Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Stressful events, social health issues and psychological distress in Aboriginal women having a baby in South Australia: implications for antenatal care

Authors: Donna Weetra, Karen Glover, Mary Buckskin, Jackie Ah Kit, Cathy Leane, Amanda Mitchell, Deanna Stuart-Butler, May Turner, Jane Yelland, Deirdre Gartland, Stephanie J Brown

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
1.
2.
Vos T, Barker B, Begg S, Stanley L, Lopez AD. Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. Int J Epidemiol. 2009;38(2):470–7.CrossRefPubMed
3.
Li Z, Zeki R, Hilder L, Sullivan EA. Australia's mothers and babies 2010. Perinatal statistics series no. 27. Cat. no. PER 57. Canberra: AIHW; 2012.
4.
Eades S, Read AW, Stanley FJ, Eades FN, McCaullay D, Williamson A. Bibbulung Gnarneep (‘solid kid’): causal pathways to poor birth outcomes in an urban Aboriginal birth cohort. J Paediatr Child Health. 2008;44(6):342–6.CrossRefPubMed
5.
Sullivan EA, Hall B, King JF. Maternal deaths in Australia 2003–2005. Maternal deaths series no. 3. Cat. no. PER 42. Sydney: AIHW National Perinatal Statistics Unit; 2007.
6.
Stamp G, Champion S, Anderson G, Warren B, Stuart-Butler D, Doolan J, Boles C, Callaghan L, Foale A, Muyambi C. Aboriginal maternal and infant care workers: partners in caring for Aboriginal mothers and babies. Rural Remote Health. 2008;8:883.
7.
Middleton P, Glover K, Weetra D, Bubner T, Crowther C, Rumbold A, Brown SJ. Evaluation of the Aboriginal Family Birthing Program. Adelaide: RANZCOG 2014 Indigenous women’s health meeting; 2014.
8.
Brown SJ, Weetra D, Glover K, Buckskin M, Ah Kit J, Leane C, Mitchell A, Stuart-Butler D, Turner M, Gartland D, Yelland J. Improving Aboriginal women’s experiences of maternity care: results of the Aboriginal Families Study. Birth. 2015;42(1):27–37.
9.
Buckskin M, Ah Kit J, Glover K, Mitchell A, Miller R, Weetra D, Wiebe J, Yelland J, Newbury J, Robinson J, Brown SJ. Aboriginal Families Study: a population-based study keeping community and policy goals in mind right from the start. Int J Equity Health Care. 2013;12:41.
10.
Brown SJ, Yelland JS, Sutherland GA, Baghurst PA, Robinson JS. Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care. BMC Public Health. 2011;11:196.CrossRefPubMedPubMedCentral
11.
12.
Australian Institute of Health and Welfare. Measuring the social and emotional well-being of Aboriginal and Torres Strait Islander Health Survey 2004-05. Canberra: Australian Bureau of Statistics; 2006, ABS Cat. No. 4715.0.
13.
Kessler RC, Andrews G, Colpe LJ, Hirilpi E, Mroczek DK, Normand SLT, Walters EE, Zaslav AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32:959–76.
14.
Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfoerer JC, Hiripi E, Howes MJ, Normand SLT, Mandersheid RW, Walters EE, Zalavsky AM. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60:184–9.
15.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. British J Psychiatr. 1987;150:782–6.CrossRef
16.
Campbell A, Hayes B, Buckby B. Aboriginal and Torres Strait Islander women’s experience when interacting with the Edinburgh Postnatal Depression Scale: a brief note. Aust J Rural Health. 2008;16(3):124–31.CrossRefPubMed
17.
Thomas A, Cairney S, Gunthorpe W, Paradies Y, Sayers S. Strong Souls: development and validation of a culturally appropriate tool for assessment of social and emotional well-being in Indigenous youth. Aust NZ J Psychiatry. 2010;44(1):40–8.CrossRef
18.
StataCorp. Stata Statistical Software Release 13. College Station. TX: StataCorp LP; 2013.
19.
De Maio JA, Zubrick SR, Silburn SR, Lawrence DM, Mitrou FG, Dalby RB, Blair RM, Griffin J, Milroy H, Cox A. The Western Australian Aboriginal Child Health Survey: Measuring the Social and Emotional Wellbeing of Aboriginal Children and Intergenerational Effects of Forced Separation. Perth: Curtin University of Technology and Telethon Institute for Child Health Research, 2005.
20.
Askew DA, Schluter PJ, Spurling GKP, Bond CJR, Brown ADH. Urban Aboriginal and Torres Strait Islander children’s exposure to stressful events: a cross-sectional study. MJA. 2013;199:42–5.PubMed
21.
Holt S, Buckley H, Whelan S. The impact of exposure to domestic violence on children and young people: a review of the literature. Child Abuse Negl. 2008;32:797–810.CrossRefPubMed
22.
Shonkoff J, Garner A. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129:e232–46.CrossRefPubMed
23.
Glover V. Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective. J Child Psychol Psychiatr. 2011;52(4):356–67.CrossRef
24.
Cker AL, Sanderson M, Dong B. Partner violence during pregnancy and risk of adverse pregnancy outcomes. Paediatr Perinat Epidemiol. 2004;18:260–9.CrossRef
25.
Silverman JG, Decker MR, Reed E, Raj A. Intimate partner violence victimization prior to and during pregnancy among women residing in 26 US states: associations with maternal and neonatal health. Am J Obstet Gynecol. 2006;195(1):140–8.CrossRefPubMed
26.
Sanchez SE, Alva AV, Diez Chang G, Qui C, Yanez D, Gelaye B, Williams MA. Risk of spontaneous preterm birth in relation to maternal exposure to intimate partner violence during pregnancy in Peru. Matern Child Health J. 2013;17(3):485–92.
