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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Barriers and enablers to postpartum contraception among Aboriginal Australian women: factors influencing contraceptive decisions

Sarah James A B E , Maree Toombs C D and Wendy Brodribb A
+ Author Affiliations
- Author Affiliations

A Discipline of General Practice, Faculty of Medicine, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.

B General Practice Training Queensland (GPTQ), 4 Tourist Road, East Toowoomba, Qld 4350, Australia.

C Rural Clinical School, Faculty of Medicine, The University of Queensland, c/o Centre for Health Sciences Research, Level 3, The Phoenix Building, The University of Southern Queensland, Toowoomba, Qld 4350, Australia.

D Carbal Medical Services, 18–29 Hannah Court, Toowoomba, Qld 4350, Australia.

E Corresponding author. Email: sathjames2@gmail.com

Australian Journal of Primary Health 24(3) 241-247 https://doi.org/10.1071/PY17041
Submitted: 30 March 2017  Accepted: 20 January 2018   Published: 7 May 2018

Abstract

This qualitative research obtained insights into factors influencing postpartum contraception use among Aboriginal women in southern Queensland. Seventeen women participated in focus groups or interviews from July to October 2015 at an Aboriginal and Torres Strait Islander Community-Controlled Health Organisation. Data were analysed with open coding and thematic analysis. The results affirmed Aboriginal women want control over family planning. Participants indicated more could be done to improve health literacy and contraception uptake. A variety of family planning preferences were revealed, with an almost universal desire for increased access to postpartum contraception. Participants wanted information given antenatally and postnatally. Obtaining and using contraception were difficult for many. Social factors that hinder access such as shame, ideas surrounding women’s health, cultural disengagement, social isolation and using childbearing to control relationships were identified. The reproductive outcomes of Aboriginal women often do not reflect their preferences. A mandate exists to provide information about and access to postpartum contraception, empowering women with greater control over their reproductive practices. Health professionals can play a key role in dismantling barriers to autonomous family planning by offering information and resources both antenatally and postnatally.

Additional keywords: family planning services, Indigenous health services, primary health care, women’s health services.


References

Aliyu MH, Jolly PE, Ehiri JE, Salihu HM (2005) High parity and adverse birth outcomes: exploring the maze. Birth 32, 45–59.
High parity and adverse birth outcomes: exploring the maze.Crossref | GoogleScholarGoogle Scholar |

Arabena K (2006) Preachers, policies and power: the reproductive health of adolescent Aboriginal and Torres Strait Islander peoples in Australia. Health Promotion Journal of Australia 17, 85–90.
Preachers, policies and power: the reproductive health of adolescent Aboriginal and Torres Strait Islander peoples in Australia.Crossref | GoogleScholarGoogle Scholar |

Australian Institute of Aboriginal and Torres Strait Islander Studies (2012) ‘Guidelines for Ethical Research in Australian Indigenous Studies.’ Revised second edition. (AIATSIS: Canberra, ACT, USA)

Bell D (1981) Women’s business is hard work: Central Australian Aboriginal women’s love rituals. Signs 7, 314–337.
Women’s business is hard work: Central Australian Aboriginal women’s love rituals.Crossref | GoogleScholarGoogle Scholar |

Budd JM (2008) Critical Theory. In ‘The Sage Encyclopedia of Qualitative Research Methods’. (Ed. LM Given) pp. 175–179. (SAGE Publications Inc.: Thousand Oaks, CA, USA)

Burbank V, Chisholm JS (1992) Gender differences in the perception of ideal family size in an Australian Aboriginal community. In ‘Father–Child Relations: Cultural and Biosocial Contexts’. (Ed. BS Hewlett.) pp. 177–190. (Aldine De Gruyter: New York, NY, USA)

Burns J, Burrow S, Drew N, Elwell M, Gray C, Harford-Mills M, Hoareau J, Lynch R, MacRae A, O’Hara T, Potter C, Ride K, Trzesinski A (2015) ‘Overview of Australian Indigenous Health Status 2014.’ (Edith Cowan University: Perth, WA, Australia)

Conde-Agudelo A, Rosas-Bermudez A, Kafury-Goeta AC (2007) Effects of birth spacing on maternal health: a systematic review. American Journal of Obstetrics and Gynecology 196, 297–308.
Effects of birth spacing on maternal health: a systematic review.Crossref | GoogleScholarGoogle Scholar |

Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, Simmons KB, Pagano HP, Jamieson DJ, Whiteman MK (2016) US medical eligibility criteria for contraceptive use, 2016. Morbidity and Mortality Weekly Report 65, 1–103.
US medical eligibility criteria for contraceptive use, 2016.Crossref | GoogleScholarGoogle Scholar |

