Transcript for
When I got the news: Research to support Aboriginal fathers through inclusion

Erica Spry (00:01): 

Men’s health matters, men’s roles have changed, and it’s good to get in there and strengthen the family, and this is what this study has demonstrated. Let’s start getting in there, let’s start strengthening and supporting our men; especially expecting fathers. Because what came out a lot in the study as well is that once you became a parent, especially the fathers, you started reflecting on your childhood: “Was my dad there? How can I be a better father?” 

Announcer (00:31): 

Welcome to the Emerging Minds Podcast. 

Rosie Schellen (00:36): 

Hi, I’m Rosie Schellen, and you’re listening to an Emerging Minds Podcast. 

(00:41): 

But before we begin, I’d like to acknowledge the land, seas, and waterways of the Yarradugun peoples in Broome and pay my respects to the ancestors, elders, knowledge holders, and future generations, and for the nurturing care they have provided to this country for over 60,000 years. 

(00:58): 

In this episode, you will hear from Erica Spry and Zaccariah Cox as they share what they heard when speaking with expecting and new fathers in rural and remote communities of Western Australia. 

(01:11): 

Thanks for speaking with me today, Erica and Zac. Firstly, though, could you tell me a little bit about yourself? 

Erica Spry (01:16): 

So my name is Erica Spry. My Aboriginal Bush name is Roobinjin and I always start with that I’m Shadowland’s daughter. 

(01:23): 

So we’re up in the Kimberley and just out of Broome, Bardi Jawi Country, so I’m connected out there. I’m a traditional owner, so grew up out on country, and all around the place really. And I’ve got family over in the East Kimberley, Kija family over in Warmun community, Turkey Creek. So I travel through the Kimberley, but across Australia, then stayed in here. It’s home here. 

(01:49): 

So I work for two organisations. So the first one is the Kimberley Aboriginal Medical Services as a research officer and then with the University of Western Australia, the Rural Clinical School as a Research Fellow. 

Zaccariah Cox (02:01): 

And Zaccariah Cox, I’m of the Nimanburru people, a bit south of Erica’s country there, the Bardi Jawi people there, and also the Kija people as well, from around the Warmun Turkey Creek Country there. And I’m the Social and Emotional Wellbeing manager at KAMS here in Broome. 

Rosie Schellen (02:21): 

Tell me a little bit about the work you’ve been doing in the antenatal period that Aboriginal men. 

Erica Spry (02:27): 

One of the projects that I got to be a part of in the Kimberley was actually starting off working with the women up here, so Aboriginal women in the Kimberley region, and we were wanting to have conversations and find out how do we improve antenatal care? How do we make it better for the mum and the pop? And so we focused a lot on women and improving this system, in that way they’re meeting their needs. 

(02:52): 

Through that process we did a qualitative study, and I was called out around the Kimberley to various remote communities and towns. And in particular I was in Broome one day and I was tracking down a mum that fitted our criteria to have an interview and in order to get to her I found her mum, and I said, “Where’s your daughter? We’re trying to interview so we can improve antenatal care.” And she goes, “Why is it that you always just focus on the woman, the mum? It takes two to make a baby. Why don’t you start including the fathers?” 

(03:32): 

So this is a senior elder here in Yarra country, and I’m being told that, and I’ve been brought up by my elders and for all our family’s best interests, and so I had to really listen here. And being in this wonderful space of health research, I was in an opportunity and a place where I could go back and say to the team, look, we’re getting direction by a senior elder to include fathers, because there’s a huge gap there. We must respect what she’s saying. 

(04:04): 

It’s always focused on the mum, expecting mother, but the father’s involved, too. So how do we start going forward to include our expecting fathers and really start to work towards the family unit of care as a model of care for the family? And so that’s how it evolved into getting the men’s paper started. 

(04:29): 

And we did a little bit out in other areas, but we came back into the Broome area, and then Zac came along. And between us we did a few of the interviews. Zac went out and scoped out a few and on my side I had to go with culturally-appropriate family kinship, where I could actually go out and say to a brother of mine, like a cousin-brother, or I could go out and say to one of my older sons, my nephews, you’d just become a dad, or you’re expecting your first child. We want to include fathers. And do you want to be a part of sharing your story so that we can start to amplify, I suppose, the needs of their fathers? And then take it from there how we could work this into the system to be able to deliver better services, not just for the mum, but the father, and possibly forward planning as a family unit. 

