Current evidence

What Australian research shows about maternity care for migrant, refugee and culturally diverse women — and what still is not in place.

Lived experience and research sit together. Women’s stories show what unsafe and disrespectful care feels like. Evidence shows how often the gaps appear, which parts of the system create them, and which models already improve care.

This page is not clinical advice. It does not speak for First Nations maternity leadership.

What the evidence shows

A substantial share of women giving birth in Australia were born overseas. Around one quarter of mothers were born in countries where English is not the primary language. Equitable maternity care is therefore a core health-system issue, not a niche one.

Migrant and refugee women are not a single group. Across communities, the same system barriers keep appearing.

Many women receive safe, respectful care. Too many do not. Australian studies and national reporting show that migrant, refugee and culturally and linguistically diverse women are more likely to face:

later start to antenatal care
language barriers, including interpreters that are booked and then not used
models of care that do not recognise cultural, religious or family needs
high costs, short consultations and limited tailored information
experiences of racism, stereotyping and disrespect
higher rates of some adverse outcomes in particular communities, including gestational diabetes, some birth injuries, stillbirth and poorer reported experience of care

These patterns are not explained by “culture” alone. They sit inside a system that is often hard to enter early, hard to navigate without English, and poorly designed for continuity or shared decision-making.

Temporary visa holders face a further barrier: delayed or limited access to Medicare-eligible care. That delay can push women into later booking, out-of-pocket costs and fewer choices.

National data still hide part of the problem. Country of birth is collected. Ethnicity, language spoken, interpreter use, racism and model of care are not routinely reported together. That makes inequity easier to miss and harder to fix.

Access to continuity is unequal

Midwifery continuity of care — one midwife or a small team through pregnancy, birth and the early postnatal period — is linked to better experience, fewer interventions and improved outcomes. It is also the model that fills first.

Recent Australian hospital research found a stepped gap:

about 23% of Australian-born women received midwifery continuity of care
about 12% of women who migrated five or more years ago
about 6% of women who migrated within the last five years

After adjustment, new migrants were about 70% less likely than Australian-born women to receive that model. The gap was larger again for some groups, including recent Southeast Asian and Middle Eastern migrant women.

Continuity is still only available in a minority of Australian maternity services. Dedicated migrant and refugee continuity programs exist in a handful of sites, not as the national standard.

What works

The evidence is not thin on solutions. The same cluster of models appears across Australian research, service evaluations and women’s accounts.

What works is not mysterious. Acceptable and accessible models consistently include continuity of care, effective communication, in-language information, support to navigate services, psychosocial and practical support, and culturally responsive care designed with communities rather than for them.
The same cluster of models appears across Australian research, service evaluations and women’s accounts.
Continuity of care
A known midwife or small team. Early booking matters, because these programs fill quickly. In one Australian Refugee Midwifery Group Practice, women were more likely to have spontaneous labour and a normal birth, less likely to use epidural analgesia, and less likely to have a preterm baby than women receiving standard care.
Professional interpreting
Free in public care. Family members should not carry the clinical conversation. Interpreters need to be present for the booking visit and for later visits, labour and postnatal care — not only the first appointment. Women still report problems with availability, timing, confidentiality, dialect match, and use across the whole care journey.
Bicultural and cross-cultural workers
Staff who can walk with women through the system, explain options, and help services hear what the woman actually needs. Australian service evaluations report improved understanding, confidence, navigation and cultural safety, with very high satisfaction.
Group pregnancy care
Community-based groups, often by language, with time for questions, peer support and health information. When delivered with continuity and language support, group and community-based care can reduce isolation, build health literacy, and create trust and belonging.
Early, understandable information
How to book, what public and private options cost, how to ask for a female clinician, how to use an interpreter, and where to go if care does not feel safe.
When women have a trusted clinician and a way to speak in their own language, they are more likely to attend care, ask questions and stay in the system.
Training alone is not enough. Culturally responsive care fails when organisations do not embed referral pathways, workforce roles, coordination and accountability.

How to read this page

This is a public summary for services, colleges, researchers and families. It draws on Australian research and national reporting, and on what migrant parents in MCRMC describe in their own care.

It is not a systematic review and it is not medical advice. Individual risk always depends on the woman, the pregnancy and the service.

If you are pregnant and need help to navigate care, write to info@mcrmc.org.au. If you are in immediate distress: your hospital, Lifeline 13 11 14, PANDA 1300 726 306, 13YARN 13 92 76, Translating and Interpreting Service 131 450.

Where the system still fails

Knowing what works has not made it usual care.

Most migrant women still cannot get continuity.
Interpreters are requested and then unused, late, or missing in labour and after birth.
Bicultural roles remain short-term, grant-dependent or confined to a few hospitals.
Group models and refugee midwifery programs are evaluated in a small number of places and then left as pilots.
Workforce training in cultural safety and trauma-informed care is often a one-off workshop, not everyday practice.
Lived experience is invited to tell a story, then left out of design, data and governance.

The result is a two-speed system: flagship programs in a few sites, and standard fragmented care for everyone else.

Australia already knows many of the models that improve maternity care for migrant and refugee women. They are still not standard care across the system.

