Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study

Suzanne Belton, Sue Kruske, Lisa Jackson Pulver, Juanita Sherwood, Kylie Tune, Geraldine Vaughan, Michael Peek, Claire McLintock, Elizabeth Sullivan, Jonathan Carapetis

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: To study rheumatic heart disease health literacy and its impact on pregnancy, and to identify how health services could more effectively meet the needs of pregnant women with rheumatic heart disease. Materials and methods: Researchers observed and interviewed a small number of Aboriginal women and their families during pregnancy, childbirth and postpartum as they interacted with the health system. An Aboriginal Yarning method of relationship building over time, participant observations and interviews with Aboriginal women were used in the study. The settings were urban, island and remote communities across the Northern Territory. Women were followed interstate if they were transferred during pregnancy. The participants were pregnant women and their families. We relied on participants’ abilities to tell their own experiences so that researchers could interpret their understanding and perspective of rheumatic heart disease. Results: Aboriginal women and their families rarely had rheumatic heart disease explained appropriately by health staff and therefore lacked understanding of the severity of their illness and its implications for childbearing. Health directives in written and spoken English with assumed biomedical knowledge were confusing and of limited use when delivered without interpreters or culturally appropriate health supports. Conclusions: Despite previous studies documenting poor communication and culturally inadequate care, health systems did not meet the needs of pregnant Aboriginal women with rheumatic heart disease. Language-appropriate health education that promotes a shared understanding should be relevant to the gender, life-stage and social context of women with rheumatic heart disease.

Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume58
Issue number4
Early online date6 Nov 2017
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • Indigenous health
  • communication
  • health literacy
  • pregnancy
  • rheumatic heart disease

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