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School of Public Health

Health and Social Care - Research Profile

Comprising gerontology, health service coordination, rehabilitation studies, palliative care, and research methods. Staff research interests include personal control and disabling health conditions, vocational rehabilitation, social support, healthy ageing, effective case management in the delivery of health services, prediction of return to work following disabling injury, and rural health and rehabilitation. The Palliative Care Unit includes education and training, social research, community development and education and direct service provision. Staff research interests include palliative care health policy, spirituality and pastoral care, the domestic experience of living with lifethreatening illness, palliative care health services research, near-death experiences and visions, public health perspectives in palliative care, and the sociology of death and dying. The Research Methods Unit is responsible for the provision of teaching and research in research methods across all programs within the School of Public Health. Staff conduct a wide range of research in health and human services and are actively engaged in community development and education activities.

Research Projects:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Experience of Childbearing and Motherhood among Thai Women in Northern Thailand [completed in 2005]

A research project conducted in Chiang Mai by Professor Pranee Liamputtong as part of OSP programs in 1999 and 2003, in collaboration with the Faculty of Nursing, Chiang Mai University, Thailand, 1999-2000, with Assistant Professor Susanha Yimyam, Associate Professor Sukanya Parisunyajul and Associate Professor Chavee Baosoung, received funding in 1999 and 2003.

 

Research Summary:
Childbearing is seen as a biosocial event in the context of the socio-cultural environment within which it occurs. Every society provides a system of knowledge and behaviours for coping with the life crisis of childbirth, including beliefs and practices concerning pregnancy, parturition, and the puerperium; the social organization of birth; and the mobilization of emotional and social support. In different cultures, pregnancy, parturition and the puerperium are each, therefore, experienced differently. Motherhood is also culturally determined. The expectations of rearing the children and attitudes towards motherhood in different cultures differ though the common aim is to maintain the health and safety of the children.

Professor Pranee Liamputtong's earlier research among Asian women in Australia indicated that their experience of childbearing depends heavily on culturally sensitive forms of childbirth practice. These are seldom available even in a large metropolitan centre. Distress during childbirth and in the neonatal period places both women and infants at risk of physical and mental health problems, with clear implications for health policy. In this comparative research, Pranee examined whether the same pattern exits among women in Northern Thailand.

The research had the potential to contribute significantly to birthing services and policy for Thai women. It promoted better understanding between Thai health service providers and women from Thai communities, and for future planning and management to improve the quality and efficiency of health care services to women of childbearing age in Thailand.

This research aimed to:

  • Examine the experience and patterns of childbearing practices among Thai women in Northern Thailand. The following will be assessed:
  • Examine the perceptions and experience of motherhood among Thai women in Northern Thailand.
  • Analyse relationships between the experience of motherhood and the experience of childbearing. Earlier research suggests the following areas as likely to be important:
  • Derive culturally sensitive policy in birthing services for women in the north of Thailand and elsewhere.

This research project has been completed and has resulted in a number of publications. A book has been submitted for consideration for publication.

Publications:

Liamputtong, P. Birth and social class: Northern Thai women's lived experiences of caesarean and vaginal birth. Sociology of Health & Illness, 27(1), 243-270, 2005.

Liamputtong, P. Yu duan practices as embodying tradition, modernity and social change in Chiang Mai, Northern Thailand. Women & Health, 40(1), 79-99, 2004.

Liamputtong, P. Giving birth in hospital: Childbirth experiences of women in Northern Thailand. Health Care for Women International, 25(2), 454-480, 2004.

Liamputtong, P., Yimyam, S, Parisunyakul, S., Baosoung, C. and Sansiriphun, N. Traditional beliefs about pregnancy and child birth among women from Chiang Mai, Northern Thailand. Midwifery, 12(2), 139-153, 2005.

Liamputtong, P., Yimyam, S, Parisunyakul, S., Baosoung, C. and Sansiriphun, N. When I become a mother!: Discourses of Motherhood among Thai women in Northern Thailand. Women's Studies International Forum, 27(5-6), 589-601, 2004.

Liamputtong, P., Yimyam, S, Parisunyakul, S., Baosoung, C. and Sansiriphun, N. Women as mothers: The case of Thai women from Northern Thailand. International Social Work, 45(4), 497-515, 2002.

Liamputtong, P. Childrearing and rituals in Northern Thailand. In Liamputtong, P. (ed.) Childrearing and infant care: A cross-cultural perspective. New York: Nova Science Publishers, forthcoming.

Liamputtong, P. Yu duan ritual: The significance of traditional postpartum beliefs and practices on women's health in northern Thailand. In Balin, R.E. (ed.) Trends in midwifery research, Nova Science Publishers, New York, 2005.

