Culturally safe maternity care — structured SAQ (15 marks)

(a) Communication, privacy and safety (5 marks)

One mark for each distinct safe action, maximum five.^[5][12]

• Address the woman directly and establish preferred spoken and written language; call a qualified Dari interpreter, by telephone or video if needed. Her husband may remain as support if she wishes but is not the sole interpreter.^[12]
• Ask who she wants present and offer private time with the interpreter. Explain confidentiality and that she controls what may be shared.^[12]
• Check immediate obstetric safety — maternal observations, pain or bleeding, fetal movements, fetal heart assessment and labour symptoms — while communication support is arranged.^[5]
• Ask open, non-assumptive questions: what she understands, what worries her about hospital birth, prior healthcare experiences, and what would make care feel safer.^[5]
• Screen privately where indicated for family violence, coercion, mental illness, trauma and immediate social risk; do not force a trauma narrative.^[5][11]

(b) Focused clinical, psychosocial and access assessment (4 marks)

One mark per domain with case-specific content.^[5]

• Obstetric: confirm gestation and dating source, parity and prior births, current symptoms, fetal movements, blood group and available results, pregnancy complications, examination and clinically indicated investigations. Obtain records and avoid duplicating intimate examinations.^[5]
• General and preventive health: acute/chronic illness, medicines and allergies, immunisation, nutrition, oral health and clinically indicated infectious-disease or women's-health screening, with consent and a results pathway.^[5]
• Psychosocial: mood, trauma symptoms, safety, family violence, sexual violence or FGM only when clinically relevant and sensitively asked; strengths, family and community supports.^[5][11]
• Access: transport, cost or Medicare/visa issues, housing, food, childcare, work, phone and literacy; ask why appointments were difficult before labelling non-adherence.^[5]

(c) Qualified interpreter for consent and examination (3 marks)

One mark for preparation, one for technique, one for closure and documentation.^[12]

• Brief: confirm dialect and gender preference where feasible; explain the purpose and sensitive topics; ask for first-person complete interpretation and confidentiality.^[12]
• Consult: face and speak directly to the woman in short plain phrases; pause; explain indication, steps, alternatives and right to stop; seek explicit consent before and during the examination; minimise exposure and repeated touch.^[12][11]
• Close: use teach-back through the interpreter, invite questions, document interpreter identity, language and mode, who was present, consent and the patient's own words.^[12]

(d) Culturally safe birth and follow-up plan (3 marks)

One mark each for continuity, trauma-informed birth planning and usable follow-up.^[5]

• Continuity and access: nominate a maternity team or known clinician; pre-book interpreters for visits and birth; involve refugee health, social work and a cross-cultural worker with the woman's agreement.^[5]
• Birth plan: document preferred support people, interpreter, clinician gender where feasible, modesty, religious or dietary needs, consent preferences, stop signal, examination minimisation and emergency communication plan. Explain that choices may change with clinical need and will be revisited.^[12][11]
• Follow-up: translated information plus interpreter-mediated teach-back, specific return triggers, next appointment booked, transport and cost addressed, primary-care and maternal-child-health linkage, and mental-health or family-violence referral if accepted.^[5]