Australian Women Research Articles

“Everyone needs a Deb”: what Australian indigenous women say about breast cancer screening and treatment services

BackgroundBreast cancer continues to be the second most diagnosed cancer overall and the most diagnosed cancer for women in Australia. While mortality rates overall have declined in recent years, Indigenous women continue to be diagnosed at more marginal rates (0.9 times) and are more likely to die (1.2 times). The literature provides a myriad of reasons for this; however, the voices of Indigenous women are largely absent. This study sets out to understand what is happening from the perspectives of Australian Indigenous women with a view to charting culturally safer pathways that improve participation in screening and treatment by Indigenous women.MethodsThis co-design study was conducted using semi-structured, in-depth interviews and focus group discussions. Recruitment of study participants was via snowball sampling. Participants were subsequently consented into the study through the Aboriginal Health Service and the research team. Interviews were audio recorded and transcribed verbatim, and data coded in NVivo12 using inductive thematic analysis.ResultsA total of 21 Indigenous women and 14 health service providers were interviewed predominantly from the same regional/rural area in NSW, with a small proportion from other states in Australia. Six major themes were identified: Access, Awareness, Community and Family, Lack of control, Negative feelings and associations and Role of services.ConclusionTo improve access and participation of Indigenous women and ultimately improve mortality rates, breast cancer services must explicitly address cultural and community needs.

'It just stops me from living': A qualitative study of losses experienced by women with self-reported endometriosis.

To understand the experience of loss in Australian women with endometriosis. A total of 532 participants completed an online survey containing three open-ended questions relating to pelvic pain and activity loss due to endometriosis. Participants were Australian women aged between 18 and 50 years (M = 30.8, SD = 7.1) with a self-reported diagnosis of endometriosis. An inductive, qualitative approach, with template analysis was used to identify and organize themes. A pragmatic feminist perspective was used to interpret the findings. Three main themes were identified: the loss of liberty: 'I'm trapped in the house'; the loss of bodily autonomy: 'I can barely move/breathe/talk' and loss of connection: 'It stops me from being social'. Pain emerged as the greatest concern for participants, preventing them from the physical functioning required to participate in many of life's activities. The losses women with endometriosis experience are wide-reaching, restricting control and choice across multiple life domains. Losses were often unacknowledged by loved ones and healthcare providers, further impacting the physical, emotional and mental health of participants. People with endometriosis were involved in the design of the study, including identifying topics of interest.

Barriers and enablers to participation in the National Cervical Screening Program experienced by young women and people with a cervix aged between 25 and 35.

Cervical screening rates for young women aged between 25 and 35 are lower than older Australian women, however, little research has been conducted to understand why. This study aimed to identify and explore the barriers and enablers faced by young Victorians with a cervix to regular cervical screening. This study used a mixed method exploratory design consisting of qualitative focus groups and a quantitative online survey. Four focus groups were conducted with 24 Victorians with a cervix aged between 25 and 35. Barriers, enablers and knowledge of cervical screening were explored. Focus groups were recorded and transcribed for thematic analysis of common themes. A supporting online survey was completed by 98 respondents. Summary statistics were analysed for differences in age. Focus groups and the online survey revealed four main factors that influence young people's cervical screening behaviour. These include past negative screening experiences, practitioner factors, priority placed on cervical screening, and cervical screening knowledge. These factors differ to the opinions of people older than 35, with young people focusing more on the psychological elements of cervical screening compared with practical factors. This research provides a unique insight into cervical screening barriers faced by women and people with a cervix aged between 25 and 35 as well as what factors motivate them to screen. SO WHAT?: These findings should be utilised to inform the design of public health campaign messaging targeting this age demographic. Findings can also assist practitioners to improve how they communicate with young people in a clinical setting.

Prevalence and Persistence of Prescription Opioid Use Following Hospital Discharge After Childbirth: An Australian Population-Based Cohort Study.