Liamputtong, P. Mae: Becoming a mother among women in northern Thailand. Submitted for publication, Cornell University Press, Ithaca.

 

Women's Knowledge and Attitudes about Prenatal Diagnostic Testing for Birth Defects [completed in 2003]

A research project conducted by Professor Pranee Liamputtong in collaboration with the Murdoch Institute, Royal Children's Hospital (Dr Jane Halliday), Department of Perinatal Medicine, Royal Women's Hospital (Dr Robin Bell) and the Mothers' and Child Health Research Centre, La Trobe University (Lyn Watson), received funding from VicHealth for 1997-1999.
 
Funding:
Funding of $130,000 from the Victorian Health Promotion Foundation Public Health for the study: women's knowledge and attitudes about prenatal testing for birth defects, with Jane Halliday, Robin Bell and Lyn Watson, 1997- 1998.

 

Research Summary

There are now over 5000 prenatal diagnostic tests done in Victoria each eyar, two thirds amniocentesis and one third chorion villus sampling. Most tests are done in women 37 years and over, because of concern over the possibility of having a baby with Down syndrome. Approximately 60% of women 37-39 years of age and 75% of women 40 years and older have one or other of these tests. However, there is a significant underrepresentation of tested women with specific backgrounds - non-English speaking (NESB), rural residence, and high parity (Halliday et al, 1995). This underrepresentation is either the result of lack of access to testing or the informed choice not to be tested. The prevalence of these determinants was unknown. Based on the results of previous population-based studies in Victoria, it was possible to focus the study on the underrepresented women and sample accordingly.

Objectives of the study were:

  • To identify and recruit a representative sample of pregnant women who were approximately 28 weeks pregnant;
  • To identify gateways and barriers to testing using a short questionnaire, which the women were able to copmlete in a hospital antenatal clinic setting; and
  • To identify whether there was a need to establish more prenatal diagnostic or genetic counselling services and perhaps consumer support or advice groups.

Participants were those who attended selected hospital antenatal clinics, specifically the clinic at which they were tested for glucose tolerance, in metropolitan and rural Victoria. Translated questionnaires were available to women of non-English speaking background.

Results of the study highlighted community health activities that would lead to appropriate uptake of of prenatal diagnostic services, as perceived by the women themselves, for avoidable disability.

Publications:

Liamputtong, P., Halliday, J., Warren, R. Watson, L. and Bell, R. Why do women decline prenatal screening and diagnosis?: Australian women's perspective. Women & Health,37(2), 89-108, 2003.

Halliday, J., McDonald, G., Warren, R., Liamputtong, P., Watson, L., and Bell, R. Prenatal diagnosis for women 37 years and over: To have or not to have. Prenatal Diagnosis, 21, 842-847, 2001.

 

Childbirth and the Health of Women from Southeast Asia (Cambodian, Lao, and Vietnamese Women) [completed in 2000]

A research project conducted by Professor Pranee Liamputtong in collaboration with the Mothers' and Child Health Research Centre, La Trobe University, received funding from the NHMRC and VicHealth for 1996-1999, with Lyn Watson.
 
Funding:
Funding from Public Health Research and Development Council and Victorian Health Promotion Foundation for the study ($250,000): childbearing, childrearing and reproductive health: cultural beliefs and practices and the impact of social change among Southeast Asian women in Australia, with Lyn Watson, 1996-1998.

 

Research Summary:
The number of migrants from Southeast Asia has increased since 1973. A high proportion of these are women, aged 20-35 years. Earlier research among Hmong and Thai women has indicated that their experience of childbearing depends heavily on culturally sensitive forms of childbirth practice. These are seldom available even in a large metropolitan hospital. Distress during childbirth and in the neonatal period places both women and infants at risk of physical and mental health problems, with clear implications for health policy. In this research the experience of Southeast Asian women will be used as a paradigm for developing services which are culturally sensitive to the needs of all migrant women, and in particular to devise inform policy for culturally sensitive birthing services for Southeast Asian women in Australia.
 
Objectives

This research had four main aims.

