Patient-Defined Cultural Safety in Perinatal Interventions: A Qualitative Scoping Review.

Abstract

Cultural safety is an approach to patient care designed to facilitate respect of patients' cultural needs and address inequities in care in culturally diverse situations. Much literature considers culturally safe care during the perinatal period, yet little is known about how patients experience and understand cultural safety. This is despite patient-defined care being one of the definitions of cultural safety. This scoping review investigates what is known from existing qualitative literature about patients' experience of cultural safety frameworks in perinatal interventions. A search for "cultural safety" OR "culturally safe" in PubMed, Ovid Medline, Ovid Embase, Cumulated Index to Nursing and Allied Health Literature, Scopus, Scielo, and Latin America and the Caribbean Literature on Health Sciences returned 2233 results after deduplication. Title-abstract and full-text screenings were conducted to identify qualitative studies of cultural safety from perinatal patients' perspectives. Seven studies were included in the final analysis. Data were open coded using NVivo. Three themes were identified: (1) care that acknowledged that their lives were different from patients in the dominant culture, (2) receiving care in community, and (3) care providers who respected their choices and culturally specific knowledge. This research shows how cultural safety intersects with other equity-based frameworks used in midwifery and obstetrics. Building on this research could lead to new protocols that address complex social and physical needs of marginalized people during the perinatal period.