“If it was at home, you will suffer on your own.” Burmese migrants’ experiences of the 6week post-natal general practice check in Victoria, Australia.

Problem

Numbers migrating from Burma to Australia has increased rapidly in recent years, by 65% between 2006 and 2011. Their experiences of prolonged civil war and decades of human rights violations make the Burmese particularly vulnerable to poor health outcomes. This study was part of a larger project exploring the sexual and reproductive health needs of this population, and the ways in which they are being met through primary care. The study explored the perceptions of Burmese refugee women resettled in Melbourne, Victoria about their access to and experiences of the 6-week postnatal check offered by general practitioners (GPs).

Approach

Through community based playgroups in a region with many Burmese, women were invited to participate in semi-structured individual and group interviews, conducted in Burmese. Interviews were recorded, transcribed and analysed iteratively using content and thematic analysis. Women such were asked about their understanding of the 6 week check, their experience of it, and attitudes towards discussion of contraception at the check. They were also asked about whether alternative traditional postnatal practices were still utilised once they had settled in Australia.

Findings

Fifteen Burmese refugee women were interviewed; all had had at least one child in Australia; five had also given birth in Burma. Over half had had a positive experience of the 6-week postnatal check. However, information the women received prior to attendance was limited to the need to attend the check and did not extend to its purpose, so most women were unaware that the check was for their benefit as well as for their child. Those not attending the check perceived that the home visit from the Maternal and Child Health (MCH) nurse, in the first week at home, was sufficient. Most participants did not use any contraception and suggested that 6 weeks was too early to discuss family planning. Traditional post-natal practices were still utilised by many women, particularly around avoiding cold water, ingesting turmeric, and binding the stomach. Most feared the consequences of breaking traditional beliefs but trust in their new country in Australia overcame their reluctance. Facilitators to care were health providers from ethnically similar backgrounds and a strong preference for female health providers to carry out pelvic examinations.

Consequences

Burmese women trusted Australian healthcare practitioners but had little understanding of the purpose of the 6-week GP check. The majority of women believed a contraceptive discussion was unnecessary at 6 weeks, as contraception was unimportant for women growing their families. Increasing GPs’ knowledge of traditional post-natal practices may add value to their future interactions with Burmese women.