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Having Your Baby in Australia? We Speak Your Language. Pamela Leslie Nursing Unit Manager - Antenatal Clinic Westmead Hospital NSW. THE ISSUES & CHALLENGES. Migrants have brought with them customs that can affect their interaction with the western style of health care
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Having Your Baby in Australia?We Speak Your Language Pamela Leslie Nursing Unit Manager - Antenatal Clinic Westmead Hospital NSW
THE ISSUES & CHALLENGES • Migrants have brought with them customs that can affect their interaction with the western style of health care • Cultural practices and beliefs remain important in pregnancy, birth, confinement and infant care following migration • Different birth expectations and preferences • Lack of language specific information about the procedures, services and care options at birth. • Frustration & fear of the unknown re the labour process. • The management of childbirth in women from Culturally and Linguistically Diverse (CALD) background is complicated by social economic and cultural influences. • These issues persist long term and can jeopardize the woman and the infant’s well being and safety.
Needs Assessment • Sample Recruitment Criteria: New mothers of CALD who gave birth in Westmead Hospital without planned C/S. • Participants: 238 new mothers • Venue: Postnatal Ward, Westmead • Survey Period: 25August – 30 Sept. 2006 • Survey Instrument: Face to Face or telephone interview with a structured questionnaire
Survey Findings From the Needs Assessment (Aug-Sep. 2006) • Diverse Cultural Background (60% births from CLDB mothers who represented over 50 countries and spoke over 40 languages at home)
Disadvantages • 64.5% of them were first time mothers; • 23.5% of them were poor English proficiency; • No request for interpreter services at birth • Family member whom the women rely on to communicate did not have adequate proficiency in English themselves • Poor Knowledge level about birth in Australia
Birth Outcomes • Lower incidence of normal vaginal birth (10% lower than the English Speaking counterparts) • Higher incidence of emergency caesarean sections (10% higher than the English Speaking mothers)
The Impact of Communication Barriers on Birth OutcomesAssociation of the Birth Outcomes and the Mother’s English Proficiency
The Impact of Communication Barriers on Birth OutcomesBirth Outcomes and the Degree of Information Understanding
“Having Your Baby In Australia? We Speak Your Language! Description: An audio CD detailing the birthing process as well as the practices procedures and care options for childbirth in Australian Hospital. The duration of the CD: 17 Minutes. Language Available: Arabic, Cantonese, Korean, English, Hindi, Mandarin, Persian and Tamil
Production of the CD • Funding: $9,415 of Seeding Grant Program, Sydney West Area Health Services • Script Writing and Evaluation • Translation and Production (by SBS)
Process Evaluation 1 • Script was examine by seven leading hospitals in NSW: Royal Women’s Hospital, Royal North Shore Hospital, The Princes of Alfred Hospital, Liverpool Hospital, Auburn Hospital, Blacktown and Nepean Hospitals • Each script translations were assessed by the Health Care Interpreter Services before production
Process Evaluation 2 • Script was examined in the Multicultural antenatal classes before production. • Audio CD products were evaluated by the Health Care Interpreter Services for each language. • Audio CD products were piloted in two Focus Groups
Impact EvaluationControl Study • Control Group: The group (n=238) surveyed in August – September 2006 for the needs assessment • Study Group : a. Women with Arabic, Cantonese, Mandarin, Korean, Persian, Hindi and Tamil speaking backgrounds at approximately 38 weeks gestation onward without planned C/S b.Women with diverse cultural background who were able to understand the CD in English at approximately 38 weeks gestation onward without planned C/S
Impact EvaluationControl Study • Study Group: Venue: CD was piloted in Antenatal Clinic Day Assessment Unit and Birth Unit Participant: 257 women who have listened to the CD were interviewed in the postnatal ward after their birth with the same structured questionnaire which was used for the needs assessment Period: May and September – October 2007
Impact on Knowledge LevelControl Study of Knowledge Level about Self –help Techniques and Pain Reliefs At Birth
Impact on Birth OutcomesThe Comparison of the Birth Outcomes among the Women in the Control Study and the NSW Data
Impact on Birth Outcome 2Control Study of the Association of Birth Outcomes and the Mother’s English Proficiency