Opioid analgesics are used for acute postpartum pain relief but carry risks, including persistent long-term opioid use. Our primary objective was to estimate the prevalence of persistent use following hospital discharge after childbirth. We conducted a population-based cohort study of women discharged from public or private hospitals in New South Wales, Australia, between 2012 and 2018 following vaginal birth (VB) or cesarean delivery (CD). We used linked hospitalization and medicine dispensing data to calculate the prevalence of opioid use within 14 days of hospital discharge for childbirth using an external estimate of the total number of hospital admissions for childbirth per year as the denominator. Among women dispensed an opioid postdischarge, we estimated the prevalence of persistent use defined as ≥3 dispensings between 30- and 365-days postdischarge. To calculate the odds of persistent opioid use, we performed a series of logistic regressions each including a single characteristic of interest. Included characteristics were maternal and birth characteristics, maternal medical conditions, prior use of certain medicines, and the initial opioid dispensed following discharge for childbirth. The final cohort comprised of 38,832 women who were dispensed an opioid in the 14 days following discharge after childbirth. Between 2012 and 2018, the prevalence of opioid use was increased following CD (public hospital 16.6%-21.0%; private hospital 9.8%-19.5%) compared with VB (public hospital 1.5%-1.5%; private hospital 1.2%-1.4%) and was higher following discharge from public hospitals compared with private. The most commonly dispensed opioids following discharge for childbirth were oxycodone (44.8%; 95% confidence interval [CI], 44.3-45.3), codeine (42.1%; 95% CI, 41.6-42.6), and tramadol (12.9%; 95% CI, 12.6-13.2). Among women dispensed an opioid, the prevalence of persistent opioid use was 5.4% (95% CI, 5.1-5.6). This prevalence was 11.4% (95% CI, 10.5-12.3) following a VB as compared with 4.3% (95% CI, 4.1-4.6) among those who underwent a CD ( P < .001). Characteristics associated with persistent opioid use included smoking during pregnancy, age <25 years, living in remote areas, discharged from a public hospital, history of opioid use disorder, other substance use disorder, mental health diagnosis, or prior use of prescription opioids, nonopioid analgesics, or benzodiazepines. The results of this cohort study indicate that Australian women have a higher prevalence of opioid use following CD compared to VB. One in 19 women dispensed an opioid postdischarge used opioids persistently. Careful monitoring of opioid therapy following childbirth is warranted, particularly among women with characteristics we identified as high risk for persistent opioid use.

Prevalence of Low and High BMI in Patients with Infertility

Background: The number of individuals who are underweight as well as overweight is increasing worldwide and is known to lead to menstrual disorders and subfertility. Data regarding the prevalence of infertility in Austrian women are lacking. This study aimed to determine the prevalence of a pathologically low and high body mass index (BMI) in Austrian patients with infertility and to evaluate the live birth rate (LBR) after assisted reproductive technologies (ARTs) compared with normal weight patients. Methods: A total of 585 couples with infertility who sought treatment at a single center between April 2017 and April 2019 were included in this retrospective study. The patients were categorized into study group 1 (BMI &lt;19 kg/m2, n = 35), study group 2 (BMI &gt;30 kg/m2, n = 40), and control group (BMI 19–30 kg/m2, n = 95. They were randomly selected from the n = 522 women within these BMI values). Results: The prevalence rates of BMI &lt;19 kg/m2 and BMI &gt;30 kg/m2 were 5.9% and 6.7%, respectively. Baseline clinical and laboratory characteristics as well as the prevalence of pathospermia in their male partners were similar in all study groups. In women undergoing ART (n = 112), LBR was comparable between the study groups (27.3% vs. 31.9% and 22.2%, p = 0.4). Conclusions: The prevalence of low and high BMI in Austrian patients seeking fertility treatment was almost 13%. Although LBR was not reduced, physicians should be more attentive to the BMI values of patients with infertility because pregnancy-related complications are linked to being underweight and obese.

