[00:00:01] Speaker A: Men's health matters, men's roles have changed. You know, it's good to get in there and strengthen the family. And this is what this study has demonstrated. Let's start getting in there. Let's start strengthening and supporting our men and especially expecting fathers. Because what came at a lot in the study as well is that once you became a parent, especially the fathers, you started reflecting on your childhood. And was my dad there? How can I be a better father?
[00:00:30] Speaker B: Welcome to the Emerging Minds podcast.
Hi, I'm Rosie Shellan and you're listening to an Emerging Minds podcast. But before we begin, I'd like to acknowledge the land, seas and waterways of the Yaru Jugun peoples in Broome and pay my respects to the ancestors, elders, knowledge holders and future generations and for the nurturing care they have provided to this country for over 60 and years. In this episode, you will hear from Erica Spry and Zachariah Cox as they share what they heard when speaking with expecting and new fathers in rural and remote communities of Western Australia.
Thanks for speaking with me today, Erica and Zeig. Firstly, though, could you tell me a little bit about yourself?
[00:01:16] Speaker A: So my name is Eric Asprey, my Aboriginal bush name is Robinjan and I always start that I'm Jadawin's daughter.
So we're up in the Kimberley and just out of Broome, Adijawi country. So I'm connected out there. I'm a traditional owner, so grew up out on country and all around the place really. And I've got family over in the East Kimberley, Gidja family over in Warmond community at Turkey Creek.
So travel through the Kimberley, but you know, across Australia that stayed in Tirna, its home here. So I worked for two organisations. So the first one is the Kimberley Aboriginal Medical Services as a research officer and then with the University of Western Australia, the Royal Clinical School as a research fellow.
[00:02:01] Speaker C: And yeah, Zachariah Cox, I'm of the Limanburg people, bit south of America's country there, the Badi Jawi people there and also the Gija people as well from around the warm and Horse Creek country there. And I'm the social and emotional wellbeing manager at Cairns here in Broome.
[00:02:21] Speaker B: Tell me a little bit about the.
[00:02:23] Speaker A: Work you've been doing in the antenatal period with Aboriginal men.
One of the projects that I got to be a part of in the Kimberley was actually starting off working with the women up here. So Aboriginal women in the Kimberley region. And we were wanting to, you know, have conversations and find out, you know, how do we improve antenatal care. How do we make it better for the mum and the pup? And so we focused a lot on women and improving this system in that way. They're meeting their needs through that process.
We did a qualitative study and I was called out around the Kimberley to various remote communities and towns. And in particular, I was in Broome one day and I was tracking down a mum that fell, fitted our criteria to have an interview. And in order to get to her, I found her mum and I said, where's your daughter? Let's, you know, we're trying to interview so we can improve antenatal care. And she goes, why? Why is it that you always just focus on the woman a the mum? It takes two to make a baby. Why don't you start including the fathers? You know, so this is the senior elder here in Yaru country, and I'm being told that. And I've been brought up by my elders and, you know, for all our family's best interests. And so I had to really listen here. And being in this wonderful space of health research, I was in a opportunity in a place where I could go back and say to the team, look, we're getting direction by a senior elder to include fathers because there's a huge gap there. You know, we must respect what she's saying. It's always focus on the mum expecting mother, but, you know, the father's involved too.
So how do we start going forward to include our expecting fathers and really start to work towards the family unit of care as a model of care for the family?
And so that's how it evolved into getting the men's paper started. And we did a little bit out in other areas, but we sort of came back into the Broome area and then Zach came along and, you know, we're between us. We did a few of the interviews. Zach went out and scoped out a few. And on my side, I had to go with culturally appropriate family kinship, where I could actually go out and say to, like, a brother of mine, like a cousin brother, or I could go out and say to, like, one of my oldest sons, my nephews, you know, you just become a dad or, you know, you're expecting your first child, you know, when we want to include fathers and do you want to be a part of sharing your story so that we can start to, you know, voice, you know, make, amplify, I suppose, the needs of our fathers and then take it from there? How we could work this into the system to be able to deliver Better services, not just for the mum, but the father and possibly, you know, forward planning as a family unit. And so I managed to get a couple of interviews done and it was. They felt in a safe place to share. And I think they felt relieved too, that someone heard them and they were being heard in that we could go back and try to make things better for our families. Because you find a lot of our mop, they're just waiting for that opportunity. They just need that voice.
