Trauma-Informed Care and Equity in Group Pregnancy Care for Women of Refugee Background: Reflections from the Workforce

Abstract

For women and families of refugee background having a baby in Australia, trauma-related experiences contribute to maternal and neonatal health inequities. Group Pregnancy Care for women of refugee background is a new model of care that was codesigned with communities of refugee background, to incorporate a trauma-informed approach to care. The aim of this paper is to explore how trauma-informed care is understood by Group Pregnancy Care professional staff. An exploratory descriptive qualitative study involving twenty-three semi-structured interviews with past and present professional staff was conducted. Data were analysed using reflexive thematic analysis. The results reported in this paper include five themes: acknowledging the universal potential for trauma; accountability to community; practising in trauma-informed ways; how can we determine whether trauma-informed care is happening?; and understanding equity. The analysis showed that GPC staff aimed to practise in trauma-informed ways and understood that their ability to integrate trauma-informed care could improve over time. However, there were times when participants perceived organisation- or structural-level barriers that were incongruous with their understanding of health equity, which created tension and led to feelings for some of being in a ‘battle against the system’. Key individual- and organisation-level factors were identified that assisted with integrating trauma-informed care, including a safe and accessible space to hold the program, strategies to minimise the risk of retraumatisation and burnout, and adequate time to facilitate group processes and support staff to participate in team reflective practises. Understanding trauma-informed care and equity were seen to have important implications for workforce wellbeing and the promotion of refugee maternal and child health.

Keywords

• trauma-informed care
• health equity
• health professionals
• refugee populations
• group pregnancy care
• qualitative study