Melanie Briggs is gazing out at a grassy field, swatting away mosquitoes as we walk through the brush and scrub on a sunny autumn afternoon on the New South Wales south coast. We come to a stop amid the knee-length grasses where the tall eucalyptus trees reach up to the blue sky. Here she unfurls her vision for women giving birth on country.
“I can see the first birth here,” she says. “It will happen at night.”
The birth will take place at a new, culturally safe holistic maternity care centre. The NSW government has committed $45m over seven years to Waminda Minga Gudjaga Gunyah, a local Aboriginal health clinic, for the three-storey Gudjaga Gunyahlamai birth centre. Some of the eucalypts that surround us will have to be felled to make way for the clinic but the wood will be used in the building and to make coolamons – traditional carrying vessels made from the trees will be given to mothers.
“We want [you] to be wrapped in culture when you walk into the space,” Briggs says.
Briggs’ mission is reclaiming the birthing suite and centring the mother’s cultural strength and resilience. The Birthing on Country project aims to decolonise medical care and fuse traditional knowledge and practices with maternity care – improving clinical outcomes for mothers and newborn babies in the process.
“Birth is the first ceremony,” Briggs says, “our sacred birthing practices and bringing them back into a place for Aboriginal women.
“We’ll have smoke going, we’ll cleanse the baby and mother, we’ll use the cultural practices we’re not allowed to use in the system.”
Racism and discrimination
Briggs is a senior endorsed midwife at Waminda, an Aboriginal community-controlled organisation that provides everything from early vaccinations and primary health checks to elder care, mental health services and social support. It has expanded its midwifery services, matching Aboriginal midwives with pregnant women at Nowra’s Shoalhaven hospital to provide accessible, culturally safe support for Aboriginal women and babies during pregnancy, birth and postpartum.
The freestanding birthing centre for low-risk pregnancies is the next big step on the long road to improving maternity services in the region.
A landmark birth trauma inquiry by the NSW parliament in 2024 heard harrowing testimony in about 4,000 submissions detailing women’s experiences of being disrespected, traumatised or coerced into unwanted or unnecessary interventions. In some cases, women were left with debilitating birth injuries, denied pain relief and experienced systemic discrimination and a lack of culturally safe care.
Briggs says she and her colleagues at Waminda have heard first-hand accounts from women who came to the clinic for antenatal and postnatal care of racism and discrimination in maternity wards.
“We weren’t in the labour room, so we had no control over who was walking into the room or who was putting their judgment and their racial acts upon our women and our babies,” she says.
“There was a lack of culturally safe maternity care. Women weren’t accessing care because of racism and judgment. [They are] fearful of child removals, which are still ripe today … What that has created is different layers of trust and distrust within an institution that has caused harm.”
‘Aboriginal women are seen as a risk’
Briggs says she saw racism daily in her early career working in Sydney hospitals.
“As a midwife in the system, I experienced racism,” she says. “That’s the last place I want to work because I’m experiencing it as a minority in that system.”
The midwifery program at Waminda is about building trust. “You’re building a relationship with someone who knows your fears, your hopes, your plans, your dreams,” Briggs says.
Last month Waminda celebrated the 60th baby born in the program.
In just 12 months, Briggs says, they have seen a marked reduction of interventions such as inductions of labour, caesareans and instrumental births: 72% of labours have been spontaneous, 94% of births happened at full term and 80% of mothers are breastfeeding. “Mums and bubs have come out of their birthing experience with more power, more understanding and more nurturing,” she says. “Women can make these decisions with their midwives.”
Judgment and discrimination still happen in healthcare settings, says Carly David, a midwife and registered nurse who has been with Waminda for 12 years.
“As a non-Aboriginal person here, my journey has also been about unlearning,” she says. “In a mainstream public system Aboriginal women are seen as a risk. They’re seen as a clinical risk but [the mainstream system] can be a risk to Aboriginal women because they’re labelled and judged. Aboriginal women thrive when they’re cared for in a culturally safe way.”
As we speak, David stops to take a call from a mother worrying about her new baby: high fever, feeding poorly, vomiting. She conducts a rapid assessment, asking the worried mother for details and gently advising her to take her child to the local hospital.
A few decades ago, in her mother’s generation, Briggs says, Aboriginal women weren’t allowed to access maternity services in local hospitals. Women would give birth in segregated wards or on hospital verandas.
She says women sometimes walked as far as 15km to a hospital to give birth. “Many babies during this time were born sleeping.”
The Minga Gudjaga Gunyah clinic is in a house on a tidy street just a few minutes’ walk to the hospital. There are no healthcare workers rushing through clinical corridors in scrubs. Instead, the midwives and practitioners wear T-shirts from Waminda and Indigenous-owned brand Clothing the Gaps. In the waiting room there are woven baskets of full with baby clothes and colourful paintings and shell designs created by local women decorate the clinic.
There’s a kitchen with a table and chairs surrounded by evidence of the program’s achievements: the birth statistics and weight records of those first 60 babies.
For the clinic’s patients, many of whom carry trauma from negative experiences with healthcare services or past births, it does not feel like a standard doctor’s or midwife’s room.
‘Life-changing’ service
Kimberley Ray is a mother of five children; her second pregnancy was an unexpected set of twins. She’s experienced a range of births and antenatal care: at Waminda; at the local Nowra hospital; and at Westmead hospital in Sydney. Her twins were a high-risk pregnancy so she spent a lot of time resting in bed at Westmead to prevent a preterm labour. Her family and friends were two-and-a-half hours’ drive away. “It was really tough, very isolating and I felt really unsupported,” she says.
She says caring for her newborn twins after her caesarean was a challenge with little support beyond a hospital lactation consultant. Born at 37 weeks, the baby boys were small. “I’d just had the surgery and you’re lying in the bed and it’s hard to look after one baby – let alone two,” she says. “They were just kind of like, ‘Well, you just have to do it’.”
During her last pregnancy, with her seven-month-old daughter, Ivana, Ray experienced perinatal depression and anxiety and was supported by a Waminda midwife through her antenatal appointments and underwent a caesarean at the local hospital.
“I felt held the whole way through,” she says. “Waminda really carried me and my daughter’s spirit and soul before she even entered the world. It brought me back to the mother I was. It was life-changing.”
Her midwife, well versed in her previous birth histories, gave her “a moment to breathe” throughout the surgery, as machines beeped in a busy bustling hospital.
“Taking her there, I still feel that,” Ray says. “Ivana is loved as if she was family.”
Back at the birthing centre site, Briggs says construction will begin soon with the first births expected by the end of the year. “We’ve been given the responsibility as women to take this on because it’s needed, it’s so desperately needed,” she says.