They need that voice to be heard so that then you can help others in other levels advocate their needs right down at the grassroots community level, reaching the systems, all our policies and that to change, to make it better for our whole community, the individual, the family, and then, you know, ripples out to your community.
[00:06:16] Speaker C: Yes. I think Eric has covered sort of the beginnings to why and how interviewing men about their experiences with antenatal services and pregnancy came about. And sort of why I got involved, sort of pressured. I wasn't working for the research team there, but was strongly encouraged to come and help out and to assist the team in conducting the, or performing the interviews with Aboriginal men in Broome. And obviously with my local knowledge of the town and men who, you know, whose partners were expecting or, you know, who I had the knowledge of, that their partners were pregnant, you know, that sort of was helpful in a sense as well, having that community knowledge about who to reach out to, to contact, to gauge or to check their interest in being interviewed with their experiences with the antenatal services.
So I agreed to helping out and to assisting with these interviews. You know, research was new to me at the time, and so I thought, you know, it was a good opportunity to. To get some, you know, professional development and some learning in a different field. And I really sort of took it on board and sort of started to reach out and lock in some interviews with local men in the town who, you know, pretty much all of them I had relationships with, whether they were friends, whether they were family members or whether, you know, we were known to each other.
That was quite, I suppose, rewarding as well, in a sense, to be able to encourage men to talk about their experiences, because we know men find it hard sometimes to express their feelings and their experiences and sort of what it's like for them when their partners do become pregnant. I think, as Erica identified, a lot of the focus is on the women, which we understand that it needs to be, but, you know, understanding and moving away from the sort of the traditional pathways and processes and procedures to caring for and looking after Women who've become pregnant and identifying and acknowledging that obviously men play a big part in that as well, and sort of trying to understand their perception and their experiences through that process as well was quite rewarding and obviously mental. I found when I interviewed them, they found that reflecting back on their experiences was really sort of helpful to them as well, in a sense. It sort of gave them more of a sort of clear understanding of sort of what was happening for them, how important it was for them and how they had got to the point at that point in time and feeling how they felt, I suppose, if that makes sense. Yeah.
[00:08:45] Speaker B: So what did you hear? What were the things that you heard.
[00:08:48] Speaker C: That the men felt her. The responsibility, obviously, of such a big change, I suppose, in their lives and understanding that their lives were pretty much going to change in a significant way. The second part to that was that they felt it important to be a part of attending antenatal services and being involved with antenatal care of their partners. Some of the men reflected by saying that they weren't too keen in attending some of the antenatal classes, but they'd obviously attended, not forced themselves or sort of pushed through to attend with their partners and the outcomes were quite sort of promising, or they felt that they had learned a lot out of those classes and had really sort of valued attending and were thankful that they did go to attend those classes whilst being reluctant in the first instance. One person in particular even went as far as downloading a development app, a baby develop an app to sort of check every day and every week on the different stages and the different sort of growth patterns of the child or the baby at the time. I suppose one of the concerning findings was that all participants had experienced three or more significant stresses in their lives during the antenatal period and at the time of the interview. And, you know, they ranged from things like financial problems, employment problems, accommodation challenges and family problems as well, which included, you know, people passing away and their family and stuff. So that was quite. Not surprising for me as an Aboriginal male and father myself. But obviously, you know, really identified and pointed out that, you know, our Melbourne and our mothers and our fathers do, you know, experience significant stress during that antenatal period and, you know, when it should be a smooth and a calming and a, you know, a time where people shouldn't have to worry about those things. But we know that's. That's a reality for a lot of our people up here and across Australia.
