Elsevier

Women and Birth

Volume 28, Issue 4, December 2015, Pages e124-e133
Women and Birth

ORIGINAL RESEARCH – QUANTITATIVE
Another country, another language and a new baby: A quantitative study of the postnatal experiences of migrant women in Australia

https://doi.org/10.1016/j.wombi.2015.07.001Get rights and content

Abstract

Background

Governments and service providers have consistently acknowledged the importance of support for women and families in the transition to parenthood. Lower levels of satisfaction and concern about postnatal depression have highlighted women's needs at this time. Migrant women may also face relocation, distant family and support networks, language barriers and potentially discriminatory or culturally insensitive care.

Objective

The present study evaluates the unique contribution of migrant status, comparing the experience of this group to that of native-born English-speaking women.

Method

Secondary analysis of data from a population-based survey of maternity care in Queensland. Experiences of 233 women born outside Australia who spoke another language at home were compared to 2722 Australian-born English-speaking women with adjustment for demographic differences.

Results

After adjustment, differences between the groups included physical, psychological aspects and perceptions of care. Women born outside Australia were less likely to report pain after birth was manageable, or rate overall postnatal physical health positively. They more frequently reported having painful stitches, distressing flashbacks and feeling depressed in the postnatal period. Few differences in ratings of care providers were found, however, women born outside Australia were less likely to feel involved in decisions and to understand their options for care. However, they were more likely to report being visited by a care provider at home after birth.

Conclusions

The findings represent an important addition to existing qualitative reports of the experiences of migrant women, reflecting poorer postnatal health, issues associated with migration and parenthood and highlighting areas for care improvement.

Introduction

The arrival of a new baby represents a momentous life event, both joyous and challenging. The early days and months after birth are characteristically a period of relationship-building, growing maternal attachment, changes in identity, and learning to care for the newborn. Yet, while governments and service providers have acknowledged the importance of providing support at this time (e.g.1, 2), research on women's views has frequently found low levels of satisfaction with care provided during the postnatal period.3, 4, 5, 6 Postnatal depression prevalence estimates of 10–15%7 have further elicited concern for women's postnatal mental health and wellbeing.

Migrant women represent a significant proportion of women birthing in many countries.8, 9 In Queensland, Australia, over one fifth of women who gave birth in 2010 were born overseas.10 These women are likely to face many barriers throughout their maternity care, including challenges of relocation, distance from family and support networks, a language barrier, and potentially discriminatory or culturally insensitive care from maternity service providers.11, 12, 13 Epidemiological studies across western contexts have found migrant women to have poorer obstetric outcomes compared to native born women.14, 15, 16 Studies have also found migrant women to have poorer mental health outcomes, with up to 42% classified as experiencing postnatal depression.7 In order for migrant women and their babies to receive effective postnatal care it is essential to understand their current experiences and identify avenues for improvement.

Section snippets

Postnatal experiences of migrant women

Studies of the experiences of migrant women have commonly been qualitative.17, 18 Two recent syntheses of this literature have emphasised themes of struggle, anxiety and communication problems. Communication difficulties in particular were identified as a barrier to effective clinical and interpersonal care.17, 18 Both syntheses highlighted that many studies reported migrant women struggled to cope without family or social networks and expressed a need for more practical and emotional support.18

Data collection and participants

All women who had a live singleton or multiple birth in Queensland, Australia between February and May 2010 were invited to participate in the survey.4 The survey was mailed by the Queensland Registry of Births, Deaths and Marriages four to five months after birth, followed by a reminder two weeks later. Survey packages were mailed to 20,908 eligible women (543 undelivered). Survey packages included an introductory letter, information sheet, a copy of the survey and a reply-paid envelope. A

Respondents

A total 7193 women completed the survey. Only women who completed the longer version of the survey were included in the present study; a total of 3530 women with a response rate of 34.2%. Of those who completed the longer survey, 540 did so online and 12 completed the telephone survey. Only 3 women participated in the telephone survey using an interpreter. Few differences have been found in the survey programme between women who completed the paper survey and those who completed the survey

Discussion

The present study provided a recent, quantitative description of the postnatal experience and perceptions of care for women born outside Australia who speak another language at home in Queensland, and compared this experience to that of native-born English-speaking women whilst adjusting for differences between the groups. This work has highlighted areas of similarity, and important differences which can be addressed in future research and practice.

Conclusion

Pregnancy, childbirth and motherhood create challenges that are made more difficult by the isolation and stress that often accompany migration. Research in this area is largely qualitative and has focused on women from specific countries of origin. Comparative quantitative data presented on the experience of migrant and native born women, with adjustment for key factors has the advantage of providing insight into the ways migrant women are disproportionately disadvantaged compared to

Acknowledgements

The research on which this paper is based was conducted as part of the Having a Baby in Queensland Survey Program of the Queensland Centre for Mothers & Babies at The University of Queensland. We are grateful to Queensland Government for funding and to the women who provided survey data. The Queensland Registry of Births, Deaths and Marriages contacted women to invite them to participate on behalf of the Queensland Centre for Mothers & Babies (QCMB) to ensure women's privacy was protected.

