Accessing perinatal education in the Australian health system: A mixed-methods exploration of the experiences of migrant and refugee women

Abstract

Although many migrant and refugee women in Australia experience healthy pregnancies, inequities in perinatal outcomes persist. Perinatal education supports health literacy and informed decision making about pregnancy, birth and early parenting, yet little is known about how migrant and refugee women become aware of and experience these services. This study explores the experiences of migrant and refugee women in Western Sydney in navigating the Australian health system and accessing perinatal education. We adoted a mixed-methods phenomenological research approach, comprising semi-structured interviews in Arabic, Mandarin, Dari and Hindi alongside a quantitative survey. Purposive sampling was used to recruit women from culturally and linguistically diverse backgrounds through antenatal clinics and community health centres, with participants representing varying levels of engagement in perinatal education. Qualitative data was analysed using thematic analysis and quantitative data were analysed descriptively. A total of 22 participants completed interviews, and 246 participants completed the survey. Nearly all survey participants (92.3%) spoke a language other than English, representing more than 18 languages and 34 countries of birth. Quantitative findings demonstrated low uptake of perinatal education, with 86.2% (n = 212) reporting no engagement with formal programs. Qualitative analysis identified four key themes: (1) Pregnancy as a pivotal introduction to health care; (2) Mirrored barriers to engagement with care and education; (3) Care through connection - social and cultural bridges, and (4) Scrolling for solutions: the digital classroom. Across both qualitative and quantitative data, women described intersecting barriers including language, cost, cultural expectations, and limited awareness of available services alongside facilitators such as bilingual providers, community networks and digital platforms. These findings highlight the need for equity-oriented approaches to perinatal education, including community based and culturally responsive awareness and delivery methods.