[00:10:34] Speaker A: Yeah, they were the key themes. But I think the other thing is that some of them did attend the anonatal appointments at some, you know, throughout the pregnancy when they could. Otherwise they were out of town and for work. And that was one of the big factors that we identified a lot of FIFO work around here, that when they did attend the health service, some of them felt included, they were heard, they got asked questions and others didn't really feel like they were, you know, met in a cultural appropriate way. You know, they then called out, how can we get a, perhaps an Aboriginal health worker or practitioner in the maternal child health team so that when the mother does present at antenatal clinic, there's a male Aboriginal health worker practitioner there and say, hey, dad, how you going today? And some of them felt like they weren't asked how they felt. You know, they were expecting father, but no one asked how they felt. You know, it was all focused on the mum and the bum bub's development. Fair enough. But as the father, he was also experiencing all those emotions as well. But no one did a check in on him. And then when you went to look at the resources, it's all woman focused and it's all baby focused. But, you know, the father felt, you know, can I get some resources here, some flyers, some pamphlets, and can someone, one on one, explain to me as well? Because perhaps my, you know, she's in a. In one of those days where she. She's finding it trying and I want to be her support and, you know, make sure that I'm doing the best that I can, you know, that we're doing changes together to prepare for the baby's arrival. But who's checking in on me and can, you know, can I have perhaps separate appointments in this antenatal space where I can say, tell me what she needs or how can I best support her, you know, so this was reflected in the paper as well. And it's what Zach had brought up. It's not your traditional style. This particular cohort of men, you know, shared this. But in the Kimberley, we also know diversity as Aboriginal people. We've got many languages, so we have over 26, 27 different Aboriginal language groups. And we come from different countries. Even though we're a Kimberley region, we're quite diverse in that, on that note. And so we got traditional cultural practices where we do our law and culture customs. And so some of the fathers will have cultural appropriate ways where they only want to know minimum of antenatal care stuff, whereas others are contemporary. And I don't want to sound like I'm judging, but Everyone is allowed to be how they feel it suits them. It's their type of model of care for themselves. And I say it's case by case. And so, you know, when a mother is birthing and if you're traditional, the father will wait outside, whereas others want to be in the room with their partner and actually do one on one supports. So we don't discriminate against, you know, the Aboriginal person. We're not here to divvy up all that type of, you know, statuses there. We simply say that when someone presents at the antenatal clinic that, you know, they meet the mother and father, should the mother and father want to come along. But just extending that out there is the beginning to, you know, really getting the family unit together.
[00:13:56] Speaker C: For a lot of Aboriginal men, times are changing and for a lot of Aboriginal men, we are finding it important now that we do have a big part to play in pregnancy and in looking after yourself and looking after your partner, being involved with the antenatal care services, being at the birth. A lot of the men were planning to, intending to be at the birth, in the room. I know I was myself at the birth of my daughter and in the room, you know, with my daughter, which pretty sure my father wasn't. But, you know, the times were different back then in those days and, you know, since no one's fault, no one's to blame or. And even if that's still the case in different areas across the Kimberley and across Australia where men stay out of women's business, which includes pregnancy, then that's right too for them or for them or better. There's no right or wrong answers in how people are progressing and how people are progressing culturally and how people want to stay and what they want to believe and follow. And obviously others have different ways of thinking and different perceptions and understandings of what their role is and how involved.
[00:14:57] Speaker A: They should be, I suppose, is this study, you know, was. We see it as opening the door, you know, that currently, you know, it's. It's female focus, it's mother and bub focus. And so this was a sample frame to start that conversation, to start that spotlight that fathers do want to be included. So what Zach spoke about, it was not what we had planned to. We're not here to exclude anybody, you know, we want to include as many people as we can, but this particular cohort was opening the door to start the conversation. And so, you know, when we now look forward that, you know, we want to do further in this space, we then want to be able to bring others in. You know, from all the background that we spoke on men's health matters, men's roles have changed. You know, it's good to get in there and strengthen the family. And this is what this study is. Has demonstrated. You know, let's. Let's start getting in there. Let's start strengthening and supporting our men, you know, especially expecting fathers. Because what came at a lot in the study as well is that once you became a parent, especially the fathers, you know, what Zach shared, you started reflecting on your childhood. Was my dad there? You know, how can I be a better father? I better start making changes now. And as a family, we're gonna do changes together to really give our child the best start. But they called on health services to hear them and invite them in and include them in the care. But they also respectfully said, you know, we know mum and bub comes first, but wherever opportunity is available, please include the fathers and have that conversation. Do the chicken. You know, mum, are you feeling comfortable today?
