Bridging the Racial Empathy Gap: Enhancing Cultural Responsiveness and Cultural Safety in Aboriginal Perinatal Healthcare

Ayesha Gadsdon

Introduction: Since colonisation, Aboriginal people have endured a tumultuous history marked by great disparities, particularly in perinatal health. The racial empathy gap – where non-Aboriginal healthcare workers struggle to empathise with Aboriginal patients – contributes to these poor healthcare experiences and outcomes (Trawalter et al., 2012; Khatri et al., 2023). This study explores how empathy, or the lack thereof, affects perinatal care for Aboriginal women and investigates the role of culturally responsive and safe care in closing this gap. By gathering insights from Aboriginal women and healthcare workers, this study revised the Cultural Competence Assessment Toolkit (CCAT) (Walker, 2010), tailoring it to further assess and promote cultural safety and responsiveness within healthcare services, now known as the Cultural Audit Tools (CAT, 2024). Methods: To ensure that women’s voices stay central throughout the revision process, yarning sessions were conducted with six Aboriginal perinatal patients and two Aboriginal health workers (key informants). Yarning, a culturally appropriate qualitative research method, enabled participants to share their experiences in a comfortable and respectful environment. These yarning sessions provided deep insights into the lived experiences of Aboriginal perinatal patients, while key informants offered professional perspectives on systemic issues affecting cultural safety. Thematic analysis was used to identify reoccurring themes from these yarns. Findings: Findings revealed that the racial empathy gap manifests in miscommunication, a lack of cultural sensitivity, and emotional disengagement from healthcare workers. Participants reported feeling misunderstood, dismissed, and unsupported during their care. It was also reported that non-Aboriginal workers showing genuine respect and interest in community, having more Aboriginal staff, and workers participating in compulsory, ongoing cultural training would significantly improve their experience. Conclusion: The racial empathy gap in perinatal healthcare continues to impact the health outcomes of Aboriginal women and their babies. Culturally safe and responsive practices are critical in addressing this disparity and ensuring equitable care. Recommendations: 1. More Aboriginal staff be in healthcare roles across all levels. 2. That the CAT (2024) be implemented across all health facilities to ensure culturally safe and responsive practices. 3. Additional steps, such as adopting Coffin’s Cultural Security Scale, be taken to ensure culturally safe organisations.

Bridging the Racial Empathy Gap: Enhancing Cultural Responsiveness and Cultural Safety in Aboriginal Perinatal Healthcare

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