References (55)

  • A.W. Boerleider et al.

    A mixture of positive and negative feelings: a qualitative study of primary care midwives’ experiences with non-western clients living in the Netherlands

    Int J Nurs Stud

    (2013)
  • J. Yelland et al.

    Support, sensitivity, satisfaction: Filipino, Turkish and Vietnamese women's experiences of postnatal hospital stay

    Midwifery

    (1998)
  • J. Hennegan et al.

    Born in another country: women's experience of labour and birth in Queensland, Australia

    Women Birth

    (2014)
  • G. Stevens et al.

    What are pregnant women told about models of maternity care in Australia? A retrospective study of women's reports

    Patient Educ Couns

    (2014)
  • Y.D. Miller et al.

    Going public: do risk and choice explain differences in caesarean birth rates between public and private places of birth in Australia?

    Midwifery

    (2012)
  • S. Dzakpasu et al.

    The Canadian maternity experiences survey: design and methods

    J Obstet Gynaecol Can

    (2008)
  • J. Webster et al.

    Quality of life and depression following childbirth: impact of social support

    Midwifery

    (2011)
  • H. Hoang et al.

    Women's access needs in maternity care in rural Tasmania, Australia: a mixed methods study

    Women Birth

    (2014)
  • Department of Health, Australia

    Australian Health Ministers’ Conference: National Maternity Services Plan

    (2011)
  • Public Health England and Department of Health

    Midwifery services for improved health and well-being

    (2013)
  • Y.D. Miller et al.

    Findings from the Having a Baby in Queensland Survey, 2010

    (2011)
  • U. Waldenström et al.

    Intrapartum and postpartum care in Sweden: women's opinions and risk factors for not being satisfied

    Acta Obstet Gynecol Scand

    (2006)
  • C.H. Collins et al.

    Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors

    Arch Womens Mental Health

    (2011)
  • Office for National Statistics (ONS)

    Births in England and Wales, 2013

    (2014)
  • Economic and Social Research Institute (ESRI)

    Perinatal Statistics Report 2012

    (2013)
  • Z. Li et al.

    Australia's mothers and babies 2010. Perinatal statistics series no. 27. Cat. no. PER 57

    (2012)
  • R. Small et al.

    Mothers in a new country: the role of culture and communication in Vietnamese, Turkish and Filipino women's experiences of giving birth in Australia

    Women Health

    (1999)
  • Cited by (21)

    • Effect of an Australian community-based caseload midwifery group practice service on maternal and neonatal outcomes for women from a refugee background

      2023, Women and Birth
      Citation Excerpt :

      Also, women are often not proficient in the language/s spoken in the new country and might have infrequent or no access to interpreter services. Together, these barriers contribute to poor health literacy [13], which reduces personal agency, leading to absent or misinformed consent for childbirth interventions [3,13,14]. Furthermore, a lack of culturally appropriate care increases women’s dissatisfaction with services and experiences of racism are commonly reported [2,5,11,15].

    • Women from migrant and refugee backgrounds’ perceptions and experiences of the continuum of maternity care in Australia: A qualitative evidence synthesis

      2022, Women and Birth
      Citation Excerpt :

      It is critical we improve understanding of how this population perceives and experiences the continuum of maternity care in Australia [10]. Women from migrant and refugee backgrounds are more likely to have additional challenges during the maternity period compared to Australian-born women, such as language barriers, isolation from culture and family, and discrimination when accessing services [11]. Migrant women have described the process of seeking maternity care in Australia as confusing and distressing [7,12], particularly when medical advice conflicts with traditional practices [13].

    • Indian migrant women's experiences of motherhood and postnatal support in Australia: A qualitative study

      2020, Women and Birth
      Citation Excerpt :

      Cross-cultural studies among Australian migrant populations highlight the unaddressed postpartum needs of these mothers and moreover, they are expected to comply with the Western model of maternity care.15–17 Migrant mothers experiencing poor postpartum health are unlikely to be involved in making choices about their health care.17 Therefore, it is essential to explore the factors that influence postpartum experiences of migrant women from different cultural backgrounds and understand their needs and expectations in order to provide culturally competent care.

    • Perspectives on preconception health among migrant women in Australia: A qualitative study

      2020, Women and Birth
      Citation Excerpt :

      This also has relevance for midwives overseas, who support pregnancy planning and preconception care in countries such as the Netherlands.21 Prior qualitative Australian studies provide insight into migrant women’s experiences related to pregnancy22,23 and the postnatal period.24 Some Australian studies have explored women’s fertility-related knowledge11,12 and awareness of preconception care among the general population.17

    View all citing articles on Scopus
    View full text