Not all birthing parents are treated the same

Everyone deserves dignity in the perinatal period. When pregnant, giving birth, and transitioning to parenting a new child, everyone deserves the support and healthcare they need. But intersecting structural factors mean that not all births – and birthing parents – are treated the same.

This month, we gathered to advance gender equality and sexual and reproductive health (SRH) rights at the Women Deliver Conference 2023. Women Deliver speaks to the tremendous labour, care and activism of people who fight for reproductive justice: which includes the right to birth, the right to terminate and not have children, and the right to parent the children we do have in safe, sustainable communities free from gendered and racialised violence and disadvantage.

One third of women giving birth in Australia are migrants, with the majority coming from mainly non-English speaking countries. The proportion of mothers born overseas has increased over the last three decades, and demographic projections show that it will continue to increase in the coming years. Overseas-born women face a higher risk of pregnancy complications such as gestational diabetes and pre-eclampsia, impacting their continuity of care. They are also more likely to have birth-related medical interventions.

Acknowledging that migrant and refugee women deliver under inequitable conditions, we turn the spotlight to their perinatal mental health. Evidence consistently indicates that migrant and refugee women face multiple structural barriers to achieving perinatal wellbeing. These are particularly acute for refugee women, who report more than double the rates of major depressive disorder (32.5%) in the antenatal period compared with pregnant Australia-born women (14.5%).

For the overall overseas-born population, the situation seems to improve after birth. In the perinatal period, overseas-born women experience similar risk factors for mental health issues and illness as the Australian-born population. However, we know that migrant and refugee women face distinct, intersecting risk factors which make new parenting particularly challenging: including low levels of social support, precarious migration status, and barriers to accessing perinatal health and family violence services. These factors are compounded for birthing parents on temporary visas who are not eligible for Medicare.

Working with and amplifying migrant and refugee women is key to improving perinatal mental health outcomes for all. Governments can do this at the intersections of migration and healthcare policy by extending Medicare to all people living in Australia, regardless of visa status, and eliminating visa precarity. Mental and perinatal health providers can train and invest in their workforce, ensuring that their staff represent the communities they serve, and that they deliver services which are tailored, equitable, and trauma-informed. Universal healthcare is key to addressing health inequities based on gender, race and migration status, to ultimately deliver health equity to all.

First published in edition #122 of The WRAP on 27 June 2023.