What needs to change

Improvement will not come from another isolated pilot. It needs:

funded continuity pathways that migrant and refugee women can actually enter, including women who book later or hold temporary visas
professional interpreting as a standard of care, not an optional extra
standing bicultural and multicultural liaison roles, not rotating project officers
national data that can show language, ethnicity, model of care, interpreter use and experience — including racism
cultural safety and anti-racism built into midwifery, obstetric and student training
migrant and refugee parents in governance, guideline work and evaluation, not only in patient stories

MCRMC convenes organisations around those points. We do not compete with them for the same frontline service funding.

How to read this page

This is a public summary for services, colleges, researchers and families prepared by the MCRMC. It draws on Australian research and national reporting, and on what migrant parents in MCRMC describe in their own care.

It is not a systematic review and it is not medical advice. Individual risk always depends on the woman, the pregnancy and the service.

References

Australian Institute of Health and Welfare. (2014). Australia’s mothers and babies 2012. AIHW.

Bains, S., Skråning, S., Sundby, J., Vangen, S., Sørbye, I., & Lindskog, B. (2021). Challenges and barriers to optimal maternity care for recently migrated women: A mixed-method study in Norway. BMC Pregnancy and Childbirth, 21, Article 686.

Bali, A. G., Vasilevski, V., & Sweet, L. (2024). Barriers and facilitators of access to maternity care for African-born women living in Australia: A meta-synthesis of qualitative evidence. Systematic Reviews, 13, Article 170.

Billett, H., Vazquez Corona, M., & Bohren, M. A. (2021). Women from migrant and refugee backgrounds’ perceptions and experiences of the continuum of maternity care in Australia: A qualitative evidence synthesis. Women and Birth.

Dube, M., Gao, Y., Steel, M., Bromley, A., Ireland, S., & Kildea, S. (2022). Effect of an Australian community-based caseload midwifery group practice service on maternal and neonatal outcomes for women from a refugee background. Women and Birth.

Dube, M., Ireland, S., Bromley, A., Steel, M., Gao, Y., & Kildea, S. (2023). “It’s all about cultural understanding”: A reflexive thematic analysis of women’s experiences at a dedicated refugee midwifery group practice service. Women and Birth.

Fair, F., Raben, L., Watson, H., Vivilaki, V., van den Muijsenbergh, M., & Soltani, H. (2020). Migrant women’s experiences of pregnancy, childbirth and maternity care in European countries: A systematic review. PLoS ONE, 15(2), e0228378.

Kuipers, Y., Aitken-Arbuckle, A., Jenkins, H., Watson, S., King, M., & Zemouri, C. (2025). Midwife continuity of care: A systematic review and meta-analysis of case-control and cohort studies. International Journal of Nursing Studies.

Melov, S., Elhindi, J., Qian, H., Byrnes, O., Cheung, N. W., de Vroome, P. M., Gilroy, G., Nippita, T., Simmons, M., Talla, G., White, L., Zachariah, D., Cummins, A., & Pasupathy, D. (2025). Do migrant women have equity of access to midwife continuity of care? Women and Birth.

Riggs, E., Muyeen, S., Brown, S., Dawson, W., Petschel, P., Tardiff, W., Norman, F., Vanpraag, D., Szwarc, J., & Yelland, J. (2017). Cultural safety and belonging for refugee background women attending group pregnancy care: An Australian qualitative study. Birth.

Rogers, H., Hogan, L., Coates, D., Homer, C., & Henry, A. (2020). Responding to the health needs of women from migrant and refugee backgrounds-Models of maternity and postpartum care in high-income countries: A systematic scoping review. Health & Social Care in the Community.

Vazquez Corona, M., Hazfiarini, A., Cao, J., Aryal Lees, R., Ansari, D., Tran, G., Shankar, M., Block, K., & Bohren, M. A. (2025). Migrant Mums and Maternity Care: A qualitative participatory health research study. BJOG.

Verschuuren, A. E. H., Tankink, J. B., Franx, A., van der Lans, P. V. D., Erwich, J., Jong, E. I. F., & de Graaf, J. P. (2023). Community midwives’ perspectives on perinatal care for asylum seekers and refugees in the Netherlands: A survey study. Birth.

Yelland, J., Mensah, F., Riggs, E., McDonald, E., Szwarc, J., Dawson, W., Vanpraag, D., Casey, S., East, C., Biro, M., Teale, G., Willey, S. M., & Brown, S. (2020). Evaluation of systems reform in public hospitals, Victoria, Australia, to improve access to antenatal care for women of refugee background: An interrupted time series design. PLoS Medicine, 17(7), e1003084.

Yeshitila, Y., Gold, L., Abimanyi-Ochom, J., Sweet, L., Riggs, E., & Le, H. N. D. (2024). Trends and disparities in perinatal health outcomes among women from refugee backgrounds in Victoria, Australia: A population-based study. Midwifery.

Yeshitila, Y., Gao, L., Gold, L., Riggs, E., Abimanyi-Ochom, J., Sweet, L., & Le, H. N. D. (2026). Cost-effectiveness of refugee midwifery group practice in reducing preterm birth among women from refugee backgrounds in Australia. Women and Birth.