
history of oppression, discrimination and exploitation, resulting in huge inequities within the
context of education and health, especially in terms of women, new born children and even
resources and services associated with maternal and child health (Shepherd et al., 2017).
The following paper will hence demonstrate a reflection of the three important moments
in my personal life, which not only impacted my understanding of my privileges and socio-
cultural development of my community but also influenced my perception of cultural
proficiency. Taking insights from my important personal moments of pregnancy, healthcare
education and child health, this paper also demonstrates a reflection of how these experiences
would have been influenced in the context of Indigenous populations.

2HEALTHCARE REFLECTION: PHOTO ESSAY
Discussion
Three Moments in Time
The three moments in my life which influenced my understanding of the privileges and
health opportunities I have been fortunate to receive in term of social determinants of health, are
linked to my pregnancy, accessibility to healthcare educational resources and child care. The
following comprises of the reflection of the three important moments in my life using the Gibb’s
reflective model.

3HEALTHCARE REFLECTION: PHOTO ESSAY
Description: The primary incident which prompted me to reflect upon my privileges and
social determinants of health is when I was pregnant with my first child. While me and my
spouse were extremely delighted and excited about our future new born, I was however, quite
nervous regarding how I would deal with my pregnancy and healthy development of child.
Feelings: The pregnancy was an experience which both me and my spouse were looking
forward to. However, the extensive psychological and physiological changes which I was
encountering left me overwhelmed and fearful of what I will be encountering in the future and
whether I will be able to provide optimum care for myself and especially my child. It has been
evidenced that pregnancy is associated with major emotional and psychological upheavals in
mothers-to-be which often results in increased levels of stress and anxiety (Hasanjanzadeh &
Faramarzi, 2017). Further, I was also unaware of who should I be contacting or the specific
health professionals I should be interacting with for the care of my child as well as the
precautions I must undertake to ensure positive personal health outcomes as well as the healthy
growth and development of my child. It has been evidenced that young mothers or mothers
pregnant with their first child are often unaware of the personal care strategies they must engage
in due to inadequate levels of health literacy and hence, need access to education and appropriate
clinical support (Guendelman et al., 2017).
Evaluation: A major negative or ‘bad’ thing about the experience was the associated and
psychological effects which I encountered as a result of the pregnancy. As the pregnancy
progressed I became increasingly anxious, tensed, nervous as well as doubtful whether my
delivery will be successful and whether I will be or being successful in providing my child with
the nutrients required for future sustenance. Additionally, another bad experience was my lack of

4HEALTHCARE REFLECTION: PHOTO ESSAY
knowledge on the whom I must contact and the strategies I must engage in to ensure a
successfully pregnancy. It has been evidenced that young mothers may often be unaware on
household nutritional and dietary strategies that must be engaged to ensure a healthy and
successful pregnancy (Barnes et al., 2018).
A good experience however, was that I received plenty of support from my spouse as
well as family in order to deal with the physiological and psychological difficulties. It has been
estimated that women receiving adequate emotional as well as material support from near and
dear ones experience better health outcomes with respect to their personal health as well as their
future children (Wiradnyani et al., 2016). Further, another good experience was the availability
of pregnancy support counseling services in the healthcare organization of my locality, where
health professionals provided me all the required information and strategies I can personally
undertake to ensure health development of my child. Visits by the Maternal and Child Health
(MCH) nurses as well as postpartum care services provided by the healthcare organization were
also helpful for achieving success pregnancy as well as obtain the specialist care required for my
new born child.

5HEALTHCARE REFLECTION: PHOTO ESSAY
Analysis: The above experience made me realize the vast range of services for mothers
and children which are available and have been developed by state and federal bodies. The
availability of such healthcare educational and maternal childcare services, not only resulted in
successful outcomes of the two most important events of my life, that is, pregnancy and child
health but also in my experience of healthcare education and literacy, which improved my
knowledge further on the personal strategies I must undertake during pregnancy and my children.
Additionally, such services and resources also made me feel privileged, fortunate and satisfied
that my healthcare needs will be handled with expert, evidence-based and supportive assistance.
Indeed, it has been evidenced that availability, accessibility and affordability of healthcare
services and resources not only ensure improved maternal health outcomes but also result in
patients like mothers feeling that their needs have been understood, respected and empathized
with (Tsawe et al., 2015).
Conclusion: While I felt privileged to receive all these services, I believed that had I
been enlightened on these services and educational resources earlier, it would have prevented all
the distress, fear and nervousness which I had to encounter throughout the pregnancy period.
Action Plan: If I were to be pregnant again, or if anyone known to me would encounter
the experience similar mine, I would promptly engage in the above available services as well as
assist other women to avail the same. Provision of adequate support by peers and family are
essentials in ensuring positive health outcomes during pregnancy – something which I would
wish to contribute to in the future, for women whom I know (Wayanti, Kusumaningtyas & Sari,
2018).