You type, I want to come, dad, how are you? On the other cultural side of it, too, is that the fathers would go out on country and go fishing and, you know, their little fishing trips, all the, you know, they'd all come together and share stories and get tips on had a better parent or what might be coming along, you know, and, you know, they also reach that to the extended family. So in Aboriginal families, it's not just uniquely a mother, father and child or other siblings, it's our extended family. You know, our cousins are our brothers or our sisters, you know, and our uncles are our dads, you know, and we've got many grandfathers and many grandmothers. And so you go and look in the family and you go, oh, look at their style. She. That's a good role model. They're up to number baby three. I'm gonna go get some tips from that brother, and then you. And then I'm gonna go see the other, you know, brother over here. I'm gonna get some tips from him, you know, so that's how men have been functioning. They've been going out there on Aboriginal, you know, extended family supports. And this is great, because the more support you have, the more protective factors you got. And you got that father feeling well, you got the mother feeling well, you got the family feeling well. And we. That's what we want best starts. And if you got the mother and the father connecting with that baby before the baby's born. And a lot of what came out in the paper Is they, most of them attended the antenatal scan. Hey, they wanted to know, boy or girl, you know, and others just, you know, where they're developing. But it's connecting, it's that first connection. And then what they say on the statistics is that that grows that family, you know, to be stronger, to then take on what life is about, to bring.
[00:18:29] Speaker B: It provides a unique opportunity, doesn't it?
[00:18:32] Speaker A: Yeah.
[00:18:32] Speaker B: Did the men speak about their experiences with mainstream or non aboriginal health services?
[00:18:38] Speaker C: Well, in Broome and the way that the system works here is that I think the early stages, you can just go to your AMS to see your GP and the maternal health nurse, but for the scans and as the pregnancy progresses, that's when people are feeling vasport use the government service. And obviously if the relationships between the health professionals at the AMS and the hospital are good and you've got the same people there, then it's usually a pretty smooth process. But, you know, given the high turnover of staff we have in the gimbaly with maternal health nurses, obstetricians, GPs, sometimes that can be a bit frustrating for anyone. And then especially with our mom having to see a new specialist or a new health professional halfway through or towards the end of your pregnancy, this be common for anyone. But with our mob, you know, they like, they like consistency, I suppose, and to build that trust takes them a bit of time.
[00:19:30] Speaker A: So what Zach's saying is if you get a straight like your 40 weeks gestation and your pregnancy and your clinic is your main place, your primary health care, and then your secondary is you go to the hospital and through that 20 or 40 weeks gestation you got various tests at the time and a lot of the comments coming back from the fathers was, can you explain what these tests are? Because you're telling the mum and then how am I supposed to support her when I'm not sure about it as well? And then is she able to hear the healthcare provider so that she is listening to understand what is being said to her? Because sometimes if you're a first mum or you that's the third child, you know, not every pregnancy is the same, so you can't assume that they're all the same or the mother knows better because it's their third child.
No, every pregnancy is different. And so you imagine a father's point of view, that they had a little bit of complications with the second child and so he's extra worried about this third baby coming along. If he's not included in the consult, how is he going to support his wife. So these are real issues and it varies what Zach touched on and we have shared care here.
So you always expose the different health professionals along that, that antenatal period in your local AMs to Private GP, General Practitioner or over to the hospital and you're in the ultrasound setup or, you know, you're going in on the ward and you manage to go and get a maternity visit before the birthing takes place. So this is what mothers are subjected to. But fathers as well, you know, going in and scoping out the maternity ward before the. The arrival of the child going into birth, because as soon as she goes into, oh, the baby's coming, you know, you imagine the father, he doesn't know. Was this a fast process? Is this a slow process? How do I go about here being actual supports? Because there, when you're into that third stage, you know, you don't know how your birthing's going to go. Everyone wants a great outcome and this is what the father wants. He wants it all to go smooth. And unless he's informed, how can he bring that extra support in there? Cause he's the first in the relationship. And then our extended family come in, you know, and the beauty about our families and our fathers and all that, we'll all get in there behind them too, you know, I'll say, what now, bro? How you going? And we'll tag. You want to have yarn, you know, so it'd be good if, you know, in the services that they have that space, because some of the expecting fathers or brothers sometimes don't want to go to a family member. You know, they've had a fallout with someone and, you know, they want to go to a service provider because they might want privacy, you know, that might be their style of how they want to understand things better, to be able to be that support for the partner, you know, So I think that they should be given these options and, you know, and it's time that this happens. We hope that message gets out there, we get a change in the primary health provider, that we get a change in our child. Maternal health units that they do bring in Aboriginal health workers and practitioners and male ones to support the expecting father and females as well. But I think that's the best beginnings, you know, for all our children going forward. And this is also a reach out, I say, too, not just for Aboriginal fathers, but maybe all fathers of all ethnicities out there too. But look, I think they were just glad to share their stories and, you know, really say, this is how we're Feeling, you know, and open that door for other fathers so we can think about then the cultural one that's got a different type of balancing in their life. You know, they're coming in from a remote community because their partner has to go do a scan at 20 weeks and the baby's not looking well and then all of a sudden she's going to be flying down to Perth to have the baby. And where does that leave the father? He'd probably want to go as the first baby or maybe it's the second one or the third one and he has to get two babies babysat so he could go down and help his partner. Because this is real world here, this is lived experiences here. This, all this happens and fathers have all this. But I call that to the fathers that aren't able to be there for their partner because they are breakups as well.
