Women In Melbourne Research Articles

Between ‘here’ and ‘there’: family violence against immigrant and refugee women in urban and rural Southern Australia

The purpose of this article is to investigate how (dis)connection with place influences immigrant and refugee women’s experiences of family violence in regional/remote and metropolitan southern Australia. We draw on research from the ASPIRE project (Analysing Safety and Place in Refugee Experience) in the states of Victoria and Tasmania. A participatory research approach was used to interview immigrant and refugee women who had experienced violence, and providers of family violence services from eight locations in the two states. Both inner urban, regional and remote locations were included in the study. The findings present new insight into how geographic isolation and the scarcity of specialized services affected the experiences of immigrant and refugee women in regional/remote areas. Across all settings, participants described experiences of social isolation associated with both distance from community networks and being ostracized or seeking to avoid the proximity of perpetrators and their social networks. Notably, the experiences of women living in regional Tasmania and regional Victoria shared more similarities than did those of immigrant and refugee women in regional Victoria and inner-urban Melbourne despite the different legislative environments in the two states.

‘Being able to bear a child’: Insights from Zimbabwean women in Melbourne

ProblemIn non-Western societies, childlessness carries numerous social consequences and has a significant impact on the gender identity and well-being of the women. BackgroundThe desire of women in non-Western societies is governed by numerous socio-cultural expectations including social norms and their own social position. At present, little is known about how Zimbabwean migrant women living in Australia perceive and experience childlessness and motherhood. AimTo discuss how children are seen in Zimbabwean culture and examine the personal and social ramification of infertility and cultural expectations of motherhood among Zimbabwean migrant women living in Australia. The perspectives and experiences of this migrant community are crucial so that we can avoid misunderstanding about the essence of motherhood among Zimbabwean women. This will ultimately lead to sensitive and culturally appropriate health and social care for migrants in a multicultural society of Australia. MethodsThe study is situated within the constructivist paradigm. Qualitative methods (in-depth interviewing, drawings and photo elicitation) were conducted with 15 Zimbabwean women. Data were analysed using thematic analysis method. FindingsBeing able to bear a child in Zimbabwean culture had a significant meaning to the women. Not only children could ensure the continuity of the society, having children was a form of social security as parents would be cared for by their children in old age. Childlessness threatens the social position of a woman and carries social consequences which significantly impact on their gender identity and well-being. Cultural expectations of motherhood placed the sole responsibility of caring for the children emotionally and physically on the mother. ConclusionThe procreative value has not diminished despite having settled in Australia. An increased awareness of procreative needs for Zimbabwean women in a culturally and sensitive manner would enhance the emotional well-being of these women.

メルボルンの高齢女性のパーソナル・ネットワークとソーシャル・サポート

メルボルンの高齢女性のパーソナル・ネットワークとソーシャル・サポート

Effect of treatment choices for cervical adenocarcinoma in situ on rates of residual disease, recurrence and progression

AbstractBackground: Cervical adenocarcinoma in situ (AIS) is the known precursor condition of cervical adenocarcinoma. The aim of this study is to evaluate treatment choices for AIS in terms of residual disease, recurrence and progression to invasive cancer.Methods: This is a retrospective cohort study conducted at the Mercy Hospital for Women in Melbourne, Australia. Women diagnosed with AIS on histology between 2000 and 2013 were included. Patient records were reviewed for notes on symptoms, cytology, colposcopy and biopsy reports, initial treatment, any subsequent treatment, outcome and follow-up.Results: A total of 114 patients were included: 87 patients were treated with one or more fertility-sparing procedures; 25 patients received a subsequent hysterectomy, one a trachelectomy and one chemo- and radiotherapy. Residual disease was found in 31% (9/29) after a previous procedure with positive margins. In 13.3% (2/15) residual disease was diagnosed despite clear surgical margins. The mean follow-up tim...

Don't call me ibu: challenges of belonging for childless transnational Indonesian women

AbstractNew forms of transnational families are being created by the feminization of migration, particularly of mobile Southeast Asian female workers who take on the financial responsibility of supporting their nieces and nephews who remain in the home country. This understudied kin relationship provides important insights into the complexities of transnational belonging among childless women. Fieldwork conducted in 2015 with Indonesian professional migrant women in Melbourne, Australia, reveals a translocalized Javanese cultural practice of fostering nieces and nephews. Using a framework that extends the anthropology of belonging into a gendered transnational context, in this article I argue that children who are absent, whether living in another country or never born, are yet present in women's narratives and are key to a larger migrant project of recreating oneself as an ambiguously valued subject.

