'Pockets of compassion': When relationality makes a difference in First Nations women's and families' maternity care experiences - a qualitative study.

PROBLEM: First Nations women in Australia continue to experience disproportionately harmful and inequitable maternity care shaped by systemic racism, intergenerational trauma, and culturally unsafe practices. BACKGROUND: In the Australian Capital Territory, maternity care is provided through Western biomedical systems that frequently fail to provide culturally safe, relational care. Racism, mistrust, and fear within these systems contribute to trauma, avoidance of care, and diminished wellbeing among First Nations women and families. AIM: To explore First Nations women and families' maternity care experiences in the Australian Capital Territory and understand their vision for restorative, culturally safe care. METHODS: Kapati Time Yarning, an Indigenous Research Method that centres relational storytelling, was used to gather the stories of 14 First Nations women, partners, and family members between October 2024 and March 2025. Transcribed data were analysed using reflexive thematic analysis. FINDINGS: Amid broader harms, participants recalled 'pockets of compassion' where health professionals listened, believed women, acknowledged grief and loss, validated prior harm, and remained present amid vulnerability, which participants described as transforming grief and trauma into healing. DISCUSSION: These findings suggest that compassionate care, as experienced by participants, can transform fear and grief into acts of solidarity, reinforcing the fundamental need for relational, restorative, and culturally safe care in maternity services. Despite its transformative potential, such care was limited and inconsistent, often provided after institutional harm. CONCLUSION: These findings extend beyond maternity care, calling for restorative, compassionate practices to be structurally embedded across systems rather than relying on pockets of goodwill, establishing respectful, relational, and culturally safe care as the norm for First Nations families.