GP Connect Clinical Feature by Dr Janet Hornbuckle, Maternal Fetal Medicine Specialist, FRANZCOG CMFM
Early pregnancy care for women from multicultural communities in Australia requires tailored approaches due to unique clinical challenges and higher risks of adverse pregnancy outcomes within this group. GPs play a critical role in addressing these challenges and mitigating risks to ensure optimal maternal and fetal health.
Women from multicultural communities are disproportionately affected by adverse pregnancy outcomes, including higher rates of preterm birth, low birth weight, gestational diabetes, stillbirth and maternal mortality compared to the general population. These disparities are influenced by a complex interplay of socio-economic factors, cultural beliefs, and access barriers to health care services.
Five tips for GPs working with pregnant women and families from multicultural communities:
- Use interpreter services and other tools to communicate effectively
Language barriers can significantly impact access to timely and appropriate prenatal care, leading to delays in seeking medical attention and suboptimal management of pregnancy-related conditions. Limited proficiency in English may hinder comprehension of medical instructions, exacerbating risks of adverse outcomes. Prioritise effective communication by utilising interpreter services and culturally appropriate communication tools to bridge language gaps and facilitate informed decision-making in early pregnancy care.
- Be aware of different cultural beliefs surrounding pregnancy
Cultural factors also contribute to disparities in pregnancy outcomes. Cultural beliefs surrounding diet, lifestyle, and traditional healing practices may influence maternal behaviours and health-seeking patterns, leading to disparities in prenatal nutrition, adherence to medical advice, and utilisation of antenatal services. Engage women from multicultural communities in culturally sensitive discussions to understand their beliefs and preferences, tailor clinical recommendations accordingly, and promote culturally appropriate health behaviours to mitigate risks of adverse outcomes.
- Utilise specific culturally and linguistically diverse resources and services
Socio-economic disparities further compound the challenges faced by pregnant women from multicultural communities, limiting access to quality health care services and exacerbating existing health inequities. Financial constraints, lack of health insurance coverage, and transportation barriers may prevent them from accessing prenatal care early in pregnancy, increasing their vulnerability to adverse outcomes. Address these barriers by providing information about available resources, facilitating access to subsidised health care services, and advocating for policies that promote equitable access to prenatal care for all women, irrespective of socio-economic status or cultural background. Clinician Assist WA has information on WA Migrant and Refugee Health Services and Support Services.
- Consider the need for additional screening and interventions
Clinical interventions targeted at mitigating adverse pregnancy outcomes in women from multicultural communities include early screening and management of gestational diabetes, culturally sensitive counselling on prenatal nutrition and lifestyle modifications, and proactive monitoring for complications associated with preterm birth and low birth weight, including stillbirth. Integrate these interventions into routine prenatal care, ensuring comprehensive risk assessment and individualised management plans tailored to their specific needs.
- Involve a multidisciplinary team
Collaboration with multidisciplinary health care teams, including obstetricians, midwives, and cultural support workers, is essential in addressing the complex clinical needs of pregnant women from multicultural communities and reducing disparities in pregnancy outcomes. By fostering partnerships with community organisations and advocating for culturally competent health care policies, GPs can improve access to quality prenatal care, promote positive pregnancy outcomes, and enhance maternal and fetal health outcomes.
Safer Baby Bundle resources for multicultural communities
Safer Baby Bundle has developed numerous resources to assist GPs and other maternity care providers to provide culturally appropriate care aimed at reducing the rates of stillbirth:
- Safer Baby, a website designed for parents.
- Culturally adapted resources, available for Arabic, Dari, Dinka and Karen speaking communities.
- Stronger Bubba Born, a website for Aboriginal patients.
- Translated resources in 25 different languages.
- Updated eLearning, including free and accredited CPD modules, as well as other clinician resources.
Other useful resources:
- Multicultural Health Communication Service: Provides resources and training for health care providers on effective communication with patients from multicultural communities.
- Stillbirth CRE (Centre of Research Excellence): Offers information and resources on stillbirth prevention, including culturally sensitive approaches to pregnancy care.
- Australian Government Department of Health and Aged Care – Pregnancy Care Guidelines: Provides evidence-based guidelines for health care providers on pregnancy care, including recommendations for women from multicultural backgrounds.
- healthdirect – Maternity care in Australia: Comprehensive overview of the maternity care system available in Arabic, Bengali, Simplified Chinese, Traditional Chinese, and Vietnamese
- Health Translations: Offers a wide range of health resources translated into multiple languages, including pregnancy-related materials.