Background:
Aboriginal and Torres Strait Islander women face maternal-child health disparities due to systemic racism, intergenerational trauma, and distrust of mainstream health services. This case study focuses on an Aboriginal woman expecting her eighth child, with a history of child removal, limited engagement with antenatal care, and clinical risks including gestational diabetes and preeclampsia.
Aims:
This case study aims to explore the medical and ethical challenges in providing care to an Aboriginal woman with high obstetric and psychosocial risk, and to identify strategies for delivering trauma-informed and strengths-based family-centred care.
Method:
A case review approach was used to analyse the journey of this woman integrating opportunistic connections, clinical observations, and cultural safety principles. It was reviewed in the context of best practice guidelines for high-risk pregnancies and Koori maternity health, with attention to care barriers, communication strategies, and collaborative birth planning.
Results:
The woman’s fear to engage with services limited gestational diabetes management and preeclampsia screening. Her history of trauma and systemic distrust posed challenges to communication and care. However, a culturally safe, trauma-informed care model - featuring continuity and shared decision-making - facilitated reengagement that focused on education, empowerment, and respectful dialogue about grand multiparity risks.
Conclusion:
This case underscores the medical and ethical complexities in supporting Aboriginal and Torres Strait Islander women with intergenerational and sociocultural trauma histories. Clinicians must move beyond a clinical model to one that acknowledges systemic harm. Trauma-informed and strengths-based practices are ethically necessary and clinically effective in promoting better engagement and risk management.