Abstract TP171: Differences Between Men and Women in Long-term Participation Restriction After Stroke: The International Stroke Outcomes Study (INSTRUCT)

Introduction: As women suffer worse functional outcomes of stroke than men, they may also face more challenges with community reintegration but data are scarce. We examined sex differences in participation after stroke and which factors might account for these disparities. Methods: INSTRUCT is an individual participant data pooling study of incident strokes obtained from 13 population-based cohorts worldwide. Two of the cohorts (Melbourne ’96-‘99 and Auckland ’02-‘03) included assessment of participation at 5 years after stroke using the London Handicap Scale (LHS). The LHS is used to assess the individual’s perspective of their involvement in life situations including orientation (person’s awareness of surroundings), physical independence, mobility, occupation, social interaction and economic self-efficiency. The total score ranges from 0 (worst disadvantage) to 100 (no disadvantage). Linear regression was used to compare LHS total scores and sub-domains for women compared to men. Study-specific multivariable models incorporated adjustment for socio-demographics, stroke-related factors, pre-stroke health and post-stroke factors were combined using random-effects meta-analysis. Results: At 5 years after stroke, there were data on participation for 351/592 (59%) of survivors in Melbourne and 266/881 (30%) of survivors in Auckland. Women suffered greater participation restriction than men (total LHS, pooled mean difference, MD -5.55 [95% CI -8.47, -2.63]). The magnitude of the difference attenuated after adjusting for covariates (pooled MD -2.48 [-4.99, 0.03]). Significant confounders in study-specific models included age, stroke severity, pre-stroke dependency and pre-stroke dementia for Melbourne; and age, stroke severity and pre-stroke dependency for Auckland. In sub-dimensions, women had greater restriction than men in mobility, physical independence and occupation. Additionally, women in Melbourne experienced poorer social integration and orientation than men. Conclusion: Greater restriction in participation after stroke among women than men was mostly attributable to their advanced age and greater pre-stroke dependency. Interventions targeting participation could reduce the impact of stroke in women.

Mercy Pregnancy and Emotional Well-being Study (MPEWS): Understanding maternal mental health, fetal programming and child development. Study design and cohort profile.

Maternal mental health represents a significant global health burden. The Mercy Pregnancy and Emotional Well-being Study (MPEWS) was established to provide a comprehensive investigation of early developmental mechanisms and modifiers for maternal, fetal and child emotional well-being. MPEWS is a prospective, longitudinal study from pregnancy to 36months postpartum that includes diagnostic measures of maternal mental health, observational measures of the mother-infant relationship, measures of child development, and repeat biological sampling. A total of 282 pregnant women were recruited in early pregnancy from the Mercy Hospital for Women in Melbourne, Australia, including 52 women on antidepressant medication, 31 non-medicated women meeting diagnostic criteria for current unipolar depression or dysthymia, and 65 women with a past history of depression. Sample recruitment characteristics included a mean age of 31years and average gestation of 16weeks. The MPEWS cohort was comparable to national averages for Australia on key pregnancy and birth variables. Those participants taking antidepressant medication had higher mean Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Inventory (STAI) scores than the cohort as a whole but were comparable on other key variables. The MPEWS protocol provides a unique opportunity to evaluate the impact of pregnancy mental health on future maternal mental health and child development to aid the development of evidence-based interventions. The study is open for collaborative proposals via approach to the principal investigators.

Utility of risk-based chlamydia testing in primary care: analysis of retrospective surveillance data among women in Melbourne, Australia.

