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Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland

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Abstract

Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland’s health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically diverse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified; however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.

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Acknowledgments

The data on which this report is based was collected as part of the Having a Baby in Queensland Survey Program of the Queensland Centre for Mothers & Babies at The University of Queensland. We are grateful to Queensland Government for funding and to the women who provided survey data. The Queensland Registry of Births, Deaths and Marriages contacted women to invite them to participate on behalf of the Queensland Centre for Mothers & Babies to ensure women’s privacy was protected. We gratefully acknowledge Dr. Rachel Thompson for her conception and design of the Having a Baby in Queensland Survey Program with Associate Professor Miller. We are grateful to Dr. Samantha Prosser and the Queensland Centre for Mothers & Babies Survey Program team for their contribution to the design and management of data collection. Anna Voloschenko from the Ethnic Communities Council of Queensland advised on the definition of CALD for application in this research and her contribution is gratefully acknowledged.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all individuals who participated in this study.

Conflict of interest

Yvette Miller declares that she has no conflict of interest. Sarah Mander declares that she is now an employee of Queensland Health but was not at the time that this research was conducted.

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Correspondence to Yvette D. Miller.

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Mander, S., Miller, Y.D. Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland. J. Racial and Ethnic Health Disparities 3, 83–98 (2016). https://doi.org/10.1007/s40615-015-0118-7

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