(05:32): 

And so I managed to get a couple of the interviews done and they felt in a safe place to share and I think they felt relieved, too, that someone heard them, and they were being heard, and that we could go back and try to make things better for our families. Because you find a lot of our mob, they’re just waiting for that opportunity. They just need that voice to be heard so that then you can help others in other levels advocate their needs, right down at the grassroots, community level, you reaching their systems or their policies and that to change to make it better for our whole community, the individual, the family, and then it ripples out to your community. 

Zaccariah Cox (06:16): 

Yes, I think Erica’s covered the beginnings to why and how interviewing men about their experiences with antenatal services and pregnancy came about, and why I got involved pressured. I wasn’t working with the research team there, but was strongly encouraged to come and help out and to assist the team in conducting, or performing, the interviews with Aboriginal men in Broome and obviously with my local knowledge of the town and men whose partners were expecting, or who I had the knowledge of that their partners were pregnant, that was helpful in a sense as well, having that community knowledge about who to reach out to contact, to gauge, or to check their interest in being interviewed with their experiences with the antenatal services. 

(07:06): 

So I agreed to helping out and to assisting with these interviews. Research was new to me at the time and so I thought it was a good opportunity to get some professional development and some learning in a different field, and I really took it on board and started to reach out and lock in some interviews with local men in the town who pretty much all of them I had relationships with, whether they were friends, whether they were family members. Or whether we were known to each other. That was quite, I suppose, rewarding as well, in a sense, to be able to encourage men to talk about their experiences. 

(07:41): 

Because we know men find it hard sometimes to express their feelings, and their experiences, and what it’s like for them when their partners do become pregnant. I think, as Erica identified, a lot of the focus is on the women, which we understand that it needs to be, but understanding and moving away from the traditional pathways, and processes, and procedures to caring for and looking after women who who’ve become pregnant and identifying and acknowledging that obviously men play a big part in that as well, and trying to understand their perception and their experiences through that process as well, was quite rewarding. 

(08:23): 

And obviously men, I found when I interviewed them, they found that reflecting back on their experiences was really helpful to them as well, in a sense. It gave them more of a clear understanding or what was happening for them, and how important it was for them, and how they had got to the point at that point in time and feeling how they felt I suppose, if that makes sense. 

(08:45): 

So what did you hear? What were the things that you heard? 

Zaccariah Cox (08:48): 

That the men felt the responsibility obviously of such a big change, I suppose, in their lives and understanding that their lives were pretty much going to change in a significant way. 

(08:59): 

The second part of that was that they felt it important to be a part of attending antenatal services, and being involved with antenatal care of their partners. Some of the men reflected by saying that they weren’t too keen in attending some of the antenatal classes, but they’d obviously attended, and forced themselves or pushed through to attend with their partners, and the outcomes were quite promising, or they felt that they’d learned a lot out of those classes, and had really valued attending, and were thankful that they did go to attend those classes whilst being reluctant. 

(09:33): 

In the first instance, one person in particular even went as far as downloading a development app, a baby development app, to check every day and every week on the different stages, and the different growth patterns of the child or the baby at the time. I suppose one of the concerning findings was that all participants had experienced three or more significant stresses in their lives during the antenatal period, and at the time of the interview. 

(09:58): 

And they ranged from things like financial problems, employment problems, accommodation challenges, and family problems as well, which included people passing away in their family. So that was quite not surprising for me as an Aboriginal male and father myself, but obviously really identified and pointed out that know our mob and our mothers and our fathers do experience significant stress during that antenatal period, when it should be a smooth and a calming time where people shouldn’t have to worry about those things, but we know that’s the reality for a lot of our people up here and across Australia. 

Erica Spry (10:34): 

They were the key themes, but I think the other thing is that some of them did attend to antenatal appointments throughout the practise here when they could, otherwise they were out of town for work, and that was one of the big factors that we identified. A lot of FIFO work around here. 

(10:52): 

But when they did attend the health service, some of them felt included, they were heard, they could ask questions, and others didn’t really feel that they were met in a cultural-appropriate way. They then called out how can we get perhaps an Aboriginal health worker or practitioner in the maternal child health team, so that when the mother does present at an antenatal clinic, there’s a male Aboriginal health worker practitioner there and say, “Hey dad, how are you going today?” 

(11:24): 

And some of them felt like they weren’t asked how they felt, they’re expecting father, but no one asked how they felt. It was all focused on the mum and the bub’s development, fair enough. But as the father, he was also experienced all those emotions as well, but no one did a check in on him. 