A longitudinal analysis was conducted on retrospective surveillance data collected among women attending general practice, family planning and sexual health clinics participating in sentinel surveillance in Melbourne, Australia. Women were aged ≥16 years and underwent urogenital testing for C. trachomatis (chlamydia) at participating clinics between 2007 and 2014. Chlamydia incidence was calculated as positive chlamydia tests over person-years (PY) among women and reported by 5-year age groups. A Cox regression model examined correlates of a positive chlamydia test among women aged ≥30 years. In all, 36770 women contributed 46432 PY and 52395 chlamydia tests, of which 2895 were positive. The overall chlamydia incidence rate was 6.2 per 100 PY (95% confidence interval (CI) 6.0-6.5). Chlamydia incidence declined with age, plateauing to <5 per 100 PY among women aged ≥30 years. Among women aged ≥30 years, being born in North-East Asia (adjusted hazard ratio (aHR) 2.9; 95% CI 1.9-4.5) and reporting multiple partners (aHR 2.5; 95% CI 1.8-3.5) in the past 12 months were associated with a positive chlamydia test. Chlamydia control remains challenging in Australia and optimising testing in primary care is a key priority. The results of the present study suggest that, at least among women aged ≥30 years, chlamydia testing should be risk-based and informed by appropriate sexual history taking.

Embodied experiences of prenatal diagnosis of fetal abnormality and pregnancy termination

Pregnant women routinely undergo prenatal screening in Australia and this has become a common experience of motherhood. When prenatal screening or prenatal testing results in diagnosis of a serious fetal abnormality, women are presented with a decision to continue or terminate their pregnancy. Few recent studies have explored women’s psychosocial experience of prenatal diagnosis and pregnancy termination for fetal abnormality, and within this small group of studies it is rare for research to consider the embodied aspect of women’s experiences. This paper reports on qualitative findings from in-depth interviews with 59 women in Melbourne, Australia who received a prenatal diagnosis of a significant abnormality and decided to terminate the pregnancy. Interview transcripts were coded inductively through thematic analysis. Two themes about embodiment were generated from the interviews: transitioning embodiment, and vulnerable bodies in un/comfortable spaces. Theory of pregnant embodiment was drawn on in interpreting women’s narratives. Recommendations arising from the analysis include health professionals recognising, acknowledging and accommodating the transitioning embodied state of women as they consider, prepare for, undergo and recover from pregnancy termination for fetal abnormality. Further recommendations address the connections and disconnections between this transitioning embodied state and the spaces of clinics, hospitals and home.

Sexual Health Knowledge and Needs: Young Muslim Women in Melbourne, Australia.

In this article, we discuss the sexual health knowledge and needs among young Muslim women living in Melbourne, Australia. Eleven young Muslim women were individually interviewed about issues relating to sexual health knowledge and needs, access to sexual health services, and their experiences of balancing their lives in relation to sexual health. Findings revealed a marked influence of religion and culture on sexual health of young Muslim women. They often faced challenges balancing Muslim culture, Australian culture, and Islamic religion. Our findings have implications for health services in a multicultural society. They could be used to promote culturally sensitive sexual health services for young Muslim women in Australia and elsewhere.

Factors Influencing Contraception Awareness and Use: The Experiences of Young African Australian mothers

The aim of this study was to examine contraception awareness and use among African Australian women in Melbourne, Australia, who have experienced teenage pregnancy, and to explore the social contexts that shape these women's attitudes towards contraception. Among young immigrant and refugee women living in sites of settlement, knowledge and use of contraception are a public health concern. The study used a qualitative research approach and was informed by anthropology, public health and human rights frameworks. Between June 2009 and November 2010, in-depth interviews were conducted in Melbourne, Australia, with 16 African Australian teenagers and women who had experienced teenage pregnancy. In addition, two focus group discussions were held with service providers and African women and five key informant interviews were conducted. Data were transcribed verbatim, coded, and key themes identified and analysed using thematic analysis. The findings revealed that attitudes towards and use of contraception are influenced by parental sexual health literacy and attitudes, gender roles and culturally informed attitudes around motherhood. Service providers should consider the value of whole-of-family and community approaches in order to improve knowledge and decision-making around contraception among young African Australian women.

Peer support groups, mobile phones and refugee women in Melbourne.

In this article, we discuss qualitative findings basing on the experiences of refugee women living in Melbourne, Australia, who participated in a peer support training programme and received a free mobile phone. We pay attention to social support as a health enhancing strategy and empowerment that occurred among the participants. Participation in peer support groups and access to a mobile phone were beneficial for the women. Peer support functioned as social support among group members. The programme allowed the women to be connected to their families and the wider communities and assisted them to access health care and other settlement aspects with greater ease. It also increased personal empowerment among the women. Our programme shows that by tapping on community resources to ameliorate personal or resettlement issues, the burden on service providers can be reduced. Our findings also offer a model for future research and programmes regarding refugee people elsewhere.

