Chinese Immigrant Women Research Articles

중국계 결혼이주민의 자녀 이중언어 교육 경험에 관한 연구

본 연구의 목적은 자녀를 양육하고 있는 중국계 결혼이자들은 어떻게 자녀에게 이중언어 교육을 실시하고 있는지, 이중언어 교육에 있어 어떠한 어려움이 있는지, 그리고 그들이 이중언어 교육을 위해 무엇을 기대하고 있는지 등을 탐색하여 지속발전 가능한 이중언어 교육의 방안을 제안하는 것이다. 이를 위해 2017년 11월부터 2018년 1월까지 중국계결혼이주여성 6명을 대상으로 내러티브 연구방법을 적용하여 이야기식 인터뷰로 자료를 수집하였다. 연구 결과, 3개의 주제 영역과 의미와 이에 따른 10개의 하위 주제 의미로 나누어 기술하였다. 첫째, 결혼이민자들이 자녀의 이중언어 사용에 대해 우려하는 바는 ‘자녀의 언어 발달지체에 대한 우려’, ‘학교 및 사회에서 차별에 대한 우려’, ‘가족구성원의 부정적 인식’ 이다. 둘째, 결혼이민자 자녀의 이중언어 교육 환경은 ‘조선족 발음과 사투리에 대한 우려’. ‘경제로 인한 사교육의 한계’, ‘사회적 지지기반 빈약’, ‘결혼이민자의 자존감 부재와 교육방법의 미숙’으로 나타났다. 셋째, 모국을 활용한 자녀의 이중언어 교육은 ‘자녀를 중국으로 유학을 보내고’, ‘방학을 활용하여 친정 방문’, ‘외할머니를 초청’하여 모국어를 가르치는 것으로 나타났다.

Experiences of Chinese immigrant women following "Zuo Yue Zi" in British Columbia.

To describe Chinese women's experiences with "zuo yue zi" in British Columbia, Canada. Women born in China and Taiwan are increasingly immigrating to westernised countries. Many women choose to follow traditional Chinese postpartum practices, also called "zuo yue zi." Few studies have examined women's use of traditional practices in western countries. The study used a qualitative descriptive design. We recruited 13 mothers who were: aged 19 or older, immigrants from mainland China, Hong Kong or Taiwan in the last 5years, and caring for infants born in the previous 6weeks. Semistructured interviews were conducted in Mandarin, translated into English, transcribed and analysed using inductive content analysis. The core theme was Chinese women's novel encounters with "zuo yue zi." The women's expectations of "zuo yue zi" were acquired through birth experiences or interactions with family and friends. The participants struggled with implementing traditional practices because social support and formal institutional structures were lacking. They modified their expectations about "zuo yue zi." Factors affecting their practices were catalysts and deterrents. Catalysts included help from Chinese family members, friends and informed healthcare providers. Deterrents included unregulated paid helpers, uninformed care providers, financial constraints and structural limitations in their new environments. Chinese immigrant women struggled to modify and implement traditional practices in their adopted country when they encountered financial constraints, unregulated paid helpers and varying support from health care providers. Some postpartum women following "zuo yue zi" believed that the practice would prevent chronic illness and strengthen their intrafamily relationships. Immigrant mothers require nursing support to follow traditional postpartum practices. Nurses can advocate on patients' behalf to increase care providers' knowledge about "zuo yue zi" and public awareness for necessary regulated institutional structures.

Becoming Homecare Workers: Chinese Immigrant Women and the Changing Worlds of Work, Care and Unionism

This article examines how the intersectional dynamics of gender, migration, and labor shape the trajectories of immigrant women into home-based elder care and how unions and community organizations mediate its conditions. Our analysis, which uses interviews with In-Home Supportive Services workers in California’s Oakland Chinatown, shows that the growth of publicly-subsidized homecare jobs has created an occupational opportunity for workers who face restrictive labor markets due to declining factory jobs and discriminatory hiring. Workers acknowledge the daily stress of working in low-paid, precarious jobs characterized by high levels of informality and coercive gender and racial-ethnic dynamics but the quasi-public nature of these jobs complicates a facile depiction of it as domestic servitude. Ethnic community organizations and labor unions open up institutional pathways to empowering forms of collective voice. Our findings contribute to the growing effort to understand how the social organization of care work both draws upon and exacerbates existing inequalities.

