Cambodian migrant women's postpartum experiences in Victoria, Australia

Abstract

Objective

to explore the postpartum experiences of Cambodian born migrant women who gave birth for the first time in Victoria, Australia between 2000 and 2010.

Design

an ethnographic study with 35 women using semi-structured and unstructured interviews and participant observation; this paper draws on interviews with 20 women who fit the criteria of first time mothers who gave birth in an Australian public hospital.

Setting

the City of Greater Dandenong, Victoria Australia.

Participants

twenty Cambodian born migrant women aged 23–30 years who gave birth for the first time in a public hospital in Victoria, Australia.

Findings

after one or two home visits by midwives in the first 10 day postpartum women did not see a health professional until 4–6 weeks postpartum when they presented to the MCH centre. Women were home alone, experienced loneliness and anxiety and struggled with breast feeding and infant care while they attempted to follow traditional Khmer postpartum practices.

Implications for practice

results of this study indicate that Cambodian migrant women who are first time mothers in a new country with no female kin support in the postpartum period experience significant emotional stress, loneliness and social isolation and are at risk of developing postnatal depression. These women would benefit from the introduction of a midwife-led model of care, from antenatal through to postpartum, where midwives provide high-intensity home visits, supported by interpreters, and when required refer women to professionals and community services such as Healthy Mothers Healthy Babies (Victoria Department of Health, 2011) for up to 6 weeks postpartum.

Introduction

Becoming a mother brings tremendous joy to women, and most women would attest to this (Liamputtong, 2006, Mbekenga et al., 2011, Kakyo et al., 2012). But under certain circumstances, it can be distressful for women (Chan et al., 2009; Wilkins et al., 2009, Darvill et al., 2010, Westall and Liamputtong, 2011, Kakyo et al., 2012). This is particularly so for those without a support network such as immigrant women (Liamputtong, 2006). They often have to deal with the double transition of their lives, not only as mothers but also as displaced people during this critical period of life (Liamputtong, 2006, Liamputtong, 2007a).

Literature suggests that the postpartum period is the time that a new mother is most vulnerable to emotional turmoil. It is the time that women recover from birth and begin to take on a new role. It is during this period that most women have mixed feelings, not only excited but also ‘emotionally fraught’ (Woollett and Dosanjh-Matwala, 1990: 178; Mbekenga et al., 2011, Razurel et al., 2011, Kakyo et al., 2012). According to Nelson (2003), the early postpartum months are physically and mentally exhausting for the new mothers. In their study with Australian women, Barclay et al. (1997) point out that the women, particularly first-time mothers, were unprepared for this period. In the early weeks and months after giving birth, women had overwhelming feelings about what was expected of them. A similar result has also been reported in a recent study by Darvill et al. (2010) in the UK.

The postpartum period has also been identified as the most important period of childbirth in cross-cultural studies (Liamputtong Rice et al., 1999; Liamputtong Rice, 2000, Whittaker, 2002, Santos-Torres and Vasquez-Guribay, 2003, Holroyd et al., 2004, Liamputtong, 2007a, Liamputtong, 2007b; Raven et al., 2007; Piperata, 2008). In many cultures, including the Cambodian culture, a new mother is perceived to be in a stage of vulnerability of harmful agents, natural and supernatural (Whittaker, 2002, Liamputtong, 2004, Hoban, 2007, Piperata, 2008, Eberhard-Gran et al., 2010, Lundberg and Thu, 2011). Within these cultures, there are numerous proscriptions and prescriptions that a new mother must observe in order to avoid negative health consequences. In order to observe traditional practices successfully, support from significant others, particularly family members, is crucial (Hung and Chung, 2001, Liamputtong, 2007a, Liamputtong, 2007b, Eberhard-Gran et al., 2010). Therefore, the postpartum period is an event where not only traditions are deeply involved, but a time that requires appropriate social support, and these can have great impact on the health and well-being of the new mothers and their newborn infants (Liamputtong, 2004; Bogossian, 2007; Raven et al., 2007, Eberhard-Gran et al., 2010, Mbekenga et al., 2011).

Immigrant women who reside in western societies where traditional postpartum practices are not recognised face difficulties when they give birth in their new settings (Kim-Goodwin, 2003, Chu, 2005, Groleau et al., 2006, Liamputtong, 2007b). Often, they have to rely on the medical model of care and are isolated from familiar faces during this critical time. The lack of acceptance of traditional postpartum practices and social support in their new homeland can impact on the well-being of many new mothers from immigrant backgrounds (Liamputtong, 2007b). Numerous studies which have documented the postpartum experiences of immigrant women have pointed to this difficulty (Yelland et al., 1998, Liamputtong Rice et al., 1999, Liamputtong Rice, 2000, Kim-Goodwin, 2003, Chu, 2005, Groleau et al., 2006, De Souza, 2007).

Although there have been some recent publications on the postpartum experience of migrant women, such as Chinese women in Scotland (Cheung, 1997), Chinese women in Australia (Chu, 2005), Filipino, Turkish and Vietnamese women in Australia (Yelland et al., 1998, Small et al., 2002), Hmong and Thai women in Australia (Liamputtong Rice et al., 1999; Liamputtong Rice, 2000), the experience of other migrant groups is still largely neglected. In particular, the postpartum experience of Cambodian women in a western country is very limited. In this paper, the experience of Cambodian women during the postpartum period in an Australian setting is examined.