Department of Human Services (2016) Closing the Gap – PBS Co-payment Measure. (Australian Government Department of Human Services: Canberra, ACT, Australia) Available at https://www.humanservices.gov.au/health-professionals/services/medicare/closing-gap-pbs-co-payment-measure [Verified 29 March 2017]

Faculty of Sexual and Reproductive Healthcare (2017) Contraception after pregnancy. (FSRH, Clinical Effectiveness Unit: London, UK) Available at https://www.fsrh.org/standards-and-guidance/documents/contraception-after-pregnancy-guideline-january-2017/ [Verified 29 March 2017]

Fusch PI, Ness LR (2015) Are we there yet? Data saturation in qualitative research. Qualitative Report 20, 1408–1416.

Griffiths EK, Marley JV, Friello D, Atkinson DN (2016) Uptake of long-acting, reversible contraception in three remote Aboriginal communities: a population-based study. The Medical Journal of Australia 205, 21–25.
Uptake of long-acting, reversible contraception in three remote Aboriginal communities: a population-based study.Crossref | GoogleScholarGoogle Scholar |

Harkins J (1994) Emotion Terms and Related Words. In ‘Bridging Two Worlds: Aboriginal English and Crosscultural Understanding’. pp. 156–160. (University of Queensland: Brisbane, Qld, Australia)

Humphrey MD (2003) Is grand multiparity an independent predictor of pregnancy risk? A retrospective observational study. The Medical Journal of Australia 179, 294–296.

Ireland S, Narjic CS, Belton S, Saggers S, McGrath A (2015) ‘Jumping around’: exploring young women’s behaviour and knowledge in relation to sexual health in a remote Aboriginal Australian community. Culture, Health & Sexuality 17, 1–16.
‘Jumping around’: exploring young women’s behaviour and knowledge in relation to sexual health in a remote Aboriginal Australian community.Crossref | GoogleScholarGoogle Scholar |

James ST, Brodribb W (2015) Contraception amongst breastfeeding Aboriginal women postpartum: a literature review. Poster presented at: Primary Health Care Research Conference, 29–31 July 2015. (PHCRIS: Adelaide, SA, Australia) Available at http://www.phcris.org.au/resources/item.php?id=8190&spindex=3 [Verified 15 January 2016].

Larkins SL, Page RP, Panaretto KS, Scott R, Mitchell MR, Alberts V, Veitch PC, McGinty S (2007) Attitudes and behaviours of young Indigenous people in Townsville concerning relationships, sex and contraception: the ‘U Mob Yarn Up’ project. The Medical Journal of Australia 186, 513–518.

Lewis LN, Doherty DA, Hickey M, Skinner SR (2010) Predictors of sexual intercourse and rapid-repeat pregnancy among teenage mothers: an Australian prospective longitudinal study. The Medical Journal of Australia 193, 338–342.

National Health and Medical Research Council (2003) ‘Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research.’ (Commonwealth of Australia: Canberra, ACT, Australia)

Parr N, Siedlecky S (2007) Use of ‘dual protection’ and other combinations of contraceptive methods in Australia. Australian and New Zealand Journal of Public Health 31, 567–570.
Use of ‘dual protection’ and other combinations of contraceptive methods in Australia.Crossref | GoogleScholarGoogle Scholar |

Patton MQ (2005) Purposeful Sampling. In ‘Encyclopedia of Evaluation’. (Ed. S Mathison) pp. 343–344. (SAGE Publications Inc.: Thousand Oaks, CA, USA)

Reid J, Gurruwiwi M (1979) Attitudes towards family planning among the women of a Northern Australian Aboriginal community. The Medical Journal of Australia 2S, 5–7.

Salkind NJ (2010) Convenience Sampling. In ‘Encyclopedia of Research Design.’ (Ed. NJ Salkind) pp. 254–255. (SAGE Publications Inc.: Thousand Oaks, CA, USA)

Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 19, 349–357.
Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.Crossref | GoogleScholarGoogle Scholar |

Wendt A, Gibbs CM, Peters S, Hogue CJ (2012) Impact of increasing inter-pregnancy interval on maternal and infant health. Paediatric and Perinatal Epidemiology 26, 239–258.
Impact of increasing inter-pregnancy interval on maternal and infant health.Crossref | GoogleScholarGoogle Scholar |

World Health Organization (2006) Report of a WHO technical consultation on birth spacing 2005. World Health Organization, Geneva, Switzerland.

World Health Organization (2015) Medical eligibility criteria for contraceptive use. WHO Press: Geneva, Switzerland.