Unique trajectories of anxiety among Chinese-Canadian women across the first postpartum year: A longitudinal cohort study

BackgroundOur objectives were to identify subtypes of Chinese-Canadian women with unique trajectories of anxiety symptomatology over the first postpartum year, investigate covariates associated with group membership, and determine if mental healthcare utilization varies by group membership. MethodsThis was a longitudinal cohort study of 570 Chinese immigrant and Canadian-born women in Toronto, Canada with live births in 2010–2014. Covariates were age, immigrant status, income, fatigue, social support, acculturative stress, and depression. Mental healthcare utilization included visits at 4–24 weeks postpartum. Anxiety symptomatology was measured using the State-Trait Anxiety Inventory-State. Growth mixture modeling was used to identify latent classes corresponding to trajectories of anxiety symptomology at 4–52 weeks. ResultsThree groups were identified: “consistently non-anxious” (74%, stable low levels of anxiety), “consistently anxious” (19.5%, clinically meaningful anxiety at baseline and across time), and “anxious-improving” (6.5%, high anxiety at baseline followed by decline). Compared to consistently non-anxious women, consistently anxious women were more likely to report baseline fatigue, depression, and acculturative stress; anxious-improving women were more likely to report baseline fatigue, depression, and history of depression before pregnancy. At 12–24 weeks, 13.8% of anxious-improving women sought mental healthcare compared to 8.6% of consistently-anxious women and 4.7% of non-anxious women (p = .06). LimitationsOur sample comprised Chinese immigrant and Canadian-born women; results should be replicated in other groups. ConclusionsWe identified three subtypes of postpartum anxiety trajectories. These groups of women may respond differently to interventions due to exposure to various combinations of risk factors.

"We Went Out to Explore, But Gained Nothing But Illness": Immigration Expectations, Reality, Risk and Resilience in Chinese-Canadian Women with a History of Suicide-Related Behaviour.

Suicide is a complex and tragic outcome driven by biological, psychological, social and cultural factors. Women of Chinese descent and women who have immigrated to other countries have higher rates of suicidal ideation and behaviour, and immigration-related stress may contribute. To understand the experiences of immigration and their relationship with distress and suicide-related behaviour in Chinese women who have immigrated to Canada. 10 semi-structured qualitative interviews with Chinese women who have immigrated to Toronto, Canada and have a history of suicide-related behaviour were completed and analyzed using a constructivist grounded theory methodology. Immigration-related and acculturation stress stemmed from unmet expectations and harsh realities. These repeated experiences resulted in hopelessness, helplessness, and alienation, which are risk factors for suicide and suicide-related behaviour. However, immigration-related support can also increase hope, self-efficacy and connectedness to foster recovery and resilience. This is the first qualitative study focusing on immigration experiences and its relationship to suicide-related behaviour in Chinese immigrant women. Knowledge of immigration and acculturation stressors can a) help identify and support women at risk for suicide and b) form a target for social intervention for all immigrant women, regardless of suicide risk.

A case study on the gender equality experience of Chinese married immigrant women in Korea

A case study on the gender equality experience of Chinese married immigrant women in Korea

The Coming Man from Canton: Chinese Experience in Montana, 1862–1943 by Christopher W. Merritt