WAND

Rooming houses are often considered last resort accommodation for people affected by homelessness. However, some rooming houses aspire to provide safe, affordable, good-quality accommodation. This article reports on research into an activity program Women Achieving New Directions (WAND) in one such rooming house for women in Melbourne, Australia. Women-only homelessness programs are important because of women’s specific, gendered experiences of homelessness. Five main themes relating to program impact and structure were identified from the data, namely, reducing isolation, the importance of leaving choice to the women, the vital role of staff support, the emerging sense of program ownership, and experiences of building community connection.

Breast milk donation after neonatal death in Australia: a report

Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia hosted Australia’s first National Stakeholder Meeting (NSM) on the topic of milk donation after neonatal death. The NSM drew together representatives from Australian HMBs, neonatal intensive care units (NICUs) currently using donor human milk, and Australia’s chief NICU parent support organization. The NSM was video-recorded and transcribed, and analyzed thematically by researchers. This article reports the seven dominant themes discussed by stakeholders during the NSM: the spectrum of women’s lactation and donation experiences after infant death; the roles of the HMB and NICU in meeting the needs of the bereaved donor; how bereaved mothers’ lactation autonomy may interface with a HMB’s donation guidelines; how milk donation may be discussed with bereaved mothers; the variation between four categories of milk donation after neonatal death; the impact of limited resources and few HMBs on providing donation programs for bereaved mothers in Australia. This article provides evidence from researchers and practitioners that can assist HMB staff in refining their bank’s policy on milk donation after infant death, and provides national policy makers with key considerations to support lactation, human milk banking, and bereavement services nation-wide.

Breast milk donation after neonatal death in Australia: a report

Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia hosted Australia’s first National Stakeholder Meeting (NSM) on the topic of milk donation after neonatal death. The NSM drew together representatives from Australian HMBs, neonatal intensive care units (NICUs) currently using donor human milk, and Australia’s chief NICU parent support organization. The NSM was video-recorded and transcribed, and analyzed thematically by researchers. This article reports the seven dominant themes discussed by stakeholders during the NSM: the spectrum of women’s lactation and donation experiences after infant death; the roles of the HMB and NICU in meeting the needs of the bereaved donor; how bereaved mothers’ lactation autonomy may interface with a HMB’s donation guidelines; how milk donation may be discussed with bereaved mothers; the variation between four categories of milk donation after neonatal death; the impact of limited resources and few HMBs on providing donation programs for bereaved mothers in Australia. This article provides evidence from researchers and practitioners that can assist HMB staff in refining their bank’s policy on milk donation after infant death, and provides national policy makers with key considerations to support lactation, human milk banking, and bereavement services nation-wide.

Migration as a Strategy for Maintaining a Middle-Class Identity: The Case of Professional Filipino Women in Melbourne

This paper surveys the diverse motives of professional Filipino immigrant women in Melbourne, Australia. In-depth interviews of 20 women reveal that their mosaic of motives challenges the traditional notion of economic advancement framed within the household theory, or ideas of purely individualistic pursuits. Their movements were facilitated through the intersection of established families and social networks in Australia, and the possession of skills required by the immigration department, defying the mail order bride stereotype that was projected on almost all Filipino women in the 1980s. It is argued that migration provided a bridge to more liberating quality of life, enabling them either to recover their declining middle-class status in the Philippines or to explore an alternative lifestyle in the new context.

Breastfeeding practices of ethnic Indian immigrant women in Melbourne, Australia.