6HEALTHCARE REFLECTION: PHOTO ESSAY
Link to Social Determinants
This experience enlightened me on privileges in my community regarding maternal and
child healthcare series. Such privileges and opportunities are prevalent in my community and in
my personal life are present due to the role of social determinants (Adler et al., 2016). According
to the Australian Institute of Health and Welfare (AIHW), the social determinants of health
include education, occupation and income (Australian Institute of Health and Welfare, 2019).
Higher levels of education enlightens people on the strategies with which they can access
available services as well as motivate them to achieve better health outcomes (Ruiz et al., 2016).
Indeed, my extensive academic experience with post graduation played a key role in
understanding the information which was given to me by the health professionals on maternal
and child care as well as identify and evaluate the services which were available.
A stable employment assists individuals with greater resources to afford healthcare
services as well as enhanced social status to access quality maternal and healthcare services
(Mahmoodi et al., 2015). In my case, my stable employment not only provided me adequate
maternity privileges but also a stable income to access the required resources for myself as well
as my child. Income has indeed been evidenced to be a key social determinant which assists
people in the acquisition of quality health services and improved health outcomes (Bishai et al.,
2016).
Historical Factors: My pregnancy and birth of my first child occurred during the year
2018 – a time when the Department of Health developed the National Strategic Approach to
Maternity Services and Stillbirth Education and Awareness Programs to support maternal health
in mothers as well as prevention of stillbirths at the national level. Such changes influenced the
care received by me during my pregnancy and also resulted in extensive care and precautions

7HEALTHCARE REFLECTION: PHOTO ESSAY
from my associated health professionals. Additionally, maternal care has improved over the ages
and mothers and children have improved rates of mortality throughout the ages (Department of
Health, 2019).
Socio-Political Factors: Maternal care and child health services are extensively covered
by the Department of Health, which I received as well, such as pregnancy counseling services
which not only educate mothers on precautions to be maintained but also rebates for three
consecutive pregnancies (Department of Health, 2019). Additionally MCH nurses were also
provided by the healthcare organization – an initiative taken by state governments to assist
newborn children and mothers at home (State Government Victoria, 2019).
Cultural Factors: Initially, approaches such as patient centeredness and family
centeredness were not adopted by healthcare organization and treatment was largely directed
solely by healthcare professionals. However, with time, health professionals are obliged to
actively interact with patients and their families and incorporate their opinions and preferences in
developing care plans and interventions. Such practices were indeed adopted by the healthcare
professionals allocated for my care, who actively enquired my level of comfort and preferences
with regards to interventions, delivery and MCH services (De Labrusse et al., 2016).
Indigenous Historical Landmark
However, comparing my personal experiences with that of Indigenous Australians, it is
worthwhile to note that there continues to remain vast inequities and discrimination in terms of
the social determinants and socio-political, cultural and historical factors underlying maternal
and child health services.