Reviewed by: The Coming Man from Canton: Chinese Experience in Montana, 1862–1943 by Christopher W. Merritt Roland Hsu The Coming Man from Canton: Chinese Experience in Montana, 1862–1943. By Christopher W. Merritt. Lincoln: University of Nebraska Press, 2017. vii + 248 pp. Illustrations, references, index. $65.00 cloth. Christopher Merritt's new book is a welcome addition to the study of Chinese immigration to North America in the late nineteenth and early twentieth centuries. It's a compelling account of Chinese immigrants' contributions to the economic and social development of the Great Plains in general, and to the state of Montana in particular. Merritt is adept in placing the chronology of the region's gold rush, the building of the Northern Pacific Railroad connection to the Transcontinental line, and the growth of Chinese commercial districts into larger historical context. This book replaces the prevailing view of the Chinese as exploited and passive victims with a view of nineteenth-century Chinese immigrants as foundational actors in the regional history of enterprise, and in the social fabric of the American West. Through historically informed research, Merritt reveals that by the last decades of the nineteenth-century, individual Chinese were able to circumvent the racially discriminatory Alien Law to purchase and work older placer mines. Several thousand Chinese also moved from the recently completed Central Pacific Railroad line in California, Nevada, and Utah to contribute significantly to the building of the Northern Pacific rail line. Merritt's distinctive theoretical contribution is to rethink the casting of the Chinese immigrant community as peripheral. While the Chinese at the time were indeed segregated from non-Chinese residences and work groups, in this analysis the Chinese in fact maintained direct economic and social ties to their homeland. In Merritt's account, an important and sustainable source of wealth generated by the Chinese community in Montana came from the business of provisioning its own laborers. The business of supplying the Chinese miners, railroad workers, and urban small businesses meant thoroughly integrating into a network of Chinese ethnic organizations in the United States—so-called secret societies and the Chinese Six Companies—and doing profitable business with wholesale purveyors of foods and goods from China. Merritt shows how the Chinese artifacts from sites of former rail line work camps, food and supply retailers, and burial plots point to the vital role of the Chinese community as consumers in the Pacific's marketplace. Finally, as Merritt notes, the extensive research for this book did not produce a description of the experience of immigrant Chinese women, and their absence for the most part from the historical record is particularly poignant. The author's sensitivity to the subject of gender whets our appetite for further research in this area. Roland Hsu Chinese Railroad Workers in North America Project Stanford University Copyright © 2018 The Center for Great Plains Studies and The University of Nebraska Press

Transnational familial strategies, social reproduction, and migration: Chinese immigrant women professionals in Canada

ABSTRACT This paper fills a lacuna in the literature on gender, work, and migration by exploring the migration experience and familial arrangements of middle-class Mainland Chinese migrant women who were professionals in their home country. Informed by theoretical debates on social reproduction, and transnational migration frameworks, it explores how transnational migration is shaped by intersectional gender, race/ethnicity, and class processes, and demonstrates how these Chinese immigrant women utilized transnational familial arrangements as strategies for social reproduction. In doing so, the Mainland Chinese immigrant women professionals provide what they perceive as better opportunities for themselves and for their families. Our research starts with Chinese immigrant women’s individual articulations of their own migration trajectories, we then go further to examine how the women’s transmigration strategies are embedded in the context of the changing social, economic, political, and cultural processes in China and in Canada. In this paper, Mainland Chinese immigrant women’s motivations for immigrating to Canada; how migration shapes their experiences in Canada; as well as their transnational strategies for social reproduction are explored.

Femininities on transnational journeys and sexual health risk: experiences of Chinese immigrant women in Canada

Negotiations at work in a globalising China in regard to femininity, sexuality, and family relationships have been well documented from the 1990s. Nonetheless less is known about them in a transnational context, and femininities are far less explored than masculinities. Drawing on interview data from a larger research study of transnationalism and gendered HIV vulnerability, this article investigates the intersection of femininity, sexuality and sexual health risk through Chinese immigrant women’s narratives about their experiences in Canada. It examines to what extent these intimate negotiations within China are re-enacted through Chinese immigrant women’s transnational experiences in Canada. These women live ‘in-between’ China and Canada in terms of identity, space and time with their cross-cultural connections unveiling both virtual and actual relations. Gender norms and roles, intimate and sexual experience, and family relations are realigned in the transnational lives of these women and are impacted by both their home and host societies, as well as their past and present experience in China. Used in the article as a concept and an analytical lens, gender is acknowledged as a key organising principle in post-immigration individual and social experience.

Cervical Cancer Screening Experiences Among Chinese American Immigrant Women in the United States

