title: Compromised communication: a qualitative study exploring Afghan families and health professionals' experience of interpreting support in Australian maternity care.
abstract: BACKGROUND
  Difficulties associated with communication are thought to contribute to adverse perinatal outcomes experienced by refugee background women living in developed countries. This study explored Afghan women and men's experience of language support during pregnancy, labour and birth, and health professionals' experiences of communicating with clients of refugee background with low English proficiency.
  
  
  METHODS
  Interviews were conducted with (1) Afghan women and men in the first year after having a baby in Australia, by multilingual, bicultural researchers and (2) midwives and medical practitioners providing care to families of refugee background. Analysis was conducted thematically.
  
  
  RESULTS
  Sixteen Afghan women, 14 Afghan men, 10 midwives, five medical practitioners and 19 community-based health professionals (refugee health nurses, bicultural workers, counsellors) providing maternity or early postnatal care participated. Midwife and medical informants concurred that accredited interpreters are generally booked for the first pregnancy visit, but not routinely used for other appointments. Very few Afghan participants reported access to on-site interpreters. Men commonly interpreted for their wives. There was minimal professional interpreting support for imaging and pathology screening appointments or during labour and birth. Health professionals noted challenges in negotiating interpreting services when men were insistent on providing language support for their wives and difficulties in managing interpreter-mediated visits within standard appointment times. Failure to engage interpreters was apparent even when accredited interpreters were available and at no cost to the client or provider.
  
  
  CONCLUSIONS
  Improving identification of language needs at point of entry into healthcare, developing innovative ways to engage interpreters as integral members of multidisciplinary healthcare teams and building health professionals' capacity to respond to language needs are critical to reducing social inequalities in maternal and child health outcomes for refugee and other migrant populations.
authors.affiliation: Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, Parkville, Victoria, Australia Department of General Practice and Primary Health Care, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Yelland
authors.affiliation: Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, Parkville, Victoria, Australia Department of General Practice and Primary Health Care, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Elisha
authors.initials: E
authors.lastname: Riggs
authors.affiliation: Victorian Foundation for Survivors of Torture, Brunswick, Victoria, Australia.
authors.forename: Josef
authors.initials: J
authors.lastname: Szwarc
authors.affiliation: Victorian Foundation for Survivors of Torture, Brunswick, Victoria, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Casey
authors.affiliation: Victorian Foundation for Survivors of Torture, Brunswick, Victoria, Australia.
authors.forename: Philippa
authors.initials: P
authors.lastname: Duell-Piening
authors.affiliation: Victorian Foundation for Survivors of Torture, Brunswick, Victoria, Australia.
authors.forename: Donna
authors.initials: D
authors.lastname: Chesters
authors.affiliation: Department of General Practice and Primary Health Care, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Sayed
authors.initials: S
authors.lastname: Wahidi
authors.affiliation: Department of General Practice and Primary Health Care, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Fatema
authors.initials: F
authors.lastname: Fouladi
authors.affiliation: Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, Parkville, Victoria, Australia Department of General Practice and Primary Health Care, University of Melbourne, Parkville, Victoria, Australia School of Population Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Brown
mesh_terms: D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D018912:Arabs / Q000706:statistics & numerical data; D001315:Australia; D003144:Communication Barriers; D065246:Culturally Competent Care / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006779:Hospitals, Public; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D020380:Needs Assessment; D009774:Obstetrics / Q000379:methods; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D011247:Pregnancy; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012036:Refugees; D012924:Social Conditions; D014175:Translating
keywords: Communication; Obstetrics and gynecology; Qualitative research