Birth outcomes, postpartum health and primary care contacts of immigrant mothers in an Australian nulliparous pregnancy cohort study.
ABSTRACT To investigate differences and similarities in birth outcomes, postpartum health and primary care contacts of mothers born overseas of non-English speaking background (NESB) compared with Australian-born mothers. Nulliparous women were recruited in early pregnancy (< or =24 weeks gestation) to a prospective pregnancy cohort study from six metropolitan public hospitals in Victoria, Australia. Analyses are based on questionnaires completed in pregnancy and at 3 months postpartum. Of the 1,507 women recruited in the study, 1,431 women (95%) were followed up at 3 months postpartum. Immigrant mothers of NESB (n = 212) and Australian born mothers (n = 1,074) had similar obstetric outcomes and postpartum physical health outcomes. Immigrant women were more likely to say they had been depressed for 2 weeks or longer since the birth (Adj OR = 1.92, 95% CI 1.3-2.8); to report relationship problems (Adj OR = 1.39, 95% CI 0.9-2.1) and to report lower emotional satisfaction with their relationship with the partner (Adj OR = 1.69, 95% CI 1.1-2.6) after adjusting for age, education status, income, method of birth and genital tract trauma. Immigrant mothers were less likely to be asked about feeling low or depressed by general practitioners (OR = 0.79, 95% CI 0.5-0.9) and about relationship problems by maternal and child health nurses (OR = 0.68, 95% CI 0.5-0.9). Immigrant women of NESB reported greater psychological distress, less emotional satisfaction with their partner and more relationship problems in the first 3 months postpartum than Australian born women. Although immigrant mothers had an equivalent level of contact with primary care practitioners in the first 3 months postpartum, they were less likely to be asked about their emotional well-being or about relationship problems by health professionals.
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ABSTRACT: Background Women born outside Australia make up more than a fifth of the Queensland birthing population and like migrants in other parts of the world face the challenges of cultural dislocation and possible language barriers. Recognising that labour and birth are major life events the aim was to investigate the experiences of these women in comparison to native-born English speaking women. Methods Secondary analysis of data from a population based survey of women who had recently birthed in Queensland. Self-reported clinical outcomes and quality of interpersonal care of 481 women born outside Australia who spoke a language other than English at home were compared with those of 5569 Australian born women speaking only English. Results After adjustment for demographic factors and type of birthing facility, women born in another country were less likely to be induced, but more likely to have constant electronic fetal monitoring (EFM), to give birth lying on their back or side, and to have an episiotomy. Most women felt that they were treated as an individual and with kindness and respect. However, women born outside Australia were less likely to report being looked after ‘very well’ during labour and birth and to be more critical of some aspects of care. Conclusion In comparing the labour and birth experiences of women born outside the country who spoke another language with native-born English speaking women, the present study presents a largely positive picture. However, there were some marked differences in both clinical and interpersonal aspects of care.Women and Birth 01/2014;
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ABSTRACT: AIM: The aim of this paper is to describe the factors that impact on the mental health of Australian and New Zealand (NZ) women in the perinatal period (pregnancy and the year following birth), and to determine the impact of perinatal mental health on women's subsequent health by summarising findings from prospective longitudinal studies conducted in Australia and NZ. METHODS: A systematic search was conducted using the databases, Scopus, Medline, PsychInfo and Health Source to identify prospective longitudinal studies focused on women's social and emotional health in the perinatal period. Forty-eight papers from eight longitudinal studies were included. RESULTS: The proportion of women reporting depressive symptoms in the first year after birth was between 10 and 20% and this has remained stable over 25 years. The two strongest predictors for depression and anxiety were previous history of depression and poor partner relationship. Importantly, women's mood appears to be better in the first year after birth, when compared to pregnancy and five years later. Becoming a mother at a young age is by itself not a risk factor unless coupled with social disadvantage. Women report a high number of stressors in pregnancy and following birth and the rate of intimate partner violence reported is worryingly high. CONCLUSION: Midwives have an important role in the identification, support and referral of women experiencing mental health problems. As many women do not seek help from mental health services, the potential for a known midwife to impact on women's mental health warrants further examination.Women and Birth 04/2013;
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ABSTRACT: Objective To assess disparities in preeclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries.DesignCross-country comparative study of linked population-based databases.SettingProvincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden.PopulationAll immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995–2010).Methods Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI).Main outcome measuresPreeclampsia, eclampsia and preeclampsia with prolonged hospitalisation (cases per 1000 deliveries).ResultsThere were 9 028 802 deliveries (3 031 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of preeclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest.Conclusion Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of preeclampsia and eclampsia.BJOG An International Journal of Obstetrics & Gynaecology 04/2014; · 3.76 Impact Factor