ObjectiveTo understand the experiences and perceptions of having cervical cancer screening tests and to explore the extant barriers to having the tests among first-generation Chinese American women in the United States. DesignQualitative, descriptive, phenomenological research. SettingLos Angeles, California. ParticipantsSnowball and purposive sampling of 12 Chinese American immigrant women ages 20 to 65 years. MethodsIndividual face-to-face, in-depth, semistructured interviews in which participants were asked about their experiences and perceptions about cervical cancer screening. Interviews were audiotaped, transcribed, and translated into English. Data analysis included comparing and distinguishing, collecting and counting, and presupposing and inferring. ResultsThrough the analysis process, we identified four major themes that reflected the experiences, perceptions, and barriers to having cervical cancer screening among Chinese American women: Belief in a Healthy Lifestyle, Maintaining Privacy for Female Health Problems, Fear of Losing Control, and Feeling Vulnerable in an Unfamiliar Health Care System. These themes indicated that Chinese immigrant women in the United States face challenges to their cultural health beliefs and practices with regard to decision-making and health-seeking behaviors related to cervical cancer screening. They felt more vulnerable as immigrants because of systematic barriers to navigation of the unfamiliar health care system and limited resources. ConclusionWomen's health care providers should be aware of and give consideration to cultural differences through the provision of more educational information and comfort to Chinese immigrant women who seek cervical cancer screening. Ultimately, the development of culturally appropriate and affordable cancer prevention programs with effective strategies is important to ease Chinese American women's senses of vulnerability.

Determinants of comorbid depression and anxiety postnatally: A longitudinal cohort study of Chinese-Canadian women

BackgroundWomen with comorbid depression and anxiety in the postpartum period experience more complex and severe symptoms than women with depression or anxiety alone; however, little is known about what influences these symptoms, especially among women from specific ethnic backgrounds. The objective of this study was to identify determinants of comorbid depression and anxiety symptomatology by 24 weeks postpartum in a cohort of Chinese-Canadian women. MethodsA longitudinal cohort study was completed where 549 Chinese immigrant and Canadian-born women in Toronto were followed to 24 weeks postpartum. Questionnaires included risk factors measured at 4 weeks. Logistic regression was used to develop a model of comorbidity (Edinburgh Postnatal Depression Scale score > 9; State-Trait Anxiety Inventory score > 40) up to and including 24 weeks. ResultsPrevious history of postpartum (AOR 2.42, 95% CI 1.42–4.14) and non-postpartum (AOR 4.20, 95% CI 2.21–7.98) depression, maternal age < 26 years (AOR 1.83, 95% CI 1.04–3.22), perception of support (AOR 0.97, 95% CI 0.94–1.00), acculturative stress (AOR 1.03, 95% CI 1.01–1.04), maternal fatigue (AOR 1.12, 95% CI 1.07–1.17), and perceived infant sleep problems (AOR 2.06, 95% CI 1.27–3.43) were significantly associated with comorbid depression and anxiety in the first 24 weeks postpartum. LimitationsOur sample consisted of Chinese-Canadian women; this study should be replicated in other ethnic groups to see if and how risk factors of postpartum comorbidity differ. ConclusionThe factors identified herein offer insight into groups of Chinese-Canadian women who might benefit most from early identification and treatment and suggest targets for prevention.

Prevalence, Incidence, and Persistence of Postpartum Depression, Anxiety, and Comorbidity among Chinese Immigrant and Nonimmigrant Women: A Longitudinal Cohort Study.

Our objectives were to examine the prevalence and incidence of postpartum depressive, anxiety, and comorbid symptoms over the first postpartum year; the persistence of these symptoms; and the prevalence stratified by immigration status. We conducted a longitudinal cohort study in Ontario, Canada. Participants were 571 Chinese recent immigrant, nonrecent immigrant, and Canadian-born women with live births in 2011 to 2014. Participants were assessed at 4, 12, and 52 weeks postpartum for the presence of possible and high depressive symptomatology (Edinburgh Postnatal Depression Scale [EPDS] >9 and >12, respectively), anxiety symptomatology (State-Trait Anxiety Inventory [STAI] >40), and comorbid symptomatology (EPDS >9 and STAI >40). Prevalence and incidence with 95% confidence intervals were calculated. Prevalence rates were highest at 4 weeks and decreased across time, with possible depressive symptomatology most prevalent at most time points. Incidence rates at 12 and 52 weeks were generally similar. Of those with possible symptomatology at 4 weeks, 42.0% or less continued to have symptomatology at 12 weeks and 17.4% or less at 52 weeks. There were no differences in prevalence of any type of symptomatology between immigrant and Canadian-born Chinese women at 4 weeks, but at 12 and 52 weeks, most types of symptomatology were more common among recent and nonrecent immigrants. Our findings suggest that Chinese immigrant women are a high-risk group for postpartum depressive and anxiety symptomatology. Future research should identify cultural and psychosocial factors associated with immigration that could be addressed in the system of care for postpartum immigrant women.

