Maternity services are not meeting the needs of immigrant women of non-English speaking background: Results of two consecutive Australian population based studies
Section snippets
Background
Women of non-English speaking background who migrate by choice or seek refuge in developed countries such as Australia have notably poorer perinatal outcomes than local-born women. Immigrant mothers are over-represented in Australian, UK and European maternal mortality statistics, (Stirbu et al., 2006, Knight et al., 2009, Centre for Maternal and Child Enquiries, 2011). Several studies have documented poorer mental health among immigrant mothers (Allotey, 1999, Small et al., 2003), and although
Sample and procedure
The samples for the surveys comprised all women giving birth in Victoria in two weeks in 1999 and four weeks in 2007, excluding women who had a stillbirth or known neonatal death. Women were posted a questionnaire six months following the birth, together with a covering letter, and a reply paid envelope for returning the completed questionnaire. All women received a brief explanation of the study in four languages other than English accompanying the 2000 Survey (Vietnamese, Turkish, Chinese,
Response
In 2000, a total of 1616 women completed the survey giving an overall response fraction of 67% (1616/2412). In 2000 82.1% (1312/1616) were Australian-born women, 7.7% (123/1616) were overseas-born of English-speaking background and 10.2% (164/1616) were women who were born overseas in countries where English is not the main spoken language. By comparison, in 2008, 2900 eligible women returned completed questionnaires giving an overall response fraction of 51.2% (2900/5667). This included 79.6%
Discussion
Australia is one of the most multicultural countries in the world with proportionally higher immigration than other Western counties including Canada, the United Kingdom and New Zealand (Australian Bureau of Statistics, 2012). A quarter of Australia׳s population is born overseas. Diversity of the immigrant population is reflected in language spoken with nearly 70% of recently arrived migrants speaking a language other than English at home. Of the 295,000 women giving birth in Australia every
Conclusion
Data from repeated population-based surveys of recent mothers provides one of the few avenues for gauging whether changes to the organisation of maternity services is making a difference to immigrant women׳s experiences of care. Our findings showing no change over an eight year period – during which there were major efforts to increase access to midwifery led models of care and provide greater continuity of caregiver – suggest that different approaches, more specifically tailored to the needs
Conflict of interest
The authors declare no conflict of interest.
Acknowledgements
We are grateful to the women who gave generously of their time to participate in the survey; the Victorian Department of Human Services for commissioning and funding the 2000 survey; and the funding provided by the National Health and Medical Research Council (NHMRC), the Victorian Department of Human Services and the South Australian Department of Health for the 2008 survey. This work is supported by the Victorian Government׳s Operational Infrastructure Support Program. JY currently holds an
References (32)
- et al.
Women׳s views and experiences of postnatal hospital care in the Victorian Survey of Recent Mothers 2000
Midwifery
(2005) - et al.
Having a baby in Victoria 1989–2000: women׳s views of public and private models of care
Aust. N. Z. J. Public Health
(2003) - et al.
Sharing obstetric care: barriers to integrated systems of care
Aust. N. Z. J. Public Health
(2000) - et al.
Cross-cultural research: trying to do it better. 1. Issues in study design
Aust. N. Z. J. Public Health
(1999) - et al.
Postpartum health, service needs, and access to care experiences of immigrant and Canadian-born women
J. Obstet. Gynecol. Neonatal Nurs.
(2006) - et al.
Support, sensitivity, satisfaction: Filipino, Turkish and Vietnamese women׳s experiences of postnatal hospital stay
Midwifery
(1998) Travelling with ‘Excess Baggage’: health problems of refugee women in Western Australia
Women Health
(1999)- Australian Bureau of Statistics, 2012. 2071.0 – Reflecting a Nation: Stories from the 2011 Census, 2012–2013. from...
- et al.
Health literacy: what is it?
J. Health Commun.
(2010) - et al.
The 1993 survey of recent mothers: issues in survey design, analysis and influencing policy
Int. J. Qual. Health Care
(1997)