Complexity and contraception

Contraception

Image: Grab a Condom Embroidery Hoop/ Hey Paul Studios on flickr

People educated in Australia of  ‘a certain vintage’ have the pleasure of recalling the days when school sex education entailed a perky film about the family life of ducks and geese, followed by an obtuse talk from teachers about love and suddenly, babies. How things have changed: now children come home from school teaching their parents the proper (and not so proper) words for all things sexual and reproductive.

But we can’t take for granted that everyone in the Australian community has what they need to live informed and enjoyable sexual and reproductive lives. First, knowing where everything is and how to use it is only a small piece of the puzzle: this knowledge must be complemented by a solid grounding in respect and equality within relationships, and taught in the context of a broad, non-judgemental sexuality education. And what of migrants and refugees, the majority of whom arrive in Australia after secondary education is completed?

Recently we explored this question by conducting some research, together with researchers from Monash University, into immigrant and refugee women’s experiences of contraception in Australia. The findings, based on interviews with 84 women, were a little surprising in terms of what women know and what they choose to do with that knowledge.

Awareness of the range of contraceptives available to women was relatively high, with some variation depending on the availability of sexual and reproductive education and information in women’s country of origin. In some cases, state-funded education was available in country of origin, but only to the ‘about to be married’, which meant that many sexually active people missed out. In other cases, education was hard to come by through formal channels, and women relied on more informal means such as talking to family and friends, or Dr Google.

In many cases, awareness accorded with the likelihood that women would use that method: we noted a high awareness of non-hormonal methods (91%), such as male condoms, withdrawal, and natural family planning methods, which combined made up 76% of the women’s choices. Surprisingly, however, only 5% of women chose the pill even though 95% reported being aware of it.

A complex range of factors influenced women’s choices, including the cost and availability of, and access to, certain types and brands of contraception in Australia. Of the women who were using hormonal methods, such as Depo Provera, implants or the pill (total 15%), some obtained their supplies from practitioners overseas, in order to negotiate factors such as continuity of care, the difficulties of translating medical records, and the lack of interpreting services in Australia. A group of women reported waiting until their regular visits overseas to book in their gynecological appointments at which they would also arrange their contraception for the period until the next visit.

These findings indicate that for many immigrant and migrant women, contraception remains difficult to negotiate. Information is lacking, and structural barriers such as cost, language and lack of access prevent many women from making free and informed choices about what suits them best. What is needed is a broad and comprehensive program of sexual and reproductive education suitable for women from diverse communities. We also need to consider how access can be improved. If sex education at schools has progressed from the days of the duck family, we now need to extend that wisdom to ensure that informed choice is the order of the day for immigrant and refugee women.

Power to our future selves

girls laughing

Image: Justine Reyes via Europa.eu

Imagine being a 13 year old migrant girl for the day. Imagine how your 13 year old self might make sense of the 24/7 world of social media, schoolyard banter and popular culture, before the onset of adult cynicism and weariness. If you’ve been told you can’t be what you can’t see, imagine trying to work out why there aren’t more girls like you in the media, or why female soccer players are paid less than male soccer players, or why two women who love each other still can’t marry. It would put just enough fire in your belly to make changes for the better. How might you capture and bottle the power of that adolescent girl?

‘The Power of the Adolescent Girl’ is the theme of this year’s International Day of the Girl (11th October), a day set aside by the UN to recognise girls’ rights and the unique challenges girls face around the world. The concept of power is an interesting thing in itself and it’s not generally something associated with young girls. But, as the sage saying goes, knowledge is power and in this sense young girls should be seen as powerful agents of change in acquiring and producing new forms of knowledge.

Young women and girls from refugee and migrant backgrounds bring with them insights that have been gleaned through their own and their family’s experiences of migration, settlement and of being ‘different’ to other ‘Aussies’. These experiences are more likely to make a young migrant or refugee girl question ideas about belonging and where and how she fits in the world. This process of self-reflection can be particularly challenging if, for example, you’re also figuring out your attraction to another girl, while at the same time trying to communicate with your parents in another language why it’s not fair that your brothers get out of doing the housework.