Women’s experience of perinatal support in a high migrant Australian population during the COVID-19 pandemic: a mixed methods study

BackgroundAs a COVID-19 risk mitigation measure, Australia closed its international borders for two years with significant socioeconomic disruption including impacting approximately 30% of the Australian population who are migrants. Migrant populations during the peripartum often rely on overseas relatives visiting for social support. High quality social support is known to lead to improved health outcomes with disruption to support a recognised health risk.AimTo explore women’s experience of peripartum social support during the COVID-19 pandemic in a high migrant population. To quantify type and frequency of support to identify characteristics of vulnerable perinatal populations for future pandemic preparedness.MethodsA mixed methods study with semi-structured interviews and a quantitative survey was conducted from October 2020 to April 2021. A thematic approach was used for analysis.ResultsThere were 24 participants interviewed both antenatally and postnatally (22 antenatal; 18 postnatal). Fourteen women were migrants and 10 Australian born. Main themes included; ‘Significant disruption and loss of peripartum support during the COVID-19 pandemic and ongoing impact for migrant women’; ‘Husbands/partners filling the support gap’ and ‘Holding on by a virtual thread’. Half of the participants felt unsupported antenatally. For Australian born women, this dissipated postnatally, but migrants continued to feel unsupported. Migrant women discussed partners stepped into traditional roles and duties of absent mothers and mothers-in-law who were only available virtually.ConclusionThis study identified disrupted social support for migrant women during the pandemic, providing further evidence that the pandemic has disproportionately impacted migrant populations. However, the benefits identified in this study included high use of virtual support, which could be leveraged for improving clinical care in the present and in future pandemics. The COVID-19 pandemic impacted most women’s peripartum social support with migrant families having ongoing disruption. Gains in the pandemic included greater gender equity for domestic work as husbands/partners increased their contribution to domestic work and childcare.

Oral history as an analytical tool: Eve Mahlab and the Australian Trailblazing Women Law Project

ABSTRACT This article adds to a growing body of literature that aims to correct the traditional lack of attention to the role of women lawyers who have exercised their power as active citizens by participating in legal reform and facilitating access to social justice for all Australians. The paper highlights the unique contribution to gender equality of one such woman, Eve Mahlab AO, through a close examination of her oral history, which was drawn from the pilot stage of a project that now comprises a corpus of over fifty interviews recorded with ‘trailblazing’ Australian women lawyers. The methodology adopted is innovative in combining a legal analysis and a discourse analysis of the interview with Eve Mahlab. This approach offers insights into those aspects of her personal and professional biography that most influenced and enabled her contributions in the public and private spheres, allowing us to publicly acknowledge and record them. The paper demonstrates how such use of oral history broadens and deepens our understanding of the diverse social and professional forces that shape political consciousness and motivate feminist engagement in civic activity.

Symptoms of sleep problems and adherence to dietary guidelines in older women: evidence from the Australian Longitudinal Study on Women's Health.

This study examined adherence to dietary guidelines and symptoms of sleep problems (e.g. taking a long time to fall sleep or waking up early) and their associations in a sample of older Australian women (68-73 years of age). This was a population-based cross-sectional study. Adherence to the dietary guidelines was measured using a validated FFQ and reported as a diet quality score. Symptoms of sleep problems were measured using five questions and a total score was derived. Multivariate linear regression was used to investigate the association between these outcomes, adjusted for the potential confounding influence of demographic (i.e. age and marital status) and lifestyle (i.e. physical activity, stress, alcohol intake, sleep medication use) variables. Respondents from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health who completed Survey 9 were included. Data from n 7956 older women (mean age ± sd: 70·8 ± 1·5) were included. 70·2 % reported having at least one symptom and 20·5 % had between 3 and 5 symptoms of sleep problems (mean score ± sd: 1·4 ± 1·4, range 0-5). Adherence to dietary guidelines was poor with an average diet quality score of 56·9 ± 10·7 (range 0-100). Better adherence to dietary guidelines was associated with fewer sleep problem symptoms (β: -0·065, 95 % CI: -0·012, -0·005) and remained significant after adjusting for confounding influences. These findings support the evidence that adherence to dietary guidelines is associated with symptoms of sleep problems in older women.

