title: Women from refugee backgrounds and their experiences of attending a specialist antenatal clinic. Narratives from an Australian setting.
abstract: OBJECTIVE
  In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010.
  
  
  OBJECTIVE
  Can maternity care experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved?
  
  
  METHODS
  The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants.
  
  
  RESULTS
  The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations.
  
  
  CONCLUSIONS
  Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities.
authors.affiliation: Australian Catholic University, 1100 Nudgee Road, Banyo, Qld. 4014, Australia; Mater Research and Mater Health Services, Level 1, Aubigny Place, Raymond Terrace, South Brisbane, Qld 4101, Australia. Electronic address: helen.stapleton@acu.edu.au.
authors.forename: Helen
authors.initials: H
authors.lastname: Stapleton
authors.forename: Rebecca
authors.initials: R
authors.lastname: Murphy
authors.forename: Ignacio
authors.initials: I
authors.lastname: Correa-Velez
authors.forename: Michelle
authors.initials: M
authors.lastname: Steel
authors.forename: Sue
authors.initials: S
authors.lastname: Kildea
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D054521:Cultural Competency; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008880:Midwifery / Q000458:organization & administration*; D033262:Narration; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration* / Q000523:psychology; D015397:Program Evaluation; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D012036:Refugees / Q000523:psychology*; D055815:Young Adult
keywords: Cultural; Evaluation (MeSH); Interpreter; Midwifery (MeSH); Refugees (MeSH)