And so you got to be a bit sick sensitive of dealing with a partner like a mum with a separated in a relationship. But I mean this is why you do case by case and then you weigh up the sensitivity of it and you always do the risk factors, you know, what is the risk involved or what are the protective factors? How can we get a better model of care support for our fathers but be mindful to the expecting mother? Have they got a good relationship or do we need to be mindful on our approach and how do we culturally do this? What's the culturally appropriate way? What's a culturally safe way? And not just saying these words but actually put it into practice. You know, as soon as they walk in they feel welcome, you know, the room is where they're comfortable, you know, they're greeted well and just that common gesture to make someone comfortable and just allow that space.
[00:24:52] Speaker B: What would your advice be for a non Aboriginal, say a health worker that's just started with a mum? What advice would you give to step out of the square and to start those conversations for dad where the system doesn't support it?
[00:25:05] Speaker C: I think just you know, where possible and where people can be as open minded to the point of trying to understand the mother and if the father's there trying to hear their story, where they're at in terms of their lives and the pregnancy and learning about what they're experiencing at home in their lives to be able to treat them or provide care and in a way that reflects, you know, how they're feeling at time. Again, I would say really sort of valuable cultural awareness training as well to help non indigenous staff and staff new to the area understand the context of the community, the town that they're working in, the different, you know, tribal groups that. The different Aboriginal groups that obviously reside in that town, you know, the different families and the different dynamics of town or community life. Talking to Aboriginal GPs and nurses, if they're in the organisation about, in how they should be approaching providing care, using health workers as well as a sort of. As a, As a go to. To to prompt sort of, you know, what they should be looking for, what questions they should be asking that sort of sit outside the, the clinical documentation or the clinical stuff that resources that, you know, are currently in use.
[00:26:09] Speaker A: So, you know, like, when you in front of the Aboriginal person and like, take all that into account, what Zach has shared, you're coming in, up here in the Kimberley, it's diverse.
Not all Aboriginal people are the same, you know, that's right across Australia, but. And that is true. And in this particular region, like the language is over 26, 27 different languages. Our ways, our styles of doing things, you know. But what's the most common thing you do with a person is you just have a yarn. And sometimes you don't have to go straight into the medical consult or the procedures that you have to do. Just a straight up, hi, how you going? Is this lovely weather? We're finally in winter. I hear the south east leaves blowing and that fish is running. Hey, what's that famous fish they get here and then start a conversation. And you know, because it's Wulga Walga season, the Yaru language is salmon season. You know, whiskers, thread fin salmon season is the best, you know, and if you start that in a gentle yarning approach and you share, and I learned this from a practicing gp, where he shared this to me is you start your consult with that, you yarn. How are you going today? How's your partner? How's the children? How's your mum? Is your grandfather all right? And then you make little notes to that. So the next time they come in, they're not a number, they're not a name, they're a person. And you go, hey, that last time I saw you, you said that you were going on a trip. How did that go? You know, and then that sort of breaks the ice and then you could start going, oh, how are you feeling today? You know, we gotta, you know, do some obs on you and then start your medical consult. But a couple of like five minutes or so into getting that background that sort of sets the scene to then getting you comfortable, to be able to be honest transparent and then share in your care, you know, together.
[00:28:04] Speaker B: I'm really thankful for sharing this yarn. It's been amazing and I'm really excited to see what's going to grow from it.
[00:28:13] Speaker A: It was the ELDAR that alerted us to include fathers in the antenatal care process and that led our team to, after we published this particular paper, to be recognised and win an award on a national level for the Ray James Award and the Health Promotion Journal of Australia. And for our organisations, particularly here in the Kimberley and especially in the Aboriginal Community Control Health sector. We thank them for that recognition and we hope the voices get out there to give supports back to all our families led by that elder.
[00:28:49] Speaker B: Visit our
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