(11:43): 

And then when you went to look at the resources, it’s all woman focused, and it’s all baby focused, but the father felt, “Can I get some resources here, some flyers, some pamphlets, and can someone one-on-one explain to me as well? Perhaps she’s in one of those days where she’s finding it trying, and I want to be her support, and make sure that I’m doing the best that I can, that we’re doing changes together to prepare for the baby’s arrival, but who’s checking in on me? And can I have, perhaps, separate appointments in this only antenatal space where I can say, ‘Tell me what she needs’ or, ‘How can I best support her?'” 

(12:26): 

So this was reflected in the paper as well, and it’s what Zac had brought up. It’s not your traditional style. This particular cohort of men shared this, but in the Kimberley we also know diversity as Aboriginal people. We’ve got many languages. So we have over 26, 27 different Aboriginal language groups, and we come from different countries. Even though we’re a Kimberley region, we’re quite diverse in that note. 

(12:53): 

And so we’ve got traditional cultural practises where we do our law and culture customs, and so some of the fathers will have cultural-appropriate ways where they only want to know minimum of any antenatal care stuff, whereas others are contemporary. And I don’t want to sound like I’m judging, but everyone is allowed to be how they feel it suits them. It’s their type of model of care for themselves. And I say it’s case-by-case. 

(13:20): 

And so when a mother is birthing and if you’re traditional, the father will wait outside, whereas others want to be in the room with their partner and actually do one-on-one supports. So we don’t discriminate against the Aboriginal person, we’re not here to divvy up all that type of statuses there, we simply say that when someone presents at the antenatal clinic that they meet the mother and father, should the mother and father want to come along. But just extending that out there is the beginning to really getting the family unit together. 

Zaccariah Cox (13:56): 

For a lot of Aboriginal men, times are changing. And for a lot of Aboriginal men, we are finding it important now that we do have a big part to play in pregnancy, and looking after yourself, and looking after your partner, being involved with the antenatal care services being at the birth. A lot of the men were planning to, intending to be at the birth, in the room. 

(14:17): 

I know I was, myself, at the birth of my daughter and in the room with my daughter, which I’m pretty sure my father wasn’t. But the times were different back then in those days, and no one’s fault, no one’s to blame. And even if that’s still the case in different areas across the Kimberley and across Australia where men stay out of our women’s business, which includes pregnancy, then that’s right, too, for them or for that mob. There’s no right or wrong answers in how people are progressing, and how people are progressing culturally, and how people want to stay, and what they want to believe and follow. And obviously others have different ways of thinking, and different perceptions and understandings of what their role is and how involved they should be I suppose. 

Erica Spry (14:59): 

This study, we see it as opening the door, that currently it’s female focussed as mother and bub focussed. And so this was a sample frame to start that conversation, to start that spotlight that fathers do want to be included. What Zac spoke about, it was not what we had planned to. We’re not here to exclude anybody, we want to include as many people as we can, but this particular cohort was opening the door to start the conversation. 

(15:31): 

And so when we now look forward to that we want to do further in this space, we then want to be able to bring others in from all the background that we spoke on. Men’s health matters, men’s roles have changed, and it’s good to get in there and strengthen the family, and this is what this study has demonstrated. Let’s start getting in there, let’s start strengthening and supporting our men, especially expecting fathers. 

(15:58): 

Because what came out a lot in the study as well is that once you became a parent, especially the fathers, what Zac shared, you started reflecting on your childhood. “Was my dad there? How can I be a better father? I better start making changes now, and as a family we’re going to do changes together to really give our child the best start.” 

(16:22): 

But they called on health services to hear them, and invite them in, and include them in the care. But they also respectfully said, we know mum and bub comes first, but wherever opportunity is available, please include the fathers and have that conversation. Do the check-in, “Mum, are you feeling comfortable today? Are you calm? What about you Dad? Dad, how are you?” 

(16:48): 

On the other cultural side of it, too, is that the fathers would go out on country, and go fishing, and their little fishing trips, all the know that all come together, and share stories and get tips on how to better parent, or what might be coming along. And they also reach out to the extended family. 

(17:08): 

So in Aboriginal families, it’s not just your nuclear mother, father and child or other siblings, it’s our extended family know our cousins are our brothers or our sisters, and our uncles are our dads. And we’ve got many grandfathers and many grandmothers. And so you go and look in the family and you go, “Well look at their style, that’s a good role model. They’re up to number baby three, I’m going to go get some tips from that brother, and then I’m going to go see the other brother over here, and I’m going to get some tips from him.” 

(17:41): 

So that’s how our men have been functioning. They’ve been going out there on our Aboriginal extended-family supports, and this is great because the more support you have, the more protective factors you’ve got, and you’ve got that father feeling well, you’ve got the mother feeling well, you’ve got the family feeling well, and that’s what we want: best starts. 