Inscription on the Past from Present Inquiries Historiography of Nineteenth Century Chinese Immigrant Public Women

Chinese immigrant women arrived in America's West in the mid nineteenth century. Their arrival markedthe beginning of Chinese American women in the United States of America [1]. They left very fewdocuments of their own. They were assumed to have followed the Chinese men to the West after the goldrush to serve the men. A majoritity of them were called "One Hundred Men's Wives" or prostitutes [2]. Inthe Western construction and conceptualization of Chinese women of this particular time, they have beenportrayed as victims of patriarchy and the capitalist system.

Effects of acculturation, coping strategies, locus of control, and self-efficacy on chronic pain: study of Chinese immigrant women in Italy - insights from a thematic field analysis.

Chronic pain represents a common public health concern worldwide. It is a complex phenomenon, owing to the interaction of different factors, including biological, physiological, psychological, environmental, and social variables. Some groups, such as women and immigrants, are particularly vulnerable. However, little is known about how Chinese women in Italy live with and face chronic pain. The present study aimed at filling this knowledge gap by examining the burden of chronic pain in Chinese immigrants in Italy in terms of acculturation processes, perceived control over disease, social networks, and coping strategies. A qualitative approach was used, performing a thematic field analysis. We interviewed 82 Chinese women from different Italian towns (Genoa, Milan, Turin, Bologna, Florence, and Prato) in depth. The sense of belonging to the host culture was strong in our sample. However, this did not simply reflect or translate into a linear engagement with medical systems, as health care pathways were more complex and dual (both Chinese and Western). Chinese women who felt deeply rooted in the Italian environment did not discontinue the use of traditional Chinese medicine. Chronic pain extensively and adversely affected daily life, particularly interfering with work. Coping strategies were mainly adaptive behaviors, being problem focused or maladaptive, relying upon “cope and avoid” mechanisms. Chinese women preferred to use traditional Chinese remedies rather than conventional medicine, while using the Italian system in emergencies. Perceived control over chronic pain was usually external. Finally, Chinese women with chronic pain benefit from social networks and support, which were mainly composed of Chinese peers. In conclusion, our findings underline the tremendous burden of chronic pain affecting all aspects of Chinese women’s lives. Health care workers and providers should be aware of the complexity of chronic pain Therefore, a holistic approach, involving different stakeholders, should be adopted when managing chronic pain and approaching immigrant patients.

Elitist in Façade

Drawing on a qualitative study of a group of professional Chinese women navigating their career lives between China and Canada, this paper addresses how Chinese transnationalism is constituted within global capitalism. It starts by mapping the career lives of the Chinese immigrant women. Their experiences point to the emergence of a transnational field between Canada and China where skill/labor and capital conjoin in distinct ways. The study further shows that this transnational social field is comprised of a complex of social relations reticulated through multiple institutions, organizations, and actors. Although the interest of economic accumulation and Western-centric social and cultural orders are predominant in shaping the women’s career spaces, this transnational field also provides conduits for alternative flows of power, privileging the entrepreneurial quest for social, cultural, and economic capitals. Despite its elitist façade, the transnational field is itself also vulnerable, fractured, and prone to crisis.

Immigrant women’s food choices in pregnancy: perspectives from women of Chinese origin in Canada

ABSTRACTObjective: Following migration, pregnant immigrant women may encounter social, cultural, and economic challenges that negatively affect their food choices and subsequent health outcomes. Culturally appropriate health care is crucial during the perinatal period to ensure the health of immigrant mothers and their children. This project aims to explore and understand how the health beliefs and practices of Chinese immigrant women affect their food choices during the perinatal period.Design: This qualitative study used the methodology of focused ethnography. Women participated in one semi-structured interview, followed by a second photo-assisted, semi-structured interview which incorporated photographs taken by the women themselves.Results: The food choices and health behaviors of immigrant women were influenced by their general health beliefs, cultural knowledge concerning particular types of foods, traditional Chinese medical beliefs, social advice and information, and socio-economic factors.Conclusion: The provision of culturally appropriate health care is crucial during the perinatal period, as it is not only a vulnerable life stage for women and their children but also a sensitive period of interaction with the Canadian health-care system. Understanding these intersecting factors can help to ensure culturally appropriate care and optimized health outcomes for Chinese immigrant women during the perinatal period.