  • To compare obstetric characteristics and pregnancy outcomes among women who were born in Asia and gave birth in Victoria between 1982 and 1995. Analysis of existing perinatal database will allow: (a) comparison of Asia-born women's obstetric characteristics and pregnancy outcomes with those of Australia-born women; (b) the identification of possible explanatory factors; and (c) temporal changes occurring in the 14-year period.
  • To examine the experience and patterns of childbearing practices among Southeast Asian immigrants living in Australia. For each group of Southeast Asian women the following will be assessed: (a) traditional customs and rituals of childbirth, infant feeding, and caring for the newborn; traditional social organisation of childbearing and childrearing; and traditional health care provisions received antenatally and postnatally; (b) the experience in Australia of childbearing, childrearing and organisation of health care.
  • To analyse relationships between the experience of migration and the experience of childbearing. Earlier research suggests the following areas as likely to be important: (a) premigration use of prenatal care as determinant of women's use of such services in Australia; and how this might affect pregnancy outcome; (b) the influence of the absence of social network of Asian women in Australia on the postpartum and early mothering, including the establishment of breastfeeding; (c) the effect of period of residence on changes in childbearing and childrearing practices.
  • To account for any difference or similarity between the cultures studied on traditional and social organisation of childbearing and childrearing.
Methodology
Ethnographic research methodology was employed for the study of childbearing and childrearing practices among Southeast Asian women. Ninety-one women, 30 each from Lao and Cambodian and 31 from Vietnamese communities in Victoria were interviewed in their own homes and in their own languages, by three bi-cultural research assistants. Tapes recording the interviews were transcribed and translated. English transcripts were then analysed according to the ethnographic research procedures. For the comparison of obstetric characteristics of Asia-born women who gave birth in Victoria, quantitative methodology was applied for data collection and analysis.

 

Dissemination of Research Findings
The first dissemination of research findings was made on June 4th, 1999, and women who participated in the study and interested members as well as workers in the three communities were invited to meet at the Australian Vietnamese Women's Welfare Association, Richmond. Research findings on women's experiences of birth in Australia were presented to the meeting attended by the chief investigator, Professor Pranee Liamputtong. Leaflets summarising research findings in English as well as in Lao, Vietnamese and Cambodian languages were distributed. Leaflets in respective languages, were posted to the women who were unable to attend the meeting and also to community organisations that expressed interest in the findings of this research. On 17 April 2000, a presentation of research findings on Cambodian, Lao and Vietnamese women's health was made by the Chief Investigator, Professor Pranee Liamputtong, in a Cross-Cultural Information Session held at the Lao Australian Welfare Association, Forest Hill.
 
Publications:

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (1999) The perception and experiences of antenatal care among Lao, Vietnamese and Cambodian women in Australia, in P Liamputtoong Rice (ed), Asian Mothers, Western Birth, Melbourne, Ausmed Publications, pp. 215-36.

Liamputtong P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. Prenatal testing: The voice and concern of Lao, Vietnamese and Cambodian women in Australia. Paper submitted for publication to Midwifery 2002.

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (1999) Childbirth and Southeast Asian women - A resport. Melbourne: School of Public Health, La Trobe University.

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (1999) Childbirth and Southeast Asian women - Summary of findings. Melbourne: School of Public Health, La Trobe University.

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (1999) Childbirth and Southeast Asian women - Summary of findings (in Cambodian). Melbourne: School of Public Health, La Trobe University.

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (1999) Childbirth and Southeast Asian women - Summary of findings (in Lao). Melbourne: School of Public Health, La Trobe University.

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (1999) Childbirth and Southeast Asian women - Summary of findings (in Vietnamese). Melbourne: School of Public Health, La Trobe University.

Liamputtong Rice, P., Watson, L., Naksook, C., Doan, N., Dy, C., and Phaosihavoung, B. The perceptions and experiences of antenatal care among Southeast Asian mothers in Australia. In Liamputtong Rice, P. (ed.) Asian mothers, Western births. Melbourne, Ausmed Publications, 1999.

Liamputtong Rice P, Naksook C, Doan N, Dy C, and Phaosihavong B, Watson L. (2000) Motherhood, health and hope. Melbourne: School of Public Health, La Trobe University.

Liamputtong, P. Motherhood and "moral career": Discourses of good motherhood among Southeast Asian immigrant women in Australia. Qualitative Sociology, 29(1), 25-53, 2006.

Liamputtong, P., Watson, L. The meanings and experiences of cesarean birth amongst Cambodian, Lao and Vietnamese immigrant mothers in Australia. Women & Health, in press.

Liamputtong, P., and Watson, L. The voices and concerns about prenatal testing of Cambodian, Lao and Vietnamese women in Australia. Midwifery, 18(4), 304-313, 2002.

Liamputtong, P. and Watson, L. Motherhood and health: Lived experiences of Southeast Asian immigrant women in Australia. In Balin, R.E. (ed.) Trends in midwifery research, Nova Science Publishers, New York, 2005.


