Women's health (London, England) · 2025
Conversations about stillbirth prevention during pregnancy care from the perspectives of recent parents of refugee and migrant backgrounds, health professionals, and interpreters: A qualitative study.
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Biggs Laura J, Yelland Jane, Due Clemence, Riggs Elisha, Ziersch Anna, Green Erin, Toke Shadow, Hydari Shogoufa, Noe TaMwePaw, Sheriff Josephine, Essa Maryaan, Alias May Alqas, Baguet Ashay, Zia Sana, Szwarc Josef, Said Joanne M, Middleton Philippa, Brown Stephanie J
Аннотация
BACKGROUND: Socio-economic disparities in stillbirth persist in Australia and other high-income countries. Despite increased attention to disparities in perinatal outcomes, including stillbirth, very little is known about the way conversations about stillbirth prevention are occurring within pregnancy care.
OBJECTIVES: Understand how conversations about stillbirth prevention are experienced by parents of refugee and migrant backgrounds, interpreters, and healthcare professionals within public maternity services in Victoria and South Australia.
DESIGN: An interpretive qualitative design was used.
METHODS: Semi-structured interviews with 62 participants: 47 parents of refugee and migrant backgrounds, six midwives, five medical doctors, and four interpreters. Data were analysed using reflexive thematic analysis.
RESULTS: Analysis produced three themes: (1) searching for the right balance, reflecting health professionals' hesitation to provide direct information if it might promote unnecessary distress or fear, or result in parents' feeling coerced into medical intervention; (2) patterns and consequences of culturally unsafe care, situating conversations about stillbirth prevention within complex interpersonal and systemic contexts; and (3) safety within relationships built with time, illustrating time and trusting relationships as integral to culturally safe care. Health professionals' hesitation to discuss stillbirth prevention directly with families restricts access to important health information for a population already facing numerous, longstanding barriers to high-quality maternity care. Distrust between parents, health professionals, and interpreters, fuelled by fragmented and time-poor maternity service design and delivery, can undermine the possibility of culturally safe conversations about stillbirth prevention.
CONCLUSION: Investment to make culturally safe pregnancy care possible for women and families of refugee and migrant backgrounds is integral to reducing preventable stillbirths.
OBJECTIVES: Understand how conversations about stillbirth prevention are experienced by parents of refugee and migrant backgrounds, interpreters, and healthcare professionals within public maternity services in Victoria and South Australia.
DESIGN: An interpretive qualitative design was used.
METHODS: Semi-structured interviews with 62 participants: 47 parents of refugee and migrant backgrounds, six midwives, five medical doctors, and four interpreters. Data were analysed using reflexive thematic analysis.
RESULTS: Analysis produced three themes: (1) searching for the right balance, reflecting health professionals' hesitation to provide direct information if it might promote unnecessary distress or fear, or result in parents' feeling coerced into medical intervention; (2) patterns and consequences of culturally unsafe care, situating conversations about stillbirth prevention within complex interpersonal and systemic contexts; and (3) safety within relationships built with time, illustrating time and trusting relationships as integral to culturally safe care. Health professionals' hesitation to discuss stillbirth prevention directly with families restricts access to important health information for a population already facing numerous, longstanding barriers to high-quality maternity care. Distrust between parents, health professionals, and interpreters, fuelled by fragmented and time-poor maternity service design and delivery, can undermine the possibility of culturally safe conversations about stillbirth prevention.
CONCLUSION: Investment to make culturally safe pregnancy care possible for women and families of refugee and migrant backgrounds is integral to reducing preventable stillbirths.