Late initiation of pregnancy care and suboptimal care are associated
with perinatalmortality in migrant women [20,21]. We noted independent
associations between birth in an HSC and poor/no pregnancy care
attendance and late booking visits among women from South Asia.
Although late booking visits were more common in all groups than
has been reported in Australia’s annual perinatal report (39.3%–58.1%
vs 22%–35%) [14], only in the South Asian HSC group were they notably
more common than in the generalmaternity service population (58.1%).
The South Asian HSC group was comprised predominantly of Afghan
women, and research among this population has identified that staff
attitudes, information provision, participative decision making, and
organization of care have a strong impact on the experience of maternity
care [22], providing a useful foundation for improving the responsiveness
of current services. Other strategies could include increased
staff training for cultural awareness and understanding of refugee
experiences, and strengthening links with primary-care providers
serving refugee communities. Social barriers to accessing adequate
care—e.g. interpreter requirement and teenage pregnancy—were generally
more common in the HSC groups. This highlights the importance
of using qualified interpreters and future research could explore how
to improve pathways linking women with relevant health and social
support services.