The evolving gift-giving practices of bicultural consumers

PurposeThe purpose of this study is to offer a better understanding of contemporary consumer behaviour. This study relates to the complex and value-laden phenomenon of “gift-giving” from the perspective of bicultural consumers. The focus was on the gift-giving practices of Chinese immigrants in Canada within both their current and their past residencies (Canada and China, respectively).Design/methodology/approachConceptual guidelines for this study embodied the gift-giving conceptual framework of Sherry (1983) and Chinese cultural values on gift giving (Yau et al., 1999). A qualitative research study was implemented. Specifically, in-depth interviews with Chinese immigrant women mainly from the Greater Toronto Area (GTA) in Ontario, Canada, offered empirical evidence relating to the gestation stage of gift giving.FindingsThe findings indicate the complexity of acculturation in gift-giving practices. In terms of gift-giving occasions, Chinese immigrants in Canada, for the most part, adopted the Canadian gift-giving occasions. However, the important role of ethnicity in decision-making is found through their strong sense of differentiation between Chinese and Canadian gift receivers. The results also indicate some Chinese cultural values such as relationship, reciprocity and group orientation as being still important in shaping gift-giving practices, even after immigration to a new country quite distant from the homeland. One cautionary note is that some cultural values such as relationship can be common to both Chinese and Canadian cultural groups.Research limitations/implicationsThis research was conducted mainly in the GTA in Ontario, Canada. Future studies could address other large Canadian cities with significant bicultural Chinese populations such as Vancouver in British Columbia and Motreal in Quebec.Practical implicationsThis research extends the knowledge of bicultural consumers by examining the evolving gift-giving practices of Chinese immigrants living in Canada. A good understanding of the cultural values important to bicultural consumers will help marketers to efficiently and effectively allocate their marketing resources in attracting these niche consumers.Social implicationsThis study has contributed to the broader field of marketing research. Specifically, the current study offers the importance of understanding values transference of bicultural consumers and their behaviours in integrating into the mainstream gift-giving cultural context.Originality/valueThis study has contributed by offering evidence of how a minority consumer group formed complex acculturation realities within a gift-giving consumption context. This contribution can be counted as a step towards theoretical advancement in the field of acculturation and of understanding bicultural consumers.

"I want to save my life": Conceptions of cervical and breast cancer screening among urban immigrant women of South Asian and Chinese origin.

BackgroundBreast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low.The objective of this qualitative study was to better understand how Chinese and South Asian immigrants – the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening. We explored their experiences with screening to date. We explicitly inquired about their perceptions of the health care system, their screening experiences with family physicians and strategies that would support screening in their communities.MethodsWe conducted 22 individual interviews and two focus groups in Bengali and Mandarin with participants who had attended CARES educational sessions. Transcripts were coded through an iterative constant comparative and interpretative approach.ResultsThemes fell into five major, overlapping domains: risk perception and concepts of preventative health and screening; health system engagement and the embedded experience with screening; fear of cancer and procedural pain; self-efficacy, obligation, and willingness to be screened; newcomer barriers and competing priorities. These domains all overlap, and contribute to screening behaviours. Immigrant women experienced a number of barriers to screening related to ‘navigating newness’, including transportation, language barriers, arrangements for time off work and childcare. Fear of screening and fear of cancer took many forms; painful or traumatic encounters with screening were described. Female gender of the provider was paramount for both groups. Newly screened South Asian women were reassured by their first encounter with screening. Some Chinese women preferred the anonymous screening options available in China. Women generally endorsed a willingness to be screened, and even offered to organize women in their community hubs to access screening.ConclusionsThe experience of South Asian and Chinese immigrant women suggests that under and never-screened newcomers may be effectively integrated into screening programs through existing primary care networks, cultural-group specific outreach, and expanding access to convenient community -based screening.

