What does 'Birthing on Country' mean? A qualitative study of delegate interviews from an Australian national...

Evidence shows Birthing on Country services are cost-effective and improve outcomes for First Nations women and newborns. This has led to increasing reference to Birthing on Country; however, the term has varying meanings and definitions, resulting in misunderstanding and inaccurate use.

In 2022, over 240 delegates from across Australia convened in Mparntwe to build a collective vision and address persistent inequities for First Nations families.

Our aim was to explore delegates' understandings and meanings of 'Birthing on Country' as captured in videoed interviews.

An exploratory qualitative study design was used, involving participants recruited through purposive and convenience sampling. We applied reflexive thematic analysis remaining closely attentive to participants meanings.

Seventy-seven delegates participated in interviews. Analysis generated seven themes: (1) diversity:meaning different things to different people; (2) connections between humans, Ancestors, lands, seas, and the non-human world; (3) all babies in Australia are born on First Nations Country; (4) feeling safe, supported, and healthy; (5) cultural practices and revitalisation; (6) learning and being guided; and (7) First Nations rights and justice.

This is the first study to explore what Birthing on Country means across a diverse range of stakeholders.

Findings demonstrate Birthing on Country's potential to redress colonisation and advance health equity for First Nations women and communities. The study offers a shared understanding grounded in connection, cultural identity, and reproductive justice, with insights to guide future service design and delivery for Australian First Nations families.