Everyone waiting to give birth hopes that it will be a joyful and positive experience. Sadly, migrant and refugee mothers in Australia are more likely to have a negative birthing experience, and face additional risks and challenges.
A migrant women, Liz, recently shared her experience when she gave birth to her first baby in an Australian hospital. Rather than feeling joyful, she was left feeling traumatised, angry and helpless. The hospital did not engage an interpreter, which meant that Liz did not have an opportunity to make informed decisions about how the birth should proceed.
Concerningly, Liz’s experience is not a one-off. Communication difficulties is known to be one of the key barriers preventing equitable access to health services in Australian hospitals. There is clear evidence that ineffective communication in health care settings leads to a host of problems: reduced access to care, fewer doctor visits and subsequent reduced understanding of diagnosis and treatment, medication complications, diagnostic errors, and an increased dissatisfaction with the system, which makes people less likely to adhere to follow-up care. Tragically, in some cases, good communication is a matter of life or death.
In the case of migrant and refugee women’s sexual and reproductive health, inadequate and ineffective communication and care has led to reduced access to early intervention and prevention services, such as antenatal care, resulting in poorer pregnancy and birth outcomes. The fact that migrant women in Australia have higher rates of gestational diabetes, pre-eclampsia, birth intervention, and stillbirth than the non-migrant population, are a testament to the benefits of early pregnancy care, as well as a clear indicator of the gendered and racialised inequity that is embedded in the Australian health system.
It is too late for Liz’s hospital to go back in time and provide her with the birthing care and communication she has a right to and deserves. But it is not too late for us to make proactive and positive changes to the health system to prevent future birth trauma.
So what would make a difference? First, a better understanding of the structural and systemic barriers that prevent early and equitable access to health services. A better knowledge of the barriers, combined with policy and funding support to overcome them, will go a long way toward the development of a health system that works for women and people more generally, and migrant women in particular.
Second, learning from and supporting Aboriginal and Torres Strait Islander women's leadership in finding culturally responsive models of birthing care, and further investing into the work of trained and accredited bilingual and bicultural workers who provide in-language information to migrant women, linking them earlier to crucial preventative services, will help overcome the knowledge barrier.
Third, a community based, migrant women-led approach to health puts more power and control into migrant women’s hands, which in turn, has a positive impact on health and wellbeing, participation and leadership, not just for women but for the community more generally. Putting migrant women’s health in migrant women’s hands would definitely help spread the joy.
First published in edition #107 of The WRAP on 31st March 2022.