(18:01): 

And if you’ve got the mother and the father connecting with that baby before the baby’s born, and a lot of what came out in the paper is they, most of them attended the antenatal scan. They wanted to know boy or girl know and others just know where they’re developing. But it’s connecting. It’s that first connection. And then what they say on the statistics is that that grows their family to be stronger to then take on what life is about to bring. 

(18:30): 

It provides a unique opportunity, doesn’t it? 

Zaccariah Cox (18:32): 

Yeah. 

Erica Spry (18:32): 

Yeah. 

Rosie Schellen (18:33): 

Did the men speak about their experiences with mainstream or non-Aboriginal health services? 

Zaccariah Cox (18:38): 

Well, in Broome, and the way that the system works here, is that I think the early stages you can just go to your AMS to see your GP and the maternal health nurse. But for the scans and as the pregnancy progresses, that’s when people have to go to the hospital to use the government service. And obviously if the relationships between the health professionals at the AMS and the hospital are good, and you’ve got the same people there, then it’s usually a pretty smooth process. 

(19:06): 

But given the high turnover of staff we have in the Kimberly with maternal health nurses, obstetricians, GPs, sometimes that can be a bit frustrating for anyone. And then especially with our mob, having to see a new specialist, or a new health professional, halfway through or towards the end of their pregnancy, this is common for anyone, but with our mob, they like consistency I suppose, and to build that trust takes a bit of time. 

Erica Spry (19:31): 

What Zac’s saying is, you’re 40 weeks gestation in your pregnancy, and your clinic is the main place, your primary healthcare, and then your secondary as you go to the hospital through that 20 or 40 weeks gestation, you got various tests at the time, and a lot of the comments coming back from the fathers was, “Can you explain what these tests are? Because telling the mum and then how am I supposed to support her when I’m not sure about it as well? And then is she able to hear the healthcare provider so that she is listening to understand what is being said to her?” 

(20:07): 

Because sometimes if you’re a first mum or that’s the third child, not every pregnancy is the same. So you can’t assume that they’re all the same, or the mother knows better because it’s a third child. No, every pregnancy is different. And so you imagine a father’s point of view that they had a little bit of complications with the second child, and so he’s extra worried about this third baby coming along. If he’s not included in the consult, how is he going to support his wife? 

(20:38): 

So these are real issues, and it varies what Zac’s touched on. And we have shared care here. So you’re always exposed to different health professionals along that antenatal period. In your local AMS to private GP, general practitioner, or over to the hospital. And you’re in the ultrasound setup, or know you’ve going in on the ward, and you manage to go and get a maternity visit before the birthing takes place. 

(21:09): 

So this is what mothers are subjected to. But fathers as well know going in and scoping out the maternity ward before the arrival of the child going into birth, because as soon as she goes into, “Oh, the baby’s coming,” you imagine the father. He doesn’t know. Is this a fast process? Is this a slow process? How do I go about here being actual supports? 

(21:32): 

Because when you’re into that third stage, you don’t know how your birthing’s going to go. Everyone wants a great outcome and this is what the father wants, he wants it all to go smooth, and unless he’s informed, how can he bring that extra support in there? Because he’s the first in the relationship and then our extended family come in. And the beauty about our families, and our fathers, and all that, we’ll all get in there behind them, too. I’ll say, “What now, bro? How you going?” Or, “Tag, you want to have a yarn?” 

(22:04): 

So it’d be good if in the services that they have that space because some of our expecting fathers and brothers sometimes don’t want to go to a family member. They’ve had a fallout with someone, and they want to go to a service provider because they might want privacy. That might be their style of how they want to understand things better to be able to be that support for the partner. So I think that they should be given these options, and it’s time that this happens. We just hope that message gets out there. We get a change in the primary health provider, that we get a change in our child maternal health units, that they do bring in Aboriginal health workers and practitioners, and male ones to support the expecting father, and females as well. 

(22:52): 

But I think that that’s the best beginnings for all our children going forward. And this is also a reach out I say, too, not just for Aboriginal fathers, but maybe all fathers of all ethnicities out there, too. But look, I think they were just glad to share their stories and really say, “this is how we’re feeling” and open that door for other fathers so we can think about them. 

(23:17): 

The cultural one that’s got a different type of balancing in their life. They’re coming in from a remote community because their partner has to go do a scan at 20 weeks, and the baby’s not looking well and then all of a sudden she’s going to be flying down to Perth to have the baby, and where does that leave the father? He’d probably want to go as the first baby, or maybe as the second one, or the third one, and he has to get two babies babysat so he could go down and help his partner. 

