AbstractsMedical & Health Science

This research sought to explore whether delivery by repeat caesarean section altered decision making by whānau. Qualitative research in a Kaupapa Māori framework (Māori based framework) was used to explore whānau (family/families) decision making especially regarding delivery by repeat caesarean section or caesarean hysterectomy. This provided knowledge-rich information that was unlikely to result from other medical research methods and methodologies. Ministry of Health (MoH) statistics provided a background for this research and when compared to data for Total New Zealand Women reveal how Māori women feature in NZ maternity data, although the purpose was not comparative. These quantitative data and international research describe indications, risk factors and complications for caesarean section when indicated for Māori women, with a focus on statistics most pertinent to the women in this qualitative research. During this research process limitations in government maternity data collections were identified. This inhibited their resourcefulness when identifying data specific to Māori women, however the risks and indications for caesarean section for Māori women are closely related to findings in international literature on this subject. High risk vaginal deliveries were represented in descriptive tables to explore whether overall lower rates of caesarean section for Māori women but higher rates of emergency caesarean sections could be correlated. By taking part in this research, participating whānau provided knowledge for other whānau about the risks and implications of repeat caesarean section, and for clinicians and health professionals about how this mode of delivery alters whānau decision making. In particular, this research has identified the attributes within whānau that enable their decision making, then it has identified factors that alter decision making by whānau. Findings are also represented in the collective narratives from each whānau, which help us to explore how decision making is altered when delivery is by caesarean section within the Māori Health Framework, Te Whare Tapa Whā. The research findings fulfil Māori Treaty of Waitangi obligation to its partner (the Minister of Health and Ministry workforce) and motivates both partners to participate in improving obstetric services for Māori, reducing barriers to optimal obstetric care for Māori, and enabling obstetrics teams to engage in optimal care for Māori women and their whānau. In particular, this research increases our awareness of decision making by Māori women and their whānau regarding caesarean delivery. As research in this area is limited, this study adds to the current knowledge base.