11 hours ago
Bobbi was denied access to an Aboriginal midwifery program in her last pregnancy – and nearly lost her life
After a life-threatening three-day labour, Bobbi Lockyer woke up alone in a single room in the intensive care unit of a Perth hospital with an IV drip in her arm. She had lost five litres of blood and had been rushed to intensive care for an emergency hysterectomy. Her new baby had been discharged while she was unconscious into the care of her now ex-partner.
'I woke up alone and thought something had happened to my baby,' she says. 'I was distraught.'
With three children already, Lockyer thought she was well prepared for the joys and the challenges of a newborn. But during the birth of her fourth child, now eight years old, she experienced a medical emergency. 'While I was pushing, I literally remember telling them, 'Something isn't right, something's going wrong,'' she says. 'I birthed my baby, and then immediately started haemorrhaging and was rushed into theatre.'
The Ngarluma, Kariyarra, Nyulnyul and Yawuru woman says her unease grew throughout her pregnancy. She was moved to another hospital due to zoning changes and was denied access to the Aboriginal midwifery program after being marked as 'high risk', despite repeatedly testing negative for gestational diabetes and her young age. The test is usually only required once between 24 and 28 weeks of pregnancy. Lockyer says she believes she was tested repeatedly because she was Indigenous.
'They said to me I had to do it again and again because there was no way that I would have passed because I was Indigenous and overweight by their standards,' she says. She says it felt like doctors had 'ticked the box to say, 'You're Aboriginal, so you're high risk.' It's racist and it's traumatic.'
She felt pressed to accept an induction and epidural, driven by warnings about her baby's and her own health. Her uterus tore, triggered by too much synthetic oxytocin during her medically induced long labour.
'I was rushed into surgery and woke up in ICU several hours later,' she says. They told me my uterus had torn and I'd never have children again.'
The experience stood in stark contrast to the birth of her three older children, all born at Perth's King Edward Memorial hospital, Western Australia's major maternity hospital, grounded and loved through culture and family. 'Our family – our sisters, our aunties and mum, are very important part of that birthing process. When you're denied access to that – it's incredibly hard.'
Lockyer is one of more than a dozen First Nations women who spoke to Guardian Australia as part of an investigation into alleged racism and discrimination in mainstream maternity services. Aboriginal mothers, midwives and clinicians claim they've witnessed or experienced racial profiling, lack of consent, inadequate care or culturally unsafe treatment – failures they say can erode trust in the healthcare system, contributing to trauma, poor outcomes and long-term fear of seeking care.
Lockyer says she 'basically couldn't move' during a painful post-birth recovery and three-week hospital stay.
'I had a scar from my navel down to my vagina and that took six months to heal,' she says.
Lockyer says the hospital gave her no psychological support, even after her mother requested counselling on her behalf.
'They said they don't offer anything until six weeks postpartum. I remember just laying there in the hospital crying. I'm holding my newborn. I'm supposed to be celebrating this new life, but I'm mourning the loss of my body.'
She says despite a complaint to the hospital, she received no apology, no follow-up or meeting to discuss her concerns. 'We just felt extremely dismissed. Nothing came of it. Nothing.'
Asked by Guardian Australia about Lockyer's allegations, the WA Department of Health said it 'can't comment on individual patients' but it was 'committed to improving culturally safe and respectful care for Aboriginal women and families'. It said it provided 'a number of culturally tailored maternity programs' to support Indigenous women through pregnancy, and worked with Aboriginal health practitioners, liaison officers and midwives 'to help women feel safe and supported'.
'The Department continues to work with Aboriginal communities and health partners to build trust and ensure care is culturally safe, trauma-informed, and responsive to the needs of Aboriginal women and families,' it says.
Aboriginal and Torres Strait Islander mothers are up to three times more likely to die during childbirth than other mothers who give birth in Australia. Their babies are more likely to be born preterm, stillborn or die suddenly.
A birth trauma inquiry by the New South Wales parliament in 2024 heard harrowing testimony of women receiving poor care, including feeling disrespected or coerced, or experiencing unwanted or unnecessary intervention, and a lack of culturally appropriate care.
Dr Marilyn Clarke has worked in obstetrics and gynaecology for more than 20 years. The Worimi woman now works at Coffs Harbour hospital on NSW's mid-north coast.
'The mainstream system is not always a culturally safe space for Aboriginal women, particularly in the maternity spaces [with] the effects of colonisation and effects of racism in the care,' Clarke says.
'I've seen it in action, it still happens. They [non-Indigenous doctors] just don't see it because they're not seeing it through the lens of an Aboriginal person.'
Cultural safety training is slowly increasing awareness among junior doctors and staff but Clarke says it needs to be embedded at all levels.
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'There is definitely an assumption sometimes that [Aboriginal women are] bad mothers, just because of their race,' she says. 'Racial profiling happens big time.'
She says Indigenous women have been flagged for review for child protection services just because they were Indigenous and were therefore considered high risk for intervention, or had experienced a lack of care stemming from unconscious biases.
'Complications might be starting to develop, like infection,' she says. 'Picking up signs and symptoms early, getting antibiotics started … It comes down to engagement with services early but also receiving good care.'
A 2019 study of 344 Indigenous women living in urban, regional and remote areas of South Australia found more than half felt they had been discriminated against or received unfair treatment by hospitals or health services during pregnancy and soon after childbirth.
The same study found Aboriginal mothers who experienced discrimination in perinatal care were more likely to have a baby with a low birthweight, even after adjusting for other causes.
Mikayla*, a midwife from the Torres Strait, has spent the last five years in hospitals and clinics based in Cairns, Brisbane and Thursday Island supporting women through pregnancy and postpartum care. She says she witnessed multiple cases where consent was bypassed or ignored – especially for Indigenous women who spoke English as a second or third language.
'One midwife just grabbed a woman's breast without consent and shoved it into the baby's mouth. No tenderness, no care,' she says. 'I had to step in and say something.'
She has also seen midwives perform vaginal examinations without asking.
'I asked one woman, 'Is it OK for them to be doing this to you?' and she said no. I told the midwife, 'Even if she doesn't speak English well, at least try to ask for consent.''
Mikayla says she knew of women who were left so traumatised by receiving episiotomies (an incision to widen the birth canal) without proper explanation that they feared having more children. 'They feel stripped of their dignity, their self-determination, their right to a decision they didn't give permission for.'
A spokesperson for Queensland Health told Guardian Australia it did not tolerate racism, discrimination or unsafe care. It would not comment on specific cases but all complaints were thoroughly investigated.
Queensland is funding 17 First Nations maternity models of care in state-run and Indigenous community-controlled health organisations, the spokesperson said, as well as programs for more First Nations maternity staff, culturally safe care and wrap-around services. They said consultation was under way to 'understand how First Nations people would feel safer in raising concerns about their own health or that of a loved one whilst in hospital'.
Lockyer says she still felt 'ripped of those first moments' with her son and now feels anxious when accessing health services.
'That trauma is always there. I get really anxious for them, and I just hope that they're receiving the right care.'
* Name has been changed
In Australia, the crisis support service Lifeline is 13 11 14. The Indigenous crisis hotline is 13 YARN, 13 92 76
