Cultural safety is an essential component of healthcare, improving trust and communication between midwife and client, and allowing for optimal outcomes and experiences. Registered midwives in the province of BC are proud of the principles of informed decision-making, choice of birthplace, continuity of care and positive interprofessional collaboration, all of which can be compromised if cultural safety is neglected or absent. The purpose of this statement is to clearly convey the position of the MABC that all registered midwives and student midwives should formally and meaningfully engage in cultural safety training as an integral part of their commitment to serving BC families. In order to be partners in reconciliation and to uphold Indigenous rights, all midwives must strive to provide culturally safe care that contributes to positive Indigenous health outcomes.
Cultural safety is a term that has been defined from several angles. The following are three descriptions:
As part of an initiative to address challenges around recruitment and retention of Indigenous Maori nurses, the Nursing Council of New Zealand amended their standards to include cultural safety into their curriculum assessment process in 1990. The concept was introduced by Irihapeti Ramsden, a Maori nurse in Aotearoa (New Zealand). This initiative started the conversation about cultural safety in health care on the world stage, and in particular, where colonial relationships exist, such as in Canada. Canada’s colonial context is a lived reality for all Canadians regardless of their status or location in society, or their perception of the impact of the colonial relationship.
The MABC understands that Indigenous health outcomes go hand in hand with the availability of culturally safe health care providers. Cultural safety training is a basic first step towards culturally safe care, which itself is a step towards reconciliation. As such, the MABC commits to advocating the following Calls to Action by the Truth and Reconciliation Commission:
According to the Truth and Reconciliation Commission, adequately addressing reconciliation requires an Indigenous Rights lens. In consideration of the rights of the Indigenous families and communities BC midwives serve, and in accordance with the United Nations Declaration on the Rights of Indigenous Peoples, the MABC affirms:
In order to increase cultural safety within midwifery in BC, the MABC commits to the following actions:
The MABC understands that these are but the very minimum and initial steps required to build cultural safety within BC midwifery and only the beginning steps towards reconciliation. Continual work is required on an individual level to meaningfully engage on a path towards culturally safe care and reconciliation. The MABC is committed to improving cultural safety within BC midwifery to contribute to stronger, healthier Indigenous communities and the full realization of their rights.
First Nations Health Authority
Indigenous Physicians Association of Canada & Association of Faculties of Medicine of Canada. First Nations, Inuit and Metis health core competencies. A curriculum framework for undergraduate medical education. Ottawa, 2008.
National Aboriginal Health Organization Cultural Safety Fact Sheet
The Health of Aboriginal People Residing in Urban Areas
Nursing Council of New Zealand
Truth and Reconciliation Calls to Action
United Nations Declaration on the Rights of Indigenous Peoples