Experiences of Pregnancy, Birth and Early Mothering: Home Interview with Vietnamese, Turkish and Filipino Women [completed]

A research project conducted in collaboration with the Mothers' and Child Health Research Centre (Rhonda Small, Jane Yelland, and Professor Judith Lumley), received funding from the NHMRC and VicHealth for 1993-1997.
 
Funding:
Funding of $316,196.00 from: The Public Health Research and Development Council ($111,946.00); the Victorian Health Promotion Foundation Public Health ($198,250.00); and the Faculty of Health Sciences, La Trobe University ($6,000.00) for the study: Experiences of pregnancy, birth and early mothering: home interview with Vietnamese, Turkish and Filipino women. Professor Pranee Liamputtong, with Rhonda Small, Jane Yelland and Professsor Judith Lumley, 1993-1997.

 

Research Summary

The Ministerial Review of Birthing Services in Victoria documented several concerns from the consultation process with women of non-English speaking background: language and communication problems in negotiating the maternity care program; poor access to information; a lack of cultural sensitivity on the part of care provides, and a lack of support networks. A consumer survey at the same time found women of NESB to be more dissatisfied with thier antenatal care, less likely to have low rates of intervention in birth, more likely to be depressed 8-9 months after birth, and less likely to breast feed. As women of NESB had a relatively low response rate to the survey (50% compared with over 71% overall) the interpretation of some of these differences was uncertain. It is clear from studies elsewhere that postal serveys are an unsatisfactory way to seek the views of non-English speaking and migrant communities. Analysis of Victorian perinatal data 1985-1990 showed a significantly higher birthweight-standardised perinatal mortality ratio for normal weight infants of NESB mothers compared with the Australian-born population, which raises concerns that communication problems may contribute to a significantly worse perinatal outcome fo rthe infant as well as dissatisfaction with care by the mother.

 

The objectives of the study were:

  • To compare experiences of the maternity care system, satisfaction with care, events and procedures during birth, use of services and health after birth, and to make a standardised assessment of emotional wellbeing (Edinburgh Postnatal Depression Scale) in Turkish, Vietnamese and Filipina women 6-7 months after birth;
  • To provide feedback to hospitals and community services about the findings so as to increase the appropriateness and cultrual sensitivity of care;
  • To provide feedback to the three communities about specific needs;
  • To test the hypothesis about factors contributing to depression after birth in these very different groups so as to develop and test interventions in a subsequent project.
Publications:

Small, R., Yelland, J., Lumley, J., Brown, S., and Liamputtong, P. Immigrant women's views about care during labor and birth: An Australian study of Vietnamese, Turkish and Filipino women. Birth, 29(4), 266-277, 2002.

Small, R., Yelland, J., Lumley, J. and Liamputtong Rice, P. Cross-cultural research: Trying to do it better 1. Issues in study design. Australian and New Zealand Journal of Public Health, 23(4), 385-389, 1999.

Small, R., Yelland, J., Lumley, J., Liamputtong Rice, P., Cotronei, V., and Warren, R. Cross-cultural research: Trying to do it better 2. Enhancing data quality. Australian and New Zealand Journal of Public Health, 23(4), 390-395, 1999.

Small, R.; Liamputtong Rice, P.; Yelland, J. and Lumley, J. Mothers in a new country: The role of culture and communication in Vietnamese, Turkish and Filipino women's experiences of giving birth in Australia. Women & Health, 22(3), 77-101, 1999.

Small, R., Liamputtong Rice, P., Yelland, J., and Lumley, J. Mothers in a new home: How important are language and cultural issues in immigrant women's experiences of maternity care? In Rice, P.L (ed.) Living in a new country: Understanding migrant's health. Ausmed Publications, 1999.

Yelland, J.; Small, R.; Lumley, J. and Liamputtong Rice, P., Cotronei, V., and Warren, R. Support, sensitivity, satisfaction: Vietnamese, Turkish and Filipino women's experience of the postnatal stay. Midwifery, 14(3), 144- 154, 1998.

Small, R.; Yelland, J.; Lumley, J. and Liamputtong Rice, P. Is shared antenatal care really better for women of non-English speaking background?: The Mothers in a New Country (MINC) Study. Medical Journal of Australia, 168(1), 15-18, 1998.

Small, R., Lumley, J., Yelland, J. and Liamputtong Rice, P. MINC - Mother in a New Country: Vietnamese, Turkish and Filipino women's views of maternity care. Melbourne, Centre for the Study of Mothers' and Children's Health, 1997.

 

 

 

 

 

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Page maintained by: Personal Assistant to Head of School
Last Updated: 4 November, 2007

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