Ethnicity plays a role in the stillbirth story

Image "The Little Match Girl" courtesy of Tonia Composto and the Stillbirth Foundation Australia. See below for details on how to purchase a print.

Image “The Little Match Girl” courtesy of Tonia Composto and the Stillbirth Foundation Australia. See below for details on how to purchase a print.

Australia was recently ranked 7th among 165 countries around the world for best places to be a mother. This is a truly fine achievement – an acknowledgement of the relative privilege many women in Australia enjoy. But before we start breaking open the lamingtons in celebration, is women’s health and wellbeing equally shared across the broad diversity of Australian mums? Or are some mums more equal than others?

Recent research conducted among 44,000 women has illustrated one tragic way that inequality reigns in the Australian birthing suite. The research found that immigrant and refugee women born in South Asia run double the risk of stillbirth in late pregnancy (between 37 and 42 weeks). While the reasons for this higher rate are yet unknown, the findings are alarming when you consider our increased migration over the past decade: one in every four Australian births is to a woman born overseas. If you happen to be thatwoman born overseas and about to give birth, you would want, and rightly expect, to know why your ethnicity is a risk factor. From the little we do know, immigrant and refugee women suffer poorer maternal health, are less likely to present for antenatal care before 20 weeks gestation, and are at greater risk of some health conditions such as gestational diabetes.

There are many steps mothers can take in the early stages of pregnancy that can reduce the risk of adverse birth outcomes and this includes ensuring that women are themselves informed and educated about the care they are entitled to receive. And health professionals have an ethical responsibility to provide the best possible care to all women to ensure the best possible outcomes. This is the message underlying the Common Threads Best Practice Guide for immigrant and refugee women’s sexual and reproductive health. Using real-life case studies, the Guide offers practical examples of cross-cultural understanding in health service provision.

Ethnicity awareness for expectant mothers shouldn’t only be about ordering women to undergo more tests, but also ensuring that our health workforce is adequately trained to communicate effectively with patients from various cultural backgrounds. Of course, governments need to take the lead in making sure such a policy becomes a reality. In the meantime, the Common Threads Best Practice Guide is essential reading.

Melbourne artist Tonia Composto created a series of Fairy Tales for Hope prints in memory of her friend’s stillborn daughter, Hope Angel Heppleston. You can read more about Hope’s story or buy a print for $20AUD each + $12 for shipping in Australia and raise money for the Stillbirth Foundation Australia.

Closing the gaps in health for international students

Image (2008) courtesy of RMIT University on flickr.

Image (2008) courtesy of RMIT University on flickr.

Here’s another statistical feather to Australia’s cap: Australia has been ranked number 1 by the World Economic Forum for closing the gender gap on educational attainment. No ‘ifs’ or ‘buts’ about it, it’s a ranking we can truly be proud of, a ranking that could attract more dollars, oops, female students, to our successful international education industry. Yet, as they say, with great success comes great responsibility. While success in international education continues to be equated in dollar terms (16.3 billion in 2010-2011), we can and should define our responsibility to international students beyond educational outcomes.

Much has already been said of the international students’ lot: lack of affordable accommodation; restrictions on work rights; lack of transport concessions; experiences of, and vulnerability to, racism, discrimination and violence; and the need for greater access to services and support. Add to this what our research has found:  if you’re a female international student and happen to fall pregnant during the first twelve months of your stay, your mandatory health insurance does not cover you for any pregnancy-related costs (except in cases of emergency). And you thought that growing HECs debt was a problem. Imagine, for a moment, the choices of a full fee paying female student who finds herself in such a dire situation. Access to health services, including accessibility to contraception and abortion, has always been strongly linked to affordability. Unplanned pregnancies are just that: unplanned. Whatever the reason for the pregnancy, every choice available, whether it’s ante-natal care or abortion, should be made a feasible and accessible option for all women. If you’re a newly-arrived international student trying to make ends meet, your options are limited.

As one student told us, ‘I’m paying $13,000 per semester and I study for three semesters. The health cover I get is $700 … and the health cover is limited to only some health diagnoses … people coming from overseas aren’t rich. They are coming to get a living.’ Indeed, the international student population is generally a youthful lot who come to live, work, study and sometimes, maybe, fall in love. Or not. Things happen. International students are no different to Australian-born students when it comes to living life. So why are there restrictions on their right to access sexual and reproductive health care?

60 seconds with Maria Hach

Maria 2

MCWH National Training Manager and author of Common Threads

If you were a super-heroine, what powers would you like to have?
Teleportation because I’m pretty lazy and I really hate traffic – I would use it in my everyday life to get to different points quickly. That’s not very noble of me, is it?

If you could give one piece of advice to someone new to Australian culture, what would it be? 
I would tell them that Australians are easy-going and friendly, but also fairly persistent about particular views. I would tell them to embrace new and fun experiences but to also have a thick skin and maintain their individuality and sense of self.

What would you work for instead of money?
I’m certainly not working for money now, although I love my job [laughs]! The feeling of knowing I’m contributing to something bigger than myself and whatever that is, it’s contributing to a more positive life for people, and a nicer world.