Experiences, Knowledge Gaps and Information Needs of Women in Australia with Transfusion Dependent Thalassaemia in Regard to Fertility and Pregnancy

ObjectivesTransfusion dependent β-thalassaemia can have significant effects on fertility and is also associated with significant risks in pregnancy. However, little is known about the perspectives of women living with the condition with regards to reproductive issues. The aim of this study was to assess the experience, knowledge and information needs of Australian women living with transfusion dependent β-thalassaemia in relation to fertility and pregnancy.MethodsA cross sectional study using an online anonymous survey, self-administered through REDCap, addressing key issues related to the experience, knowledge and information needs of women with transfusion dependent β-thalassaemia. Descriptive and inferential analysis was conducted using STATA.ResultsSixty participants were included in the analysis. Two-thirds of sexually active, pre-menopausal women were using contraception. Just under half of the participants who were sexually active had children and half had required some form of assisted reproductive technology to achieve a pregnancy. Less than half identified the importance of contraception as part of ensuring optimised pre-pregnancy care, and less than half had accessed pre-pregnancy care. Although there was good understanding of the increased risk of infertility and pregnancy complications, the specific risks and causes of these risks were poorly understood. Around half of the participants indicated they wanted more information on these medical issues.Conclusions for practiceOur study demonstrated significant concerns and knowledge gaps in Australian women with transfusion dependent β-thalassaemia with regards to disease-specific issues related to fertility and pregnancy, and a desire for related patient information.

Factors associated with weight gain after breast cancer: Results from a community-based survey of Australian women.

Weight gain after breast cancer is common. The aim of this study was to determine factors associated with weight gain after breast cancer in Australian women. A cross-sectional online survey was conducted between November 2017 and January 2018. Women living in Australia who self-identified as having breast cancer or ductal carcinoma in-situ were eligible. We created stepwise linear and logistic regression models to evaluate predictors for absolute and clinically significant (≥5%) weight gain respectively. Data from 276 women were analysed. Most were Caucasian and 92% had been diagnosed with Stage 0-III breast cancer. Absolute weight gain was associated with hot flushes, being in the menopausal transition at diagnosis, being less physically active than at diagnosis, lower eating self-efficacy when watching television or using a computer, and higher self-efficacy when anxious or nervous (F-ratio=3.26, R2-adjusted=0.16, p<.001). Clinically significant weight gain was associated with tamoxifen use (OR 2.7), being less physically active than at diagnosis (OR 3.1), and lower eating self-efficacy when watching television or using a computer (OR 0.82) (Chi-square 64.94, df=16, p<.001). Weight gain was not associated with chemotherapy, radiotherapy, aromatase inhibitor use, number of lymph nodes removed, or body mass index at diagnosis. Interventions to prevent weight gain after breast cancer, particularly aiming to maintain physical activity, should be targeted at women receiving tamoxifen. The role of eating self-efficacy, especially attentive eating, in managing weight after breast cancer should be explored.

Physical activity and injurious falls in older Australian women: adjusted associations and modification by physical function limitation and frailty in the Australian Longitudinal Study on Women's Health.