8HEALTHCARE REFLECTION: PHOTO ESSAY
In terms of social determinants, the rates of education, employment and income are
evidenced to be much less in Indigenous Australians as compared to non-Indigenous populations
resulting in greater inequities in terms of accessibility, affordability and availability of maternal
and child healthcare services - hence, revealing me the vast healthcare opportunities I was
provided with during my important life events. Such inequities play a key role in the range of
healthcare problems faced by Indigenous Australians, such as cardiovascular diseases, substance
abuse and metabolic disorders (Australian Institute of Health and Welfare, 2019).
Historical: It must be remembered that upon immigration by Europeans, Indigenous
Australians since time immemorial were evicted from their lands, their native homes as well as
resources resulting in homelessness, untimely deaths and continuous exploitation and
discrimination. Such populations were deprived from basic healthcare services resulting in high
rates of mortality as well as disease burdens, especially among sensitive populations like mothers
and children (Haebich, 2015). Further, the historical context of forced removal from parents
resulting in the ‘Stolen Generation’ have continued to negatively impact Indigenous mothers and
children psychologically, resulting in perceptions of trauma, fear and mistrust with non-
Indigenous Australians. Reflecting on my personal experiences truly made me realize my
privileges since my community never had to encounter such horrors but in fact, played a key role
in the exploitation (Baidawi, Mendes & Saunders, 2017).
Socio-political factors: During 2018, the context of time when I was pregnant with my
first child, the Department of Health developed culturally competent maternal and child care
policies such as the Australian Nurse-Family Partnership Program (ANFPP) and the New
Directions Mothers and Babies Services (NDMBS) (Department of Health, 2019). This has
indeed improved maternal antenatal visits by Indigenous mothers by 13% as compared to 2012.

9HEALTHCARE REFLECTION: PHOTO ESSAY
However, child death rates continue to be high in Indigenous families, at the rate of 146 per 100,
000 children as compared to 70 per 100, 000 deaths in non-Indigenous families hence
necessitating the need for more robust interventions to combat these inequities (Australian
Institute of Health and Welfare, 2019).
Cultural factors: While cultural competency approaches are increasingly being adopted
by healthcare organizations, United Nations denote that discrimination continues to exist with
Indigenous families being provided with no say in their healthcare and respective organizations
disregarding the need to adopt new languages or cultural sensitivities. Such discrimination
indeed made me realize my privileges as I never had to encounter such discriminatory comments
by the MCH services which I visited (United Nations, 2019).
Conclusion
Thus, this paper discusses extensively on personal reflections of important incidences in
my life as well as the role of underlying social determinants in the context of the historical and
socio-cultural development of my own community as well as individuals belonging to Aboriginal
Torres Strait Islander Communities. A comprehensive personal reflection enlightened me on my
privileges in terms of availability of social determinants underlying maternal and child care as
well as educational resources, such as social status, income, prevalence of coping and supports,
level of literacy as well as conditions for employment. Despite extensive attempts by the
Department of Health to mitigate these discrepancies, the history of exploitation suffered by the
‘Stolen Generation’, forced removal of children and continued discrimination continue to
negatively impact the current health outcomes in Indigenous Australian women and children.
Thus with the help of this reflection, this paper successfully demonstrates the inequities which

10HEALTHCARE REFLECTION: PHOTO ESSAY
continue to prevail across culturally diverse groups which have developed historically and the
need for national bodies to close this gap with robust, comprehensive interventions.

11HEALTHCARE REFLECTION: PHOTO ESSAY
References
Adler, N. E., Cutler, D. M., Fielding, J. E., Glymour, M., & Koh, H. K. (2016). Addressing
social determinants of health and health disparities. Published September, 19.
Australian Institute of Health and Welfare. (2019). Australia's health 2016, Chapter 4
Determinants of health - Australian Institute of Health and Welfare. Retrieved 21 August
2019, from https://www.aihw.gov.au/reports/australias-health/australias-health-2016/
contents/determinants.
Australian Institute of Health and Welfare. (2019). Indigenous child mortality and life
expectancy. Retrieved 21 August 2019, from
https://www.aihw.gov.au/getmedia/ed34c67c-e1aa-4d4f-9ff2-366ea6f27b52/aihw-aus-
221-chapter-6-3.pdf.aspx.
Baidawi, S., Mendes, P., & Saunders, B. J. (2017). The complexities of cultural support planning
for Indigenous children in and leaving out‐of‐home care: the views of service providers
in Victoria, Australia. Child & Family Social Work, 22(2), 731-740.
Barnes, L. A., Barclay, L., McCaffery, K., & Aslani, P. (2018). Complementary medicine
products: information sources, perceived benefits and maternal health literacy. Women
and Birth.
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016).
Defining cultural competence: a practical framework for addressing racial/ethnic
disparities in health and health care. Public health reports.

