Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be culturally safe and nurturing. A cross-sectional interpretative phenomenological analysis of first interviews with 19 whānau participating in a Kaupapa Māori (by, with, for Māori) qualitative longitudinal study of preterm birth identified themes from their experiences and the meanings they attributed to them. Preterm birth was an emotional roller coaster, with the birth imaginary and anticipated roles disrupted as health practitioners took over the care of their infants. Whānau expressed the desire to be close to their infants, holding them, loving them, nurturing them, and emplacing them within whakapapa (genealogy, continual layering of foundations) networks. When health practitioners or hospital policies inhibited this intimacy by isolating, excluding, or discriminating, whānau were frustrated. Being familiar with hospital routines, staff, peers, infant cares, and being wrapped in wider whānau support were key for whānau coping. Whakawhanaungatanga (processes of establishing relationships) create safe spaces for whānau to be themselves. This quietens the ‘storm’ and returns whānau to a sense of calm, through the reclamation of their environment.

Significant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand – and in particular around a premature (preterm) delivery. Māori babies are more likely to be born preterm (8.1%, compared to an overall rate of 7.4%) and they are more likely to have a preterm death. An essential part of redressing these disparities is to examine the clinical care pathway and outcomes associated with preterm deliveries. This paper describes a protocol utilising national and local health collections to enable such a study. This is a retrospective cohort study comprising 5 years data pertaining to preterm deliveries from 2010 to 2014. These data are generated from linked national administrative and local health information collections to explore a range of neonatal outcomes and infant mortality in relation to the antenatal care pathway and known risk factors for preterm delivery. This study is being conducted within a Kaupapa Māori paradigm that dismisses victim blaming and seeks to intervene at structural levels to improve the health and wellbeing of Māori whānau (family). Our data-linkage methodology optimises the utility of New Zealand health collections to address a significant health issue. Our findings will fill the information gaps around the burden of preterm delivery by quantifying the incidence of preterm delivery and adverse neonatal and infant outcomes in Aotearoa New Zealand. It will explore access to evidenced based care including use of steroids before birth, and appropriate place of delivery. The results from this study will inform maternity care services to improve management of preterm deliveries – both locally and internationally. This in turn will improve the preterm sequela by reducing the long-term health burden and health inequities.

Aims: To describe a body of Māori translational research responses that challenge colonialised systems. Methods: To delineate and link ongoing Kaupapa Māori and Māori‐led translational research. Results: He Tapu Te Whare Tangata explores human papilloma virus (HPV) screening. Te Hā o Whānau presents a culturally responsive framework of maternity care. E Hine describes young Māori mothers’ experiences of Hapū Ora. Severe Acute Maternal Morbidity (SAMM) and SAMM Kids identify opportunities to improve avoidable morbidity. He Tamariki Kokoti Tau – Babies born prematurely, is a qualitative study of Māori experiences of preterm birth. He Tamariki Kokoti Tau – Tackling Preterm, is a quantitative analysis. He Korowai Manaaki is a wraparound maternity pathway. Whānau Manaaki – Methamphetamine aims to reduce the impact of methamphetamine. Calls for action reflect shared desires for system transformation. Conclusion: We lay the wero (challenge) down to all to transform our current systems. Action is needed!

An infant arriving early disrupts the birth imaginary of whānau (family collectives) and situates them in unfamiliar health environments that may not be culturally safe. Regaining a sense of familiarity enables whānau to cope with their unexpected preterm trajectory. He Tamariki Kokoti Tau: Babies Born Prematurely was the first Kaupapa Māori prospective qualitative longitudinal study to explore these trajectories, walking alongside whānau from birth to first birthday. This interpretative phenomenological analysis explores the final ‘first birthday’ interviews with 16 whānau. Concerns that had been raw in early days of neonatal intensive care carried over – frustrating whānau yet strengthening their resolve to support each other. Whānau described how they enacted resilience together, with their whānau collective including health practitioner champions who became ‘like whānau’ by virtue of their culturally responsive care. While pēpi (infants) continued to experience health issues, whānau felt hopeful for the year ahead. They expressed love, joy, and pride for their pēpi as the centre of their whānau. Whānau are experts of their pēpi, and healthcare champions who recognise this and promote whānau tino‐rangatiratanga (autonomy) make a world of difference. Health services can learn from these whānau, about how to better support preterm care pathways for Māori.