Calls for more bilingual midwives and doulas


Safety concerns arise as the government develops a new national plan for maternity services.

Pregnant migrant and refugee women are being put at risk because they are missing out on crucial interpreter services, midwives and multicultural groups have told SBS News. 

Sandra Elhelw Wright from the Federation of Ethnic Communities Councils of Australia (FECCA) says while interpreters are available in Australia, they are not being used enough.

She said sourcing those who speak new and emerging languages is difficult and healthcare workers can sometimes assume an interpreter isn't necessary when a woman is deemed to have basic English skills. 

"In reality, that woman might not be able to communicate some of the intricacies of medical language or some of the more detailed language to explain how she’s feeling, or might not understand what the doctor is saying."  

She might not understand what the doctor is saying.

- Sandra Elhelw Wright, FECCA

That can have serious consequences in emergency situations, she said. 

"It’s easy to imagine how things can go horribly wrong when a patient can’t communicate with their doctor or even worse, there’s a miscommunication." 

Migrant groups say pregnant women, who can speak basic English, may still need an interpreter in their preferred language during birth.
Migrant groups say pregnant women who can speak basic English may still need an interpreter.
Birth for Humankind

FECCA has raised its concerns to the Federal Government as it develops a new national plan for maternity services. 

The group points out in a submission on the consultation paper a "glaring gap" in the plan, with no inclusion of specific services for culturally and linguistic diverse women. 

Hannah Dahlen, professor of midwifery at Western Sydney University, says the attitude towards using interpreters needs to change. 

"We need to be very mindful of not being too busy to do that, and that’s often the issue because it takes time to organise and get an interpreter in," she said.

Professor Dahlen is calling for an overhaul of what she describes as a Euro-centric model that leads to discrimination. 

"I don’t think it’s intentional, but I think it’s the fact that we don’t know people, or understand their cultural preferences, that lead us to say or do things that are unkind," she said.

Sensitive conversations

A quarter of mothers who gave birth in Australia in 2015 were born in a non-English speaking country.

That’s a 17 per cent increase since 2005, and with that number set to rise, there are calls for more bilingual midwifery services. 

For almost two decades, midwife Ismat Ouaida has been running a clinic for pregnant Arabic women in Sydney's west. 

Ismat Ouaida says she loves her job running the Arabic Midwifery Clinic at Canterbury Hospital in Sydney's west.
Ismat Ouaida says she loves her job running the Arabic Midwifery Clinic at Canterbury Hospital in Sydney's west.
SBS News

Many of the women she sees are young and have left their extended family behind to move to Australia. 

"They come here they don’t have anyone, so they need to do all this on their own and it’s not easy. You’re 19 years old and you’ve got a child and you’re pregnant with the second one, not easy at all." 

They need to do all this on their own and it’s not easy.

- Ismat Ouaida, Midwife

The health check gives migrant women a chance to ask questions about breastfeeding, nutrition and contraception - sometimes sensitive conversations that wouldn't happen with a non-Arabic speaking midwife, Ms Ouaida says.

"I could tell where they were coming from. Sometimes before they ask the question I would know what they want to ask," she said.

Bilingual doulas

Melbourne charity Birth for Humankind is helping new migrants navigate Australia's maternal health system.

It trains bilingual women as volunteer doulas (a non-medical birth companion) who provide emotional and social support throughout a woman's pregnancy. 

Program manager Jen Branscombe explains: "Our doulas will go along with the woman to a hospital appointment and they'll provide an interpreter so they can actually spend some time after the appointment explaining things that have been said to them by the doctor or the midwife.

"It's quite a fast-paced environment in the hospital and things often get lost."

Volunteer doula Elizabeth Mazeyko (right) visits a mother and her new baby.
Volunteer doula Elizabeth Mazeyko, right, visits a mother and her new baby.
Krystal Seigerman/Birth for Humankind

Some of their volunteers were midwives in another country before moving to Australia.

Others, like Uruguayan doula Elizabeth Mazeyko, bring their experience of being a mother and grandmother to the role.

She understands how tough it can be for a woman to be away from her family at one of the most stressful times in her life. 

"They don't have a hand sometimes to hold, so that's where the role of the doula is, to support them emotionally and physically and make them feel very comfortable.

"We, in a way, are the voice of her decisions."

We are the voice of her decisions. 

- Elizabeth Mazeyko, Volunteer doula

Doula, Elizabeth Mazeyko with five month old Kamaal at his home in Epping, Victoria. Photography by Krystal Seigerman, 2017.
Ms Mazeyko with five-month-old Kamaal.
Krystal Seigerman/Birth for Humankind

There are also calls for more cultural training to stamp out unintentional discrimination in maternity services. 

"We know that birth centres and home births, for example, are very much dominated by white middle-class women, but why is that?" Professor Dahlen said. 

"Why do we not open those options up and do that in a culturally sensitive way?"

The government's national plan for maternity services is due to be finalised next year.

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