This year, the global community is called upon to invest in improvements to girls’ health and well-being and to promote and implement gender-responsive policies. Improving girls’ lives is generally couched in terms of ‘investment’, but we should also focus on this notion of girls’ ‘power’ and the ways in which we might be able to support them with the knowledge to make decisions for and about themselves. This might mean working with specialist organisations that can help you support young women in culturally responsive ways  or it could also mean simply listening to what young women and girls imagine their future to be. Young girls already have considerable skills and talents to produce the momentum for positive change, we just need to recognise and harness this potential. After all, wouldn’t you have wanted to make the world a more conquerable place for your 13 year old self?

60 seconds with Dr Nadia Chaves

Refugee Adult Health Fellow and classical music lover

What are you enjoying doing at the moment?
I am enjoying looking at all the Spring blossoms

Best part of my job?
Getting to meet all the passionate people who work in the refugee and asylum seeker health sector, and getting to meet the wonderful clients too.

Biggest challenge as a woman from an immigrant background
I am lucky that I don’t believe I have been discriminated against because of my background in my profession. However, as a working mother I always feel pressure (be it from my colleagues at work or at home)– to do more work or to spend more time with the kids – and balancing that is my biggest challenge!

What’s the best thing about being a woman from an immigrant/refugee background?
I actually love the fact that my name is Nadia – it is a name in so many languages around the world from Spain through to Eastern Europe, the middle east, North Africa, Russia and India – I feel that when people meet me sometimes they simply feel they can connect with me because of my name! And then I tell them I have been in Australia for 35 years they feel reassured because I love my work and family and I’m so settled in – I am Australian– and they know that they have a chance at doing that too.

An amazing woman I know is my mother. She (with my father) travelled the world with young children to four continents. She taught me about the wonder which is to be found everywhere. When I arrived in Australia in 1980 and went to school the kids called me an Abo. I asked her what that was. She replied that is an Aboriginal person, and although you are Indian if they think you are Aboriginal it is a great honour, because the Aboriginal people were the first people in Australia, they are the owners of this land and they have one of the oldest living cultures on earth.

Songs that inspire me:
I love Beethoven’s Appassionata Sonata no 23 in F Minor – one of the most beautiful pieces of music I’ve ever heard. I listened to this when I was in labour with my son and I will never forget that moment. I have another song with a similar memory for my daughter, Gurrumul’s Wiyathul.

If I could convince the world of one thing
It would be from the Depeche Mode song!
“People are people!”

Why breastfeeding is a feminist issue.

Image via theknitter.co.uk

Image via theknitter.co.uk

 

In August we celebrated World Breastfeeding Week (yes, it exists!), which this year aimed to highlight the importance of empowering women globally to combine breastfeeding and work and to make workplaces more breastfeeding-friendly.

For women who breastfeed, this empowerment is certainly important, but there are so many other reasons why breastfeeding is a feminist issue. Nursing mothers face a well-documented history of public discomfort and shaming that leads to discrimination and stigma. Everyone seems to have an opinion: whether you should or shouldn’t breastfeed, how long to do it, where and when is appropriate – advice and opinions on these issues can often be scathing and there’s nothing that says sisterhood or women’s empowerment in that.

Not to mention the double standard of our society gratuitously flaunting breasts in advertising and other media in a bid to sell more stuff, yet deeming a woman breastfeeding her baby as unacceptable to be seen in public. Once the breast’s role is no longer to sexually gratify or to be a source of pleasure, but is instead used and controlled by women to nourish a child, it suddenly becomes something society shouldn’t see. Breastfeeding is an issue that ticks all the feminist boxes – autonomy over our bodies, social and gender ownership of what is an “acceptable” female body.

For immigrant and refugee women too, the stigma, shame and judgement around breastfeeding can be a strong disincentive to make an active and free choice about whether, when and how to breastfeed. Add to the mix cultural identity (both personal and communal), traditional and family practices, as well as social isolation and barriers accessing and understanding the myriad of information and advice, and you start to wonder why we don’t just throw up our hands and reach for the formula.

One recent study found just that: Interviews with first generation immigrant Indian women in Australia, revealed that breastfeeding was inexorably linked to cultural identity and heritage for new mothers, with all participants viewing breastfeeding as an essential part of motherhood. After birth however, all but one of the women began formula feeding before 6 months of age, due to breastfeeding difficulties, return to paid work, conflicting advice from healthcare professionals, and cultural isolation and lack of support.