If you had to choose a last meal, what would it be?
It would have to be one my Dad’s home cooked Cambodian dishes, probably his fish amok (curry) because I hardly get to eat it and when I do it’s just delicious.

If you had 60 seconds to prepare a dish, what would it be?
Vegemite on toast.

What’s your favourite possession?
Apart from my wonderful family and friends – are they possessions?- they’re mine!  I was pretty sad at the thought of losing my kindle.  I was surprisingly upset when I thought I had left it on an aeroplane – that’s a pretty lame one isn’t it?

What are you enjoying doing at the moment?
Learning new things in my role as a training officer; the sunshine and beer that comes with spring; and building up my fitness after a knee injury.

THE WRAP #2

Welcome to our second edition of the WRAP.

The Australian Human Rights Commission has published a report following the study tour undertaken by the UN Special Rapporteur on Violence Against Women earlier this year. It was a great opportunity to be part of the conversation and we’ve still got something to say now! So we’re talking about violence against women, about Paul Capsis’ tribute to the wonderful migrant women of the post-war period and we’ve got a fantastic 60 seconds with MCWH Bilingual Health Educator, Elizabeth Mazeyko.

As you may know, we’ve also decided to take the plunge and join the fabulous world of social media. It’s a brave new world and we’d like to invite you to be part of the journey. So come and join our new facebook page! You can also follow us on twitter if you prefer things short and sweet.

Take care until next time,
The Wrap Team

Honouring the lives of migrant women

Photo (1960) courtesy of National Archives of Australia: A12111, 1/60/4/7.

Photo (1960) courtesy of National Archives of Australia: A12111, 1/60/4/7.

How often do we pay tribute to the immigrant and refugee women who came to Australia in the mass migration of the post-war period? These women – for many of us, our mothers or our grandmothers – have left such a clear imprint on our minds and hearts, and more broadly on Australian cultural and economic development, that we would struggle to imagine ourselves as a country without acknowledging their role in making us who we are today.

Paul Capsis, a wonderful performer of Greek-Maltese-Australian background, has created a heart-warming and entertaining tribute to his Maltese grandmother through Angela’s Kitchen, a one-man show currently playing around Australia. In a series of sketches, Capsis brings his grandmother’s strength, resilience and leadership to life.

Angela migrated to Australia in 1948, bringing five small children, one suitcase and countless experiences of war, poverty and hardship. Her story is a compelling one and is shared by many thousands of immigrant and refugee women who have made (and continue to make) the difficult and often constrained choice to make the move to Australia. Like Angela, immigrant and refugee women who came to Australia in the post-war period rarely had access to formal education, either in their countries of origin, or in Australia, and worked in poorly-paid blue-collar jobs across a range of industries such as manufacturing, cleaning, and support services.

In a recent interview, Capsis has said that he hears his grandmother’s voice while performing her story. He added that “She likes that I am telling the stories, but doesn’t know why people would be interested.” But sitting in the audience, it’s difficult to imagine why people wouldn’t. Voices like Angela’s are rarely given such a public forum, but they offer us an essential insight into the courage, humour, and community of Australia’s migrant women.

Angela’s Kitchen is playing at The Malthouse Theatre in Melbourne until 23 September, 26 – 29 September at The Powerhouse in Brisbane.

The good, the bad and the silent

Women in Bangladesh marching to spread the word against violence, April 2012. Photo courtesy of UN Women Asia & the Pacific on Flickr.

Women in Bangladesh marching to spread the word against violence, April 2012. Photo courtesy of UN Women Asia & the Pacific on Flickr.

The fact that Victorian police attended more than 50,000 family violence incidents in 2011 – 2012 is no cause for celebration. But, according to their Annual Report, the dramatic rise of 43.3% in the number of reported family violence related assaults should actually be seen as a positive, because “it indicates greater confidence and willingness on the part of victims to report such incidents”.

Given some of the truly shocking statistics on violence against women in Australia, the police may have a point. In a recently published report the Australian Human Rights Commission (AHRC) reminded us that almost every week in Australia one woman is killed by her current or former partner, often after a history of domestic violence. If an increase in reporting leads to a decrease in family violence then count us all in — particularly considering that one in three women has experienced physical violence and that three quarters of these assaults occur in the home.

But hang on, are we all in? Are we all counted? The statistics are shocking but, on some subjects, they are also silent. One of the key issues raised by the AHRC Report is the number of barriers migrant and refugee women face in reporting their experience that place them outside the reach of ‘mainstream’ services. Lack of awareness that the violence they are experiencing is unlawful, fear of consequences for their community or for their place in it, fear of authority, racism and a lack of culturally and linguistically accessible information and services are all factors which make reporting among migrant and refugee women an even greater issue. Without reporting, the real statistics on violence against migrant and refugee women, and on women in Australia as a whole, remain mere speculation.

Women’s confidence and willingness to report is one side of the story. Structural and policy mechanisms that support more vulnerable women to report is the other. Both make up the whole picture that, combined with our old friend prevention, will pave the way for a future free of violence against women. That will really be something to celebrate.