To investigate associations between leisure-time physical activity (LPA) and injurious falls in older women and explore modification of associations by physical function and frailty. Women born during 1946-51 from the Australian Longitudinal Study on Women's Health, injurious falls (self-reported fall with injury and/or medical attention) and self-reported weekly LPA (duration and type). We undertook cross-sectional and prospective analyses using data from 2016 [n = 8,171, mean (SD) age 68 (1)] and 2019 surveys (n = 7,057). Associations were quantified using directed acyclic graph-informed logistic regression and effect modification examined using product terms. Participation in LPA as recommended by World Health Organization (150-300min/week) was associated with lower odds of injurious falls in cross-sectional (adjusted Odds Ratio (OR) 0.74, 95% CI 0.61-0.90) and prospective analyses (OR 0.75, 95% CI 0.60-0.94). Compared with those who reported no LPA, cross-sectionally, odds of injurious falls were lower in those who reported brisk walking (OR 0.77, 95% CI 0.67-0.89) and vigorous LPA (OR 0.86, 95% CI 0.75-1.00). No significant association was found between different types of LPA and injurious falls prospectively. Only cross-sectionally, physical function limitation and frailty modified the association between LPA and injurious falls, with tendencies for more injurious falls with more activity in those with physical limitation or frailty, and fewer injurious falls with more activity among those without physical function limitation or frailty. Participation in recommended levels of LPA was associated with lower odds of injurious falls. Caution is required when promoting general physical activity among people with physical limitation or frailty.

Hugo Bettauer, Feminism, and the Non-White World in Interwar Vienna

This article examines how the 1920s Viennese journalist and magazine-publisher Hugo Bettauer, a Christian convert from Judaism, harnessed images of and stories about non-White peoples to the cause of Austrian female liberation. In Bettauers Wochenschrift, Bettauer and his contributors highlighted non-White ways to illuminate, by comparison, the confining nature of the social and cultural mores that structured Austrian women's subjugation. This had the effect of reaffirming the existence of a racial hierarchy, one with Black people on the bottom, despite Bettauer's sympathy for the plight of Black Americans and the magazine's open admiration of certain non-White practices regarding sex and marriage.

“We are competing with culture” the chasm between healthcare professionals and Australian Samoan women in the prevention and management of gestational diabetes mellitus

Objective: The Samoan community has a disproportionately higher incidence of gestational diabetes mellitus (GDM). We explored consumer and healthcare providers’ insight into perceptions of risk, attitudes to lifestyle behaviour change and experiences of GDM among Australian Samoan women in South Western Sydney. Methods: Semi-structured interviews and a focus group with Samoan women recruited through three churches, a diabetes and pregnancy clinic in South Western Sydney and via social media were conducted. Semi-structured interviews with healthcare providers’ were also conducted. Main themes were thematically analysed to identify recurring patterns using Quirkos software. Identified themes were framed against the constructs of the Health Belief Model. Results: One focus group (n=4) and 12 one-to one interviews were conducted among Samoan women. Eighteen semi-structured interviews with healthcare providers’ were also conducted. There was a high concordance between Samoan women and healthcare providers’ regarding perception of risk and barriers to maintaining a healthy lifestyle. However, Samoan women reported negative interactions with healthcare providers’ that hindered their behaviour change, while healthcare providers’ reported that normalisation of diabetes, confusion of GDM with type 2 diabetes and spiritual health beliefs were deterrents to behaviour change among Samoan women. Conclusion: Cross-cultural factors can influence the uptake of a healthy lifestyle. Future research should consider use of culturally tailored strategies when developing educational resources targeting Samoan women. Implications for research, policy and practice: The participants’ viewpoints expressed in this study suggest a critical need for the development of culturally-tailored health promotion strategies for Samoan women and cultural training for healthcare providers’, to improve GDM care and subsequent pregnancy outcomes.

Impact of COVID-19 Restriction on Weight, Physical Activity, Diet and Psychological Distress on People with PCOS

Background: People with polycystic ovary syndrome (PCOS) have higher weight gain and psychological distress compared to those without PCOS. While COVID-19 restrictions led to population level adverse changes in lifestyle, weight gain and psychological distress, their impact on people with PCOS is unclear. The aim of this study was to investigate the impact the 2020 COVID-19 restrictions had on weight, physical activity, diet and psychological distress for Australians with PCOS. Methods: Australian reproductive-aged women participated in an online survey with assessment of weight, physical activity, diet and psychological distress. Multivariable logistic and linear regression were used to examine associations between PCOS and residential location with health outcomes. Results: On adjusted analysis, those with PCOS gained more weight (2.9%; 95% CI; 0.027–3.020; p = 0.046), were less likely to meet physical activity recommendations (OR 0.50; 95% CI; 0.32–0.79; p = 0.003) and had higher sugar-sweetened beverage intake (OR 1.74; 95% CI 1.10–2.75; p = 0.019) but no differences in psychological distress compared to women without PCOS. Conclusions: People with PCOS were more adversely affected by COVID-19 restrictions, which may worsen their clinical features and disease burden. Additional health care support may be necessary to assist people with PCOS to meet dietary and physical activity recommendations.

Influenza and pertussis vaccine coverage in pregnancy in Australia, 2016-2021.

Vaccination in pregnancy is the best strategy to reduce complications from influenza or pertussis infection in infants who are too young to be protected directly from vaccination. Pregnant women are also at risk of influenza complications preventable through antenatal vaccination. Both vaccines are funded under the National Immunisation Program for pregnant women in Australia, but coverage is not routinely reported nationally. We reviewed all reported Australian maternal influenza and pertussis vaccine coverage data for the period 2016-2021, to identify gaps and information needs. Maternal influenza vaccine coverage was suboptimal at < 58% for 2016-2018, with higher coverage of 62-75% reported in two states (Victoria and Western Australia) for 2019-2021. Maternal pertussis vaccine coverage from 2016 was generally higher than for influenza at > 70%, with the highest jurisdictional coverage of 89% reported in Western Australia in 2020. Vaccination rates were often suboptimal among First Nations pregnant women and up to 20% lower than among non-First Nations Australian women; while data were limited, coverage was low among culturally and linguistically diverse women and among women of lower socio-economic status. Jurisdictional perinatal data collections were the best source of information on antenatal vaccine coverage but were only available for a minority of the population; a nationally consistent systematic approach is lacking. Timely and comprehensive data are needed to provide feedback to improve maternal vaccination coverage, particularly among groups with higher risk and/or low uptake, and as new vaccines are recommended, including COVID-19 vaccination.

Listening to First Nations women’s voices, hearing requests for continuity of carer, trusted knowledge and family involvement: A qualitative study in urban Darwin

ProblemAustralian First Nations women are more likely to commence care later in pregnancy and underutilise maternal health services than non-First Nations women. BackgroundDisrespectful maternity care is a major barrier to care-seeking in pregnancy, often resulting in later commencement and underutilisation of care. AimWe aimed to identify barriers and enablers to pregnancy-related care-seeking for Australian First Nations women living in the Darwin region through yarning about their experiences of pregnancy care. MethodsTen Australian First Nations women shared stories about their pregnancy care journeys. Yarns took place at a time and location determined by the women, with recruitment continuing until saturation was reached. FindingsEmerging themes included a desire for continuity of carer, particularly with midwives; access to trustworthy information, enabling informed decision-making; and a need to have family involved in all aspects of care. No specific barriers were identified within this cohort DiscussionUniversal access to continuity of carer models would provide women with the relational care they are asking for as well as address other identified needs, such as a desire for information relevant to their pregnancy; and space for partners/family members to be involved. The themes that emerged provide a picture of what a positive, respectful pregnancy care experience could be for First Nations women within the Darwin Region, thus enabling care-seeking in pregnancy. ConclusionAlthough the public sector and Aboriginal Controlled Community Health Organisations currently provide continuity of carer models, robust systems ensuring these models are made available to all women are lacking.

‘The Nation’s Health Is the Nation’s Wealth’: Portia Geach (1873–1959) and the Good Health Movement in Interwar Australia

In the interwar period, the Australian artist and activist Portia Geach was a leading advocate of the ‘good health movement’ in Australia. Geach produced a public campaign promoting nutritious eating and rejuvenation practices, helping to introduce a health consciousness to the Australian public. A ‘female sojourner’, her ideas about diet and health were imported to Australia from across the globe, where she became educated on nutrition science, home economics, natural health, and physical exercise. By foregrounding Geach as a leader of the good health movement, and an active participant in cultural formations, this article highlights an avenue through which Australian women articulated their expanding role in public life during the interwar period, and how women's leadership roles were formed through transnational engagement. Her participation in cultural exchanges helped to create a new national public health discourse led by women.

The prevalence of breastfeeding aversion response in Australia: A national cross-sectional survey.

Some women who breastfeed will experience complex ongoing difficulties, such as breastfeeding aversion response (BAR). This recently named breastfeeding challenge is defined as feelings of aversion while breastfeeding for the entire time that the child is latched. This study provides the first prevalence data for the experience of BAR in Australian breastfeeding women. A national online survey investigated the breastfeeding experience of Australian women including data on (1) participant demographics, (2) breastfeeding experience with up to four children, (3) breastfeeding challenges and prevalence of BAR, and (4) the value of available breastfeeding support. This study found that of the Australian breastfeeding women who participated (n = 5511), just over one in five self-identified as having experienced a BAR (n = 1227, 22.6%). Most reported experiencing some breastfeeding challenges, with only 4.5% (n = 247) having had no breastfeeding complications. Importantly, despite these difficulties, 86.9% of the total women in this study rated their overall breastfeeding experience as good (n = 2052, 37.6%), or very good (n = 2690, 49.3%), and 82.5% of those who experience BAR as good (n = 471, 38.7%) or very good (n = 533, 43.8%). BAR reporting was decreased in higher education and income groups. Women who are breastfeeding for the first time are more likely to encounter difficulties with breastfeeding such as BAR. Complications with breastfeeding are pervasive, but women who can overcome breastfeeding issues often report a positive overall breastfeeding experience.

Advancing menopause care in Australia: barriers and opportunities.

Advancing menopause care in Australia: barriers and opportunities.

The direct and mediating effect of social support on health-related quality of life during pregnancy among Australian women

BackgroundPrenatal stress can have a negative effect on the quality of life (QoL) of pregnant women. Social support plays a vital role in improving the psychological well-being of pregnant women by enhancing their stress-coping ability. The current study assessed the association between social support and health-related quality of life (HRQoL) as well as the mediating role of social support in the linkage between perceived stress and HRQoL among pregnant Australian women.MethodsSecondary data was obtained from 493 women who reported being pregnant in survey six of the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH). Social support and perceived stress were assessed using the Medical Outcomes Study Social Support Index (MOS-SSS-19) and the Perceived Stress Scale, respectively. The Mental Component Scale (MCS) and Physical Component Scale (PCS) of the SF-36 were used to examine the mental and physical HRQoL. A mediation model was used to examine the mediating effect of social support in the relationship between perceived stress and HRQoL. A multivariate quantile regression (QR) model was used to assess the association between social support and HRQoL after adjusting for potential confounders.ResultThe mean age of the pregnant women was 35.8 years. The mediational analysis revealed that emotional/informational support (β= -1.53; 95% CI: -2.36, -0.78), tangible support (β= -0.64; 95% CI: -1.29, -0.09), and affectionate support/positive social interaction (β= -1.33; 95% CI: -2.25, -0.48), played a significant mediating role in the relationship between perceived stress and mental health-related QoL. In addition, perceived stress had a significant indirect effect on mental health-related QoL through overall social support (β = -1.38; 95% CI: -2.28, -0.56), and the mediator accounted for approximately 14.3% of the total effect. The multivariate QR analysis indicated that all the domains of social support and overall social support scores were positively associated with higher MCS scores (p < 0.05). However, social support was found to have no significant association with PCS (p > 0.05).ConclusionSocial support plays a direct and mediating role in improving the HRQoL of pregnant Australian women. Maternal health professionals need to consider social support as an essential tool to improve the HRQoL of pregnant women. Further, as part of routine antenatal care activity, assessing pregnant women’s level of social support is beneficial.