Stressful events, social health issues and psychological distress in Aboriginal women having a baby in South Australia: implications for antenatal care.

Donna Weetra,Cathy Leane,Deirdre Gartland,Mary Buckskin,Deanna Stuart-Butler,Amanda Mitchell,May Turner,Jackie Ah Kit,Stephanie J Brown,Jane Yelland,Karen Glover

doi:10.1186/s12884-016-0867-2

Abstract

BackgroundAround 6 % of births in Australia are to Aboriginal and Torres Strait Islander families. Aboriginal and Torres Strait Islander women are 2–3 times more likely to experience adverse maternal and perinatal outcomes than non-Aboriginal women in Australia.MethodsPopulation-based study of mothers of Aboriginal babies born in South Australia, July 2011 to June 2013.Mothers completed a structured questionnaire at a mean of 7 months postpartum. The questionnaire included measures of stressful events and social health issues during pregnancy and maternal psychological distress assessed using the Kessler-5 scale.ResultsThree hundred forty-four women took part in the study, with a mean age of 25 years (range 15–43). Over half (56.1 %) experienced three or more social health issues during pregnancy; one in four (27 %) experienced 5–12 issues. The six most commonly reported issues were: being upset by family arguments (55 %), housing problems (43 %), family member/friend passing away (41 %), being scared by others people’s behavior (31 %), being pestered for money (31 %) and having to leave home because of family arguments (27 %). More than a third of women reporting three or more social health issues in pregnancy experienced high/very high postpartum psychological distress (35.6 % versus 11.1 % of women reporting no issues in pregnancy, Adjusted Odds Ratio = 5.4, 95 % confidence interval 1.9–14.9).ConclusionsThe findings highlight unacceptably high rates of social health issues affecting Aboriginal women and families during pregnancy and high levels of associated postpartum psychological distress. In order to improve Aboriginal maternal and child health outcomes, there is an urgent need to combine high quality clinical care with a public health approach that gives priority to addressing modifiable social risk factors for poor health outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0867-2) contains supplementary material, which is available to authorized users.

Highlights

Around 6 % of births in Australia are to Aboriginal and Torres Strait Islander families
This paper reports data from a population-based study, called the Aboriginal Families Study, which investigated the views and experiences of mothers having an Aboriginal baby in South Australia between July 2011 and June 2013
The aims of this paper are to: (i) describe the frequency and types of stressful events and social health issues experienced by Aboriginal women and families during pregnancy, (ii) to examine the relationship between the number and types of stressful events and social health issues experienced by families during pregnancy and maternal postpartum psychological distress, and (iii) consider implications for policy and health services

Summary

Introduction

Around 6 % of births in Australia are to Aboriginal and Torres Strait Islander families. Aboriginal and Torres Strait Islander women are 2–3 times more likely to experience adverse maternal and perinatal outcomes than non-Aboriginal women in Australia. Despite the younger age at which Aboriginal women commence childbearing, they experience higher rates of medical complications in pregnancy [4], and are two to five times more likely to die from pregnancy related complications as non-Aboriginal women [5]. Aboriginal women experience higher rates of perinatal deaths compared with non-Aboriginal women (17.1 versus 8.8 per 1000 births), and are twice as likely to have a preterm birth (13.5 % versus 8.0 %) and/or baby with a low birthweight (12.0 % versus 6.0 %) [3]

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Results

Conclusion