Time since migration and breastfeeding duration among mainland Chinese immigrant women: a two-phase prospective cohort study

BackgroundSubstantial breastfeeding disparities exist among various ethnic and racial groups, and between mainland Chinese immigrants and native born Chinese women. However, few studies have addressed the effect of migration on mainland Chinese immigrants or the effect of time since migration on breastfeeding practices. Hong Kong, SAR, China, provides a unique opportunity since immigrants are from one country and share the same race and ethnic origin. Thus, the aim of this study was to examine the effect of time since migration on the breastfeeding practices of native Hong Kong-born and mainland Chinese immigrant mothers in Hong Kong. MethodsMother–infant pairs were recruited during postnatal hospitalisation at four geographically distributed public hospitals in Hong Kong over two time periods. The first cohort was recruited from June 20, 2006 to July 11, 2007 and the second cohort was recruited from October 11, 2011 to May 31, 2012. Participants were Cantonese-speaking, Hong Kong residents; gave birth to a full-term, singleton infant; intended to breastfeed; and had no serious medical or obstetric complications. Exclusion criteria were admission to the special care nursery for more than 48 hours after birth or admission to the neonatal intensive care unit. Data were collected directly from participants during postnatal hospitalisation and after discharge by telephone. In-hospital data collection included basic demographic details, maternal and infant data, and in-hospital feeding data. Follow-up data included infant feeding status at 1, 2, 3, 6, 9 and 12 months postpartum or until breastfeeding was stopped. Participants were asked how long they had lived in Hong Kong and data were grouped into four categories: less than 5 years, 5–15 years, more than 15 years, and since birth. The primary outcome was the duration of any and exclusive breastfeeding up to twelve months postpartum. The study was approved by the Institutional Review Board of the University of Hong Kong and Hospital Authority Hong Kong West Cluster, and from all study hospitals. Informed written consent was obtained from each participant. FindingsWe recruited a total of 2704 mother–infant pairs (cohort 1, 1417; cohort 2, 1287). We excluded 217 patients after recruitment: 20 participants had a newborn transferred to the neonatal intensive care unit, 124 participants were not contactable for follow-up, 21 participants were not born in either Hong Kong or mainland China, and 52 participants had missing data. Of the remaining 2487 participants, 2419 (97·3%) completed follow-up to 12 months and 68 (2·7%) had partial follow-up. A Kaplan-Meier survival curve showed that a longer time from migration was associated with progressively shorter durations of any and exclusive breastfeeding. After adjustment for potential confounders, the relationship between length of migration and breastfeeding duration was attenuated somewhat but the pattern remained. When compared with mothers who had lived in Hong Kong for less than 5 years, Hong Kong-born participants were 34% more likely to stop any breastfeeding (HR 1·34; 95% CI 1·10–1·63) and 33% more likely to stop exclusive breastfeeding (HR 1·33; 95% CI 1·11–1·58) within 12 months. InterpretationWe found that mainland Chinese immigrants were more likely to breastfeed for longer than mothers born in Hong Kong. However, as length of residence in Hong Kong increases, breastfeeding duration decreases in a dose-response pattern. Practitioners can assess the migration patterns of pregnant women and provide culturally adapted breastfeeding support and encouragement to this population. Future research is needed to identify the specific factors associated with migration that affect breastfeeding practices. FundingThe Health and Medical Research Fund and the Food and Health Bureau of the Hong Kong Government.

Risk factors, cross-cultural stressors and postpartum depression among immigrant Chinese women in Japan.

The purpose of this mixed-method design study was to examine factors contributing to depression among immigrant Chinese women (primipara and multipara) (n = 22) delivering a child for the first time in Japan. Data were obtained just after hospital discharge by using the Edinburgh Postnatal Depression Scale (EPDS), the Social Support Scale, a new scale to measure cross-cultural stressors in the postpartum setting and a visual analogue scale for stress and a demographic survey. The average EPDS score was 9.0 (SD ± 3.7) at 1-3 weeks postpartum; yet, more than half of the subjects (n = 12; 54.5%) were high risk for depression (EPDS ≥ 10). Low household income and primiparous status were associated with depression scores. New mothers with depression also reported more general stress and more cross-cultural stress in the postpartum setting, although social support appeared to mediate cross-cultural stressors. Semi-structured interviews were held with two immigrant women at high risk for depression; these new mothers described additional stress because they could not follow Zuoyuezi, an important postpartum Chinese tradition, in the Japanese hospital. These findings suggest that immigrant Chinese women are at higher risk for postpartum depression when they give birth for the first time in Japan.