Stressful events, social health issues and psychological distress in Aboriginal women having a baby in South Australia: implications for antenatal care.
BACKGROUND
Around 6% of births in Australia are to Aboriginal and Torres Strait Islander families. Aboriginal and Torres Strait Islander women are 2-3 times more likely to experience adverse maternal and perinatal outcomes than non-Aboriginal women in Australia.


METHODS
Population-based study of mothers of Aboriginal babies born in South Australia, July 2011 to June 2013. Mothers completed a structured questionnaire at a mean of 7 months postpartum. The questionnaire included measures of stressful events and social health issues during pregnancy and maternal psychological distress assessed using the Kessler-5 scale.


RESULTS
Three hundred forty-four women took part in the study, with a mean age of 25 years (range 15-43). Over half (56.1%) experienced three or more social health issues during pregnancy; one in four (27%) experienced 5-12 issues. The six most commonly reported issues were: being upset by family arguments (55%), housing problems (43%), family member/friend passing away (41%), being scared by others people's behavior (31%), being pestered for money (31%) and having to leave home because of family arguments (27%). More than a third of women reporting three or more social health issues in pregnancy experienced high/very high postpartum psychological distress (35.6% versus 11.1% of women reporting no issues in pregnancy, Adjusted Odds Ratio = 5.4, 95% confidence interval 1.9-14.9).


CONCLUSIONS
The findings highlight unacceptably high rates of social health issues affecting Aboriginal women and families during pregnancy and high levels of associated postpartum psychological distress. In order to improve Aboriginal maternal and child health outcomes, there is an urgent need to combine high quality clinical care with a public health approach that gives priority to addressing modifiable social risk factors for poor health outcomes.
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC, 3052, Australia.
Donna
D
Weetra
South Australian Health and Medical Research Institute, North Terrace, Adelaide, 5000, Australia.
Karen
K
Glover
Aboriginal Health Council of South Australia Inc, 220 Franklin Street, Adelaide, South Australia, 5000, Australia.
Mary
M
Buckskin
Women's and Children's Health Network, 295 South Terrace, Adelaide, South Australia, 5000, Australia.
Jackie Ah
JA
Kit
Women's and Children's Health Network, 295 South Terrace, Adelaide, South Australia, 5000, Australia.
Cathy
C
Leane
Aboriginal Health Council of South Australia Inc, 220 Franklin Street, Adelaide, South Australia, 5000, Australia.
Amanda
A
Mitchell
Women's and Children's Health Network, 295 South Terrace, Adelaide, South Australia, 5000, Australia.
Deanna
D
Stuart-Butler
Council of Aboriginal Elders Inc, 50-60 Sussex St, North Adelaide, South Australia, 5006, Australia.
May
M
Turner
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC, 3052, Australia.|General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, VIC, 3052, Australia.
Jane
J
Yelland
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC, 3052, Australia.
Deirdre
D
Gartland
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC, 3052, Australia. stephanie.brown@mcri.edu.au.|South Australian Health and Medical Research Institute, North Terrace, Adelaide, 5000, Australia. stephanie.brown@mcri.edu.au.|School of Population and Global Health, General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, VIC, 3052, Australia. stephanie.brown@mcri.edu.au.
Stephanie J
SJ
Brown
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008016:Life Change Events; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D013021:South Australia; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples