Abstract
First Nations women and their infants experience significant health disparities compared to non-First Nations populations, including higher rates of gestational diabetes, preterm birth, and maternal mortality. Timely, culturally safe maternal and child healthcare is critical to addressing these inequities, yet many First Nations families report fear, anxiety, and fragmented care when engaging with mainstream health services. This qualitative study explored factors influencing continuity of care and culturally safe practices during the first 2000 days of life, from conception to a child’s second birthday. Using yarning—a culturally grounded research method—nine First Nations families (19 participants, including mothers, grandmothers, aunties, and one father) shared their experiences of accessing healthcare in South Australia. Thematic analysis identified three overarching themes: (1) Bringing culture to the centre of healthcare, highlighting the need for culturally aware practitioners and First Nations health roles; (2) Care is lost when you get jumbled around, reflecting the detrimental impact of fragmented care and lack of familiar providers; and (3) In and out for check-ups, scans, and things—no one asked if I needed help, underscoring rushed, transactional encounters that overlook holistic needs. Families emphasised the importance of trust, relational continuity, and culturally safe environments, noting that First Nations health workers play a vital role in bridging cultural gaps and improving engagement. Conversely, systemic complexity, judgmental attitudes, and reliance on online systems created barriers to care. Findings suggest that embedding First Nations health roles, improving cultural safety training, and prioritising relationship-based continuity can reduce disparities and foster trust. Implementing these strategies within mainstream services has the potential to improve maternal and infant health outcomes and strengthen cultural continuity in care.
Implications for practice: Mainstream health services should embed First Nations health roles and prioritise relationship-based continuity of care. Cultural safety training and clear communication are essential to reduce fragmentation and build trust. Services must create culturally safe environments, simplify navigation, and provide holistic support for families during the first 2000 days.
Notes
References:
Sivertsen N, Anikeeva O, Deverix J, Grant J. First Nations and Torres Strait Islander family access to continuity of healthcare services in the first 1000 days of life: a systematic review of the literature. BMC Health Serv Res. 2020;20(1):829.
Brown AE, Fereday JA, Middleton PF, Pincombe JI. First Nations and Torres Strait Islander women’s experiences accessing standard hospital care for birth in South Australia—A phenomenological study. Women Birth. 2016;29(4):350–8.
Josif CM, Barclay L, Kruske S, Kildea S. ‘No more strangers’: investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling First Nations women in northern Australia. Midwifery. 2014;30(3):317–23.
Commonwealth of Australia. Closing the Gap Implementation Plan 2025. Available from: https://www.niaa.gov.au
McCalman J, Forster D, Newton M, McLardie-Hore F, McLachlan H. “Safe, connected, supported in a complex system.” Exploring the views of women who had a First Nations baby at one of three maternity services offering culturally tailored continuity of midwifery care in Victoria, Australia. Women Birth. 2024;37(3):101583.
Sigma Membership
Psi Eta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Qualitative Research
Keywords:
Health Equity or Social Determinants of Health, Primary Care, Maternal-Child Health Services, Social Determinants of Health, Health Services Accessibility, Medical Care of Indigenous Peoples
Recommended Citation
Sivertsen, Nina; Johnson, Tahlia; Deverix, Janiene; and Grant, Julian, "Cultural Continuity of Care: First Nations Families’ Experiences in Mainstream Healthcare" (2026). International Nursing Research Congress (INRC). 316.
https://www.sigmarepository.org/inrc/2026/presentations_2026/316
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-26
Cultural Continuity of Care: First Nations Families’ Experiences in Mainstream Healthcare
Toronto, Ontario, Canada
First Nations women and their infants experience significant health disparities compared to non-First Nations populations, including higher rates of gestational diabetes, preterm birth, and maternal mortality. Timely, culturally safe maternal and child healthcare is critical to addressing these inequities, yet many First Nations families report fear, anxiety, and fragmented care when engaging with mainstream health services. This qualitative study explored factors influencing continuity of care and culturally safe practices during the first 2000 days of life, from conception to a child’s second birthday. Using yarning—a culturally grounded research method—nine First Nations families (19 participants, including mothers, grandmothers, aunties, and one father) shared their experiences of accessing healthcare in South Australia. Thematic analysis identified three overarching themes: (1) Bringing culture to the centre of healthcare, highlighting the need for culturally aware practitioners and First Nations health roles; (2) Care is lost when you get jumbled around, reflecting the detrimental impact of fragmented care and lack of familiar providers; and (3) In and out for check-ups, scans, and things—no one asked if I needed help, underscoring rushed, transactional encounters that overlook holistic needs. Families emphasised the importance of trust, relational continuity, and culturally safe environments, noting that First Nations health workers play a vital role in bridging cultural gaps and improving engagement. Conversely, systemic complexity, judgmental attitudes, and reliance on online systems created barriers to care. Findings suggest that embedding First Nations health roles, improving cultural safety training, and prioritising relationship-based continuity can reduce disparities and foster trust. Implementing these strategies within mainstream services has the potential to improve maternal and infant health outcomes and strengthen cultural continuity in care.
Implications for practice: Mainstream health services should embed First Nations health roles and prioritise relationship-based continuity of care. Cultural safety training and clear communication are essential to reduce fragmentation and build trust. Services must create culturally safe environments, simplify navigation, and provide holistic support for families during the first 2000 days.
Description
This study explores First Nations families’ experiences of continuity and cultural safety in mainstream healthcare during the first 2000 days of life. Findings reveal that fragmented care, lack of cultural awareness, and systemic complexity undermine trust and engagement. Embedding First Nations health roles and fostering relationship-based, culturally safe care are critical to improving maternal and child health outcomes.