When not even a supermodel can manage to normalise breast feeding without public backlash we really, as women, need to band together and get behind the movement. The law in Australia prohibits discrimination against breast-feeding women, but like many laws surrounding the discrimination and equality of women, these values are not always reflected in social practice and community attitudes. We need to facilitate women’s free choices about breastfeeding wherever and whenever they choose. It’s time that attitudes to women breastfeeding in public entered the 21st century. It’s up to women to lead this change together.

For our part, we want to celebrate the women who advocate for the right to make free and active breastfeeding choices. Whether you are a woman who flies back in the face of judgement about the length of time she breastfeeds, or you proudly display your choice to continue the long held tradition of breastfeeding children other than your own, or you work to increase the visibility of the diversity of women who breastfeed, we would like to honour you and value your contribution to making women’s mothering easier. Our mothers and babies need you

60 seconds with Rosi Aryal

Health and Research Project Officer and researching trekker

What are you enjoying doing at the moment?
Having recently moved to Melbourne, I’m enjoying soaking up all the arts, music, food and sport.

What talent would you most like to possess?
To always respond with genuine empathy when people come to me with their problems.

If you could give one piece of advice to someone new to Australia, what would it be?
Don’t just stick to the big cities. Australia has an incredible diversity of climates and landscapes, and each region is absolutely stunning in its own way. Well worth the effort to get out and enjoy it!

What’s the biggest challenge you’ve faced as a woman from an immigrant or refugee background?
For most of the nineties I lived with my family in Hobart, which at the time seemed markedly mono-cultural. Cultural difference was not acknowledged, and I grew up absorbing this attitude. On a few rare occasions my parents would voice concerns about discrimination and exclusion, and each time I thought it was just in their heads. Moving to multicultural Sydney at 16 was a huge shock – I saw and felt both difference and discrimination more sharply, and I finally began to understand my parents’ experiences of racism. A few years later the Cronulla riots happened, showing not only how deep the undercurrents of racism go in Australia, but also how easily they surface. It was impossible not to take the riots personally. I felt unwelcome, simply because of my brown skin, in a country that has always been home.

Tell me about an amazing woman you know
My cousin Kripa in Nepal. In our early twenties we were lying on her living room rug one day pouring over a map, daydreaming about how we would love to trek independently through some of the more remote western regions of the country. Kripa devised an MA thesis plan related to gender and conflict that required fieldwork in those areas, and three weeks later we were walking from village to village and mountain to mountain interviewing young female Maoist rebels about their motivations for joining the insurgency. I love a woman who can make the most wonderful things happen in the most unlikely circumstances!

What are you reading right now?
The Spare Room by Helen Garner, a short novel about a 64-year old woman caring for a friend who has cancer and is struggling to accept death. As I will be working with carers for my project at MCWH, I love how Garner portrays the joys and burdens of being a carer with both compassion and humour.

Finish this sentence: “We need feminism because…”
Because women in our society are still sexually objectified and subjected to disproportionate levels of violence. Because women are still valued more for their looks than their person. Because women still earn less than men for the same work. Because women still take on the bulk of the burden of housework and caring work. Because men too are expected to maintain gender roles that stop them from fully expressing (or even realising) their emotions and their respect for women. Because when over half our population is socially devalued and disempowered, the entire population will never reach its full potential.

The WRAP #34: Caring, Contemplating the Commission and 60 seconds with Mi Nguyen

Time is truly whizzing by Wrappers.

It’s July and as we see out the old financial year and welcome in the new, it’s hard not be preoccupied by budgets, balance sheets and generally asking ourselves how things are adding up. Some of us are dreading doing our tax return while others are dreaming of getting back a little extra cash to splash on a long-desired treat!

Money is definitely on our minds but this is also a good time to reflect back on the first seven months of the year and ask ourselves what we should really value.

So this WRAP we are talking about what we have cared about this year, starting with the work of immigrant and refugee carers. Their work is unpaid but it is certainly immeasurable. We have also valued the increased conversation Australians are having about stopping violence against women. We look optimistically to how this can change in the future, and hope that by the time the tax person calls again in 2016, we will have some positive reflections on strategies and programs that have been implemented to prevent violence against all women, but particularly including refugee and immigrant women.

And of course we couldn’t let the month go by without valuing another fantastic 60 seconds with Mi Nguyen!

Until next month,
The WRAP team