Self-determination and community-controlled health 1960 - 

During the 1960s there was a period of increased political activity within Indigenous communities. This led to the development of Community controlled services, in particular in the Northern Territory and Queensland. The movement that pushed for these services (including maternity services) grew from the push against racist policies such as protectionism and segregation which occurred from the 1890s to the 1950s (approx). The first Aboriginal community controlled health service was established by the local Aboriginal community in Redfern in July 1971.

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Community controlled services were, and still are, vital for Aboriginal and Torres Strait Islander people to be able to participate in decisions and have overall control over all aspects of an organisation that serves them. At this time, the self-determination of the Indigenous population – which is where people have the right to freely determine their own social, cultural, economic and political views – was beginning to be understood.

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Some Aboriginal and Torres Strait Islander women had access to small local hospitals – but services were limited, and in particular maternity services, that may have had non-Indigenous nurses (who may or may not have had midwifery experience/training), were in short supply. Often, Aboriginal and Torres Strait Islander people were denied access to these services, and women often felt safer to give birth in their own communities without accessing this care. Historically, traditional birthing practices were clan-based, and passed down between the generations of Indigenous women. Given the historical removal of children an dislocation of families instigated by the government at the time, many Aboriginal and Torres Strait Islander women and their families were suspicious of the maternity services, even if they did have access to them.

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Community controlled health services are those where the Aboriginal and Torres Strait Islander people have ownership of the services, in a framework of self-determination, reconciliation, cultural safety and identity. Local communities have control of decision making, administration and service provision, control their own destiny, and exercise responsibility within the context of their broader community: the services are planned, managed, and controlled by the communities they serve. Like any large health care service they employ a large number and wide range of health care practitioners in multi-disciplinary teams, including midwives.