(23:45): 

Because this is real world here, this is lived experiences here all happens and fathers that have all this, but I call out to the fathers that aren’t able to be there for their partner, because they are breakups as well, and so you’ve got to be a bit sensitive of dealing with a partner like a mom where they’ve separated in a relationship. 

(24:07): 

But this is why you do case-by-case, and then you weigh up the sensitivity of it, and you always do the risk factors. What is the risk involved, or what are the protective factors? How can we get a better model of care or support for our fathers, but be mindful to the expecting mother. 

(24:25): 

Have they got a good relationship, or do we need to be mindful on our approach? And how do we culturally do this? What’s the culturally-appropriate way? What’s a culturally safe way? And not just saying these words, but actually put it into practise. As soon as they walk in, they feel welcome. The room is where they’re comfortable, they’re greeted well, and just that common gesture to make someone comfortable and just allow that space. 

Rosie Schellen (24:52): 

What would your advice be for a non-Aboriginal, say a health worker that’s just started with a mum, what advice would you give to step out of the square and to start those conversations for that where the system doesn’t support it? 

Zaccariah Cox (25:05): 

I think it’s just, where possible and where people can, be as open-minded to the point of trying to understand the mother. And, if the father’s there, trying to hear their story, where they’re at in terms of their lives and the pregnancy and learning about what they’re experiencing at home in their lives to be able to treat them or provide care in a way that reflects how they’re feeling at the time. 

(25:27): 

Again, I would say, really, valuable cultural awareness training as well to help not only to get a start staff and start new to the area, understand the context of the community of the town that they’re working in, that the different tribal groups that the different Aboriginal groups that obviously reside in that town, the different families, and the different dynamics of town or community life. Talking to Aboriginal GPs and nurses, if they’re in the organisation, about how they should be approaching providing care, using health workers as well as a go-to prompt what they should be looking for, what questions they should be asking that sit outside the clinical documentation, or the clinical resources that are currently in use. 

Erica Spry (26:09): 

So when you’re in front of an Aboriginal person, and take all that into account what Zac has shared, you’re coming in up here into the Kimberley, it’s diverse. Not all Aboriginal people are the same. That’s right across Australia, and that is true. And in this particular region, like the languages of the 26, 27 different languages, our ways, our styles of doing things. 

(26:32): 

But what’s the most common thing you do with a person? Is you just have a yarn. And sometimes you don’t have to go straight into the medical consult, or the procedures that you have to do. Just are a straight up, “Hi, how are you going? It is this lovely weather. We’re finally in winter, I hear the southeast blowing and that fish is running. Hey, what’s that famous fish they get here?” And then start a conversation. 

(26:58): 

Because it’s a Walgawalga season. In the Jawi language is salmon season. Whiskers, threadfin salmon season is the best. If you start that in a gentle yarning approach and you share… I learned this from a practising GP where he shared this to me, is you start your consult with that yarn, “How are you going today? How’s your partner? How’s the children? How’s your mom? Is your grandfather all right?” And then you make a little notes to that so the next time they come in, they’re not a number, they’re not a name, they’re a person. 

(27:34): 

And you go, “Hey, that last time I saw you said that you were gone on a trip. How did that go?” And then that breaks the ice, and then you could start going, “Oh, how are you feeling today? We’ve got to do some obs on you” and then start your medical consult. But a couple of five minutes or so into getting that background, that sets the scene to then getting you comfortable to be able to be honest, transparent, and then share in your care together. 

Rosie Schellen (28:04): 

I’m really thankful for sharing this yarn. It’s been amazing and I’m really excited to see what’s going to grow from 

Erica Spry (28:13): 

It was the elder that alerted us to include fathers in the antenatal care process, and that led our team to, after we published this particular paper, to be recognised and win an award on a national level for the Ray James Award in the Health Promotion Journal of Australia. 

(28:31): 

And for our organisations, particularly here in the Kimberley, and especially in the Aboriginal community control health sector, we thank them for that recognition, and we hope the voices get out there to give supports back to all our families led by that elder. 

Rosie Schellen (28:49): 

Visit our website at emergingminds.com.au to access a range of resources to assist your practise. 

(28:56): 

Brought to you by the National Workforce Centre for Child Mental Health. Led by Emerging Minds the Centre is funded by the Australian Government Department of Health and Aged Care, under the National Support for Child and Youth Mental Health Program.