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Original research
Compromised communication: a qualitative study exploring Afghan families and health professionals’ experience of interpreting support in Australian maternity care
  1. Jane Yelland1,2,
  2. Elisha Riggs1,2,
  3. Josef Szwarc3,
  4. Sue Casey3,
  5. Philippa Duell-Piening3,
  6. Donna Chesters3,
  7. Sayed Wahidi2,
  8. Fatema Fouladi2,
  9. Stephanie Brown1,2,4
  1. 1Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  2. 2Department of General Practice and Primary Health Care, University of Melbourne, Parkville, Victoria, Australia
  3. 3Victorian Foundation for Survivors of Torture, Brunswick, Victoria, Australia
  4. 4School of Population Health, University of Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Dr Jane Yelland, Murdoch Childrens Research Institute, Parkville, VIC 3052, Australia; jane.yelland{at}


Introduction Difficulties associated with communication are thought to contribute to adverse perinatal outcomes experienced by refugee background women living in developed countries. This study explored Afghan women and men's experience of language support during pregnancy, labour and birth, and health professionals’ experiences of communicating with clients of refugee background with low English proficiency.

Methods Interviews were conducted with (1) Afghan women and men in the first year after having a baby in Australia, by multilingual, bicultural researchers and (2) midwives and medical practitioners providing care to families of refugee background. Analysis was conducted thematically.

Results Sixteen Afghan women, 14 Afghan men, 10 midwives, five medical practitioners and 19 community-based health professionals (refugee health nurses, bicultural workers, counsellors) providing maternity or early postnatal care participated. Midwife and medical informants concurred that accredited interpreters are generally booked for the first pregnancy visit, but not routinely used for other appointments. Very few Afghan participants reported access to on-site interpreters. Men commonly interpreted for their wives. There was minimal professional interpreting support for imaging and pathology screening appointments or during labour and birth. Health professionals noted challenges in negotiating interpreting services when men were insistent on providing language support for their wives and difficulties in managing interpreter-mediated visits within standard appointment times. Failure to engage interpreters was apparent even when accredited interpreters were available and at no cost to the client or provider.

Conclusions Improving identification of language needs at point of entry into healthcare, developing innovative ways to engage interpreters as integral members of multidisciplinary healthcare teams and building health professionals’ capacity to respond to language needs are critical to reducing social inequalities in maternal and child health outcomes for refugee and other migrant populations.

  • Communication
  • Obstetrics and gynecology
  • Qualitative research

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