BackgroundThe health benefits of breastfeeding are well documented in public health and medical literature worldwide. Despite this, global rates of breastfeeding steadily decline during the first couple of months postpartum. Although immigrant women have higher initiation rates and a longer duration of breastfeeding overall, breastfeeding practices are compromised because of a myriad of socioeconomic and cultural factors, including the acculturation process. The objective of this study was to show how acculturation and cultural identity influenced breastfeeding practices among Indian immigrants in Melbourne, Australia.MethodsTwelve case studies were employed to gather narratives of women’s lived experiences. Ethnographic field research methods were used to collect data, including participant observation, semi-structured interviews, case studies, and life histories. This provided in-depth information from women on various aspects of the immigrant experience of motherhood, including infant care and feeding. Participants were opportunistically recruited from Indian obstetricians and gynaecologists. Women identifying as ethnic Indian and in their third trimester of pregnancy were recruited. Interviews were conducted in women’s homes in metropolitan Melbourne over a 12 month period between 2004 and 2005. Data were coded and analysed thematically.ResultsAll women identified as ethnic Indian and initiated breastfeeding in accordance with their cultural identity. Social support and cultural connectivity impacted positively on duration of breastfeeding. However, acculturation (adopting Australian cultural values and gender norms, including returning to paid employment) negatively influenced breastfeeding duration. In addition, the high reliance of recent immigrants on the advice of healthcare professionals who gave inconsistent advice negatively affected exclusive breastfeeding.ConclusionsFor ethnic Indian immigrant women breastfeeding practice is closely linked to acculturation and identity construction, both personal and communal. The lack of social and cultural networks for recent immigrants prevents their involvement in the cultural systems that traditionally support breastfeeding. With this in mind, healthcare professionals should deliver services in a culturally appropriate and sensitive manner where women feel supported as well as empowered.

Caught Between Two Worlds: Sexuality and Young Muslim Women in Melbourne, Australia

Existing research suggests that culture has a significant influence on the sexuality of culturally and linguistically diverse communities in Australia. However, few studies have explored the influence of both religion and culture on sexuality of young Muslim women. This paper qualitatively examines the influence of Islam, Muslim culture and Australian culture on the sexuality of young Muslim women in Melbourne, Australia. This research employed an in-depth interview technique to gather data on the lived experiences of 11 young Muslim women. The findings revealed a marked influence of religion and culture on the sexuality of young Muslim women. Additionally, this study highlights the challenges that young Muslim women face in regards to balancing Muslim culture, Australian culture and Islamic religion. This study contributes to knowledge about the lived experiences of young Muslim women in Australia regarding meanings of sexuality and the difficulties they have in balancing the influences of religion and culture. This knowledge can be useful for the provision of sexual health care that reflects a culturally and religiously sensitive approach for young Muslim women in Australia and elsewhere.

Women’s experiences of sex and intimacy after childbirth: making the adjustment to motherhood

The aim of this study was to explore women’s experiences of changes to their sexual relationship, sexuality and intimacy, as a result of pregnancy, childbirth and parenting. A sub-sample of women was purposively selected from a larger prospective pregnancy cohort study of nulliparous women in Melbourne, Australia. Eighteen women (including a mixture of parity, birth methods and relationship status) were interviewed 2.5–3.5 years after a first birth. Interviews were transcribed verbatim and analyzed using interpretive phenomenological analysis. Women identified numerous factors affecting sexual and intimate relationships including extreme tiredness, changing lifestyles and body image issues, leading to changes in libido and intimacy in relationships. Of particular note were feelings of guilt and failure women experienced as a result of a lowered libido. Finding ways to stay connected – whether through sex, quality time together or working as a team – helped women and their partners navigate the transition to parenthood. This study demonstrates that pregnancy, childbirth and parenting can bring about significant changes to women’s experiences of sex and intimacy. Women who experience significant reductions in their libido may be vulnerable to feelings of guilt and failure, connected with high expectations that they should be able to “do it all”.

Infant feeding intentions among first time pregnant women in urban Melbourne, Australia

Objectiveto identify first time pregnant women's infant feeding intentions for the first 2 years of life. Designa qualitative phenomenological approach was used, with semi-structured interviews as the primary method of data collection. Settingtwo of Eastern Health's antenatal clinics in the outer east region of Melbourne, Australia. Participantsseven first time pregnant women from an Eastern Health antenatal clinic. Main outcome measurewomen's infant feeding intention for the first 2 years of life. Main findingsall the participants intend to breast feed their infant for around 6 months. Women rely heavily on information about infant feeding options from friends, books and the internet, as the information provided by health professionals was found to be inadequate, acquired late in the pregnancy and difficult to access. Key conclusionsthe information women receive from midwives at antenatal appointments and parenting classes about infant feeding options is inadequate, as women are not satisfied with the timing, amount and usefulness of the information they receive. Implications for practicein order to see an increase in the rate of breast feeding it is imperative to create supportive environments for women to breast feed, and for midwives and health professionals to provide information and continued support for women in both the pre- and postnatal period.