27.
Shepherd CCJ, Li J, Mitrou F, Zubrick SR. Socio-economic disparities in the mental health of Indigenous children in Western Australia. BMC Public Health. 2012;12:756.CrossRefPubMedPubMedCentral
28.
Yelland J, Sutherland G, Brown SJ. Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC Public Health. 2010;10:771.CrossRefPubMedPubMedCentral
29.
Buist AE, Austin MP, Hayes BA, Speelman C, Biliszta JL, Gemmill AW, rooks J, Ellwood D, Milgrom J. Postnatal mental health of women giving birth in Australia 2002-2004: findings from the beyondblue National Postnatal Depression Program. Aust NZ J Psychiatry. 2008;42(1):66–73.
30.
Cunningham J, Paradies Y. Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data. BMC Public Health. 2012;12:95.CrossRefPubMedPubMedCentral
31.
McNamara BJ, Banks E, Gubhaju L, Williamson A, Joshy G, Raphael B, Eades SJ. Measuring psychological distress in older Aboriginal and Torres Strait Islander Australians: a comparison of the K-10 and K-5. Aust NZ J Public Health 2014;online; doi:10.​1111/​1753-6405.​12271
32.
Ekman B, Pathmanathan I, Liljestrand J. Integrating health interventions for women, newborn babies and children; a framework for action. Lancet. 2008;372:990–1000.CrossRefPubMed
33.
Frenk J. Reinventing primary health care: the need for systems integration. Lancet. 2009;374:170–3.CrossRefPubMed
34.
Wong R, Herceg A, Patterson C, Freebairn L, Baker A, Sharp P, Pinnington P, Tongs J. Positive impact of a long-running urban Aboriginal medical service midwifery program. Aust NZ J Obstet Gynaecol. 2011;51:518–22.
35.
Homer CSE, Foureur M, Allende T, Pekin F, Caplice S, Catling-Paull C. ‘It’s more than just having a baby’ women’s experience of a maternity service for Australian Aboriginal and Torres Strait Islander families. Midwifery. 2012;28:e509–15.CrossRef
36.
Murphy E, Best E. The Aboriginal Maternal and Infant Health Service: a decade of achievement in the health of women and babies in NSW. NSW Public Health Bull. 2012;23(3-4):68–72.CrossRef
37.
Barclay L, Kruske S, Bar-Zeev S, Steenkamp M, Josif C, Narjic CW, Wardaguga M, Belton S, Gao U, 497 Dunbar T, Kildea S. Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change. BMC Health Serv Res. 2014;14:241.
38.
Di Lallo S. Prenatal care through the eyes of Canadian Aboriginal women. Nurs Womens Health. 2014;18(1):40–6.CrossRef
39.
Rumbold AR, Cunningham J. A review of the impact of antenatal care for Australian Indigenous women and attempts to strengthen these services. Matern Child Health J. 2008;12(1):83–100.CrossRefPubMed
40.
Jongen C, McCalman J, Bainbridge R, Tsey K. Aboriginal and Torres Strait Islander maternal and child health and wellbeing: a systematic search of programs and services in Australian primary health care settings. BMC Pregnancy Childbirth. 2014;14:251.CrossRefPubMedPubMedCentral
41.
Kramer MS, Séguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinatal Epidemiol. 2000;14(3):194–210.CrossRef
42.
National Insitute of Clinical Excellence. Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors. London: NICE; 2010.
43.
Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 2011;118(1):1–203.CrossRef
44.
Rayment-Jones H, Murrells T, Sandall J. An investigation of the relationship between the caseload model of midwifery for socially disadvantaged women and childbirth outcomes using routine data – a retrospective, observational study. Midwifery 2015; http://​dx.​doi.​org/​10.​1016/​j.​midw.​2015.​01.​003
45.
Mezey G, Bacchus L, Bewley S, White S. Domestic violence, lifetime trauma and psychological health of childbearing women. BJOG. 2005;112(2):197–204.CrossRefPubMed
46.
Hollowell J, Oakley L, Kurinczuk JJ, Brocklehurst P, Gray R. The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review. BMC Pregnancy Childbirth. 2011;11:13.CrossRefPubMedPubMedCentral
Metadata
Title
Stressful events, social health issues and psychological distress in Aboriginal women having a baby in South Australia: implications for antenatal care
Authors
Donna Weetra
Karen Glover
Mary Buckskin
Jackie Ah Kit
Cathy Leane
Amanda Mitchell
Deanna Stuart-Butler
May Turner
Jane Yelland
Deirdre Gartland
Stephanie J Brown
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0867-2

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue

Research article

The timing of antenatal care initiation and the content of care in Sindh, Pakistan

Research article

Induced abortion - impact on a subsequent pregnancy in first-time mothers: a registry-based study

Research article

Women’s experience of maternal morbidity: a qualitative analysis

Research article

Pregnancy in patients with tuberculosis: a TBNET cross-sectional survey

Research article

Could the erythrocyte indices or serum ferritin predict the therapeutic response to a trial with oral iron during pregnancy? Results from the Accuracy study for Maternal Anaemia diagnosis (AMA)

Research article

Effect of maternal Helicobacter Pylori infection on birth weight in an urban community in Uganda