12HEALTHCARE REFLECTION: PHOTO ESSAY
Bishai, D. M., Cohen, R., Alfonso, Y. N., Adam, T., Kuruvilla, S., & Schweitzer, J. (2016).
Factors contributing to maternal and child mortality reductions in 146 low-and middle-
income countries between 1990 and 2010. PLoS One, 11(1), e0144908.
Cox, B. K. (2016). A Personal Reflection on the Nature and Value of Public Memory in
Holocaust Memorials. Conversations: A Graduate Student Journal of the Humanities,
Social Sciences, and Theology, 3(1), 1.
De Labrusse, C., Ramelet, A. S., Humphrey, T., & Maclennan, S. J. (2016). Patient-centered care
in maternity services: a critical appraisal and synthesis of the literature. Women's Health
Issues, 26(1), 100-109.
Department of Health. (2019). Department of Health | Child and Family Health. Retrieved 21
August 2019, from
https://www1.health.gov.au/internet/main/publishing.nsf/Content/indigenous-maternal-
health-lp.
Department of Health. (2019). Department of Health | Pregnancy support counselling. Retrieved
21 August 2019, from
https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pcd-pregnancy-
support.htm.
Department of Health. (2019). Department of Health | Stillbirth and Maternity services.
Retrieved 21 August 2019, from
https://www1.health.gov.au/internet/main/publishing.nsf/Content/pacd-pdb-maternity.
Guendelman, S., Broderick, A., Mlo, H., Gemmill, A., & Lindeman, D. (2017). Listening to
communities: mixed-method study of the engagement of disadvantaged mothers and

13HEALTHCARE REFLECTION: PHOTO ESSAY
pregnant women with digital health technologies. Journal of medical Internet
research, 19(7), e240.
Haebich, A. (2015). Neoliberalism, settler colonialism and the history of Indigenous child
removal in Australia. Australian Indigenous Law Review, 19(1), 20-31.
Hasanjanzadeh, P., & Faramarzi, M. (2017). Relationship between maternal general and specific-
pregnancy stress, anxiety, and depression symptoms and pregnancy outcome. Journal of
clinical and diagnostic research: JCDR, 11(4), VC04.
Mahmoodi, Z., Karimlou, M., Sajjadi, H., Dejman, M., Vameghi, M., Dolatian, M., &
Mahmoodi, A. (2015). Association of maternal working condition with low birth weight:
the social determinants of health approach. Annals of medical and health sciences
research, 5(6), 385-391.
Ruiz, M., Goldblatt, P., Morrison, J., Porta, D., Forastiere, F., Hryhorczuk, D., ... & Torrent, M.
(2016). Impact of low maternal education on early childhood overweight and obesity in
Europe. Paediatric and perinatal epidemiology, 30(3), 274-284.
Shepherd, C. C., Li, J., Cooper, M. N., Hopkins, K. D., & Farrant, B. M. (2017). The impact of
racial discrimination on the health of Australian Indigenous children aged 5–10 years:
analysis of national longitudinal data. International journal for equity in health, 16(1),
116.
State Government Victoria. (2019). Postnatal Care Program Guidelines for Victorian Health
Services. Retrieved 21 August 2019, from
https://www2.health.vic.gov.au/Api/downloadmedia/%7BDA1008D9-BB44-4F4B-B955-
926E73C4D391%7D.

14HEALTHCARE REFLECTION: PHOTO ESSAY
Tsawe, M., Moto, A., Netshivhera, T., Ralesego, L., Nyathi, C., & Susuman, A. S. (2015).
Factors influencing the use of maternal healthcare services and childhood immunization
in Swaziland. International journal for equity in health, 14(1), 32.
United Nations. (2019). Indigenous Women’s Maternal Health and Maternal Mortality.
Retrieved 21 August 2019, from
https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/
19/2018/04/factsheet_print_Mar27.pdf.
Wayanti, S., Kusumaningtyas, K., & Sari, I. R. T. (2018). Role of Family in Early Detection
Towards Pregnancy Complication Risk. Aloha International Journal of Health
Advancement (AIJHA), 1(6), 130-135.
Wiradnyani, L. A. A., Khusun, H., Achadi, E. L., Ocviyanti, D., & Shankar, A. H. (2016). Role
of family support and women’s knowledge on pregnancy-related risks in adherence to
maternal iron–folic acid supplementation in Indonesia. Public health nutrition, 19(15),
2818-2828.