Moving Forward Together in Aboriginal Women's Health: - Theses ...

Moving Forward TogetherJanet KellyI asked the young women if she had any specific types of contraceptionalready in mind (she didn’t), and what her personal priorities were; wasit highly effective contraceptive cover, addressing period problems,prevention of sexually transmitted infections etc. Did she prefer to takesomething orally every day or have a ‘set and forget’ method like animplant or injection? These questions I wove into the conversation(rather than firing them off one after the other as they are written here).Then we discussed any medical issues that may impact on herdecision, and she indicated that she recently saw a doctor after she had‘blacked out’ (fainted). I wondered aloud if it could have any impact onthe kind of contraception she could choose and asked if she knew thereason for fainting. She looked at me carefully, and then after a momentsaid ‘well actually, it ended up that it was about spiritual things notmedical’. She explained that she saw a doctor and was told she wasmedically fit and healthy. After discussing with her family the situationthat led to her fainting, she discovered that the event was linked todeeper cultural / spiritual things and was taken out bush for dancingand ceremony.I felt that this was a turning point in the consultation and that what I saidand did next would be very important. I could ignore this information, asbeing not relevant to our consultation, ask questions about herexperiences which may not be appropriate for me to ask, or incorporatewhat she was saying into the consultation. From her conversation toneand non verbal communication, I felt that she had told me, the women’shealth nurse, as much as she wished to about this highly personal andspiritual experience. I wondered what to say when I remembered theadvice of Ros Pierce, an Aboriginal mentor; ‘if you don’t knowsomething, then ask’. I was also aware of the other women waiting inthe waiting room, and so there were some pragmatic timeconsiderations.I asked, ‘with this spiritual side of your life, do we need to consider howcontraception may affect that or visa versa? Is it important that you stillcycle with the moon, because if you take the pill, or some of theprogesterone’s, your periods will come at times set by thecontraception, not nature’? She said she was not sure, and would askthe Aunties (Elder women).I then suggested that we could look at a range of options, so that shecould take the information away, talk to whichever members of herfamily that she needed to, and think things over. She agreed that wouldbe a good idea. I asked if she would like some condoms to providecontraceptive cover until she was able to make a fully informeddecision. The young woman then volunteered that her partner was aTraditional man.Again, I was not sure what the significance of this was for what we werediscussing, so I asked if her partner was Ok with wearing condoms..She said she wasn’t sure but would take some and see. I then sharedinformation about sexually transmitted infections, suggesting that if shedidn’t need the information herself, she could share the information withfriends or families as needed. We discussed that it is very hard foryoung people to get accurate sexual health information sometimes. We105