Unintended pregnancies have far-reaching consequences, including adverse emotional, education, social, and medical outcomes. Culturally and linguistically diverse (CALD) women, who have either migrated to Australia or have parents born overseas, face a higher risk of unintended pregnancies. Research indicates that CALD women tend to utilize less effective contraceptive methods compared to their Australian-born counterparts. To address this issue, tailored online contraception education is proposed as a promising approach to increase uptake of long-acting reversible contraceptives (LARC) and reduce unintended pregnancies among CALD women.
Background
Women who experience unintended pregnancies are at an increased risk of postnatal depression, encounter challenges in educational attainment, and struggle with re-entering the workforce. CALD women have been found to use less effective contraceptive methods compared to Australian-born women. Long-acting reversible contraceptives (LARC), such as subdermal hormonal implants and intrauterine devices, have been identified as highly effective contraceptives.
Increasing the use of LARC among CALD women can significantly reduce the rate of unintended pregnancies. Previous research has shown that online educational videos on LARC have successfully increased its preference and use among younger women. However, it remains unclear whether a similar approach would be effective for CALD women. Additionally, cultural adaptations are necessary to tailor online educational materials to the specific needs of CALD women in the Australian context.
The recent study published in the Health Promotion Journal of Australia aimed to identify the components of an online educational intervention that would enhance LARC preference and use among CALD women. Female, English-speaking participants between 18 and 44 years of age from Indian, Chinese, and Middle Eastern cultural backgrounds were included in the study.
Semi-structured telephone interviews were conducted to gather qualitative data on personal and systemic enablers and barriers to improving online interventions. Participants were recruited through targeted advertisements on Facebook, focusing on demographic groups such as the Lebanese community in Melbourne, Chinese in Melbourne, and Indians in Melbourne. Thematic analysis was employed to analyze the interview data and identify insightful answers to the research question.
Study Findings
Twenty-nine women, including twelve Indian, nine Chinese, and eight Middle Eastern women, completed the survey. In-depth interviews were conducted with representatives from each cultural group. The participants highlighted several issues and provided valuable suggestions to improve online educational videos, ultimately enhancing LARC use among CALD women. Key areas for improvement identified by the participants included addressing knowledge gaps and misconceptions regarding LARC use, widening LARC availability, and involving partners in reproductive decision-making.
The study confirmed previous findings that CALD women face significant stigma related to contraception and premarital intercourse. The covert nature of LARC was viewed as empowering for women, as it reduces exposure to social disapproval. Participants emphasized the importance of information regarding the cost and availability of LARC, particularly for international students and young CALD women who may not be eligible for contraception subsidies provided by the Pharmaceutical Benefits Scheme.
Cultural myths and beliefs were identified as barriers to LARC use. For example, Chinese women exhibited an aversion to hormone-based contraception, requiring education about the safety of hormonal methods and alternative non-hormonal LARC options such as the copper IUD. Indian cultural beliefs regarding menstruation were highlighted, indicating the need to include information about the menstrual cycle and basic reproductive health.
Some Middle Eastern women expressed a strong aversion towards abortion, necessitating clarification about the mechanism of action of LARC and dispelling the myth that LARC is associated with abortion. The study also emphasized the importance of featuring a female doctor in the video content to address cultural sensitivity.
The study findings underscore the importance of tailoring online contraception education for culturally diverse women to address their specific needs and challenges. To effectively promote LARC preference and use among CALD women, the following key considerations emerged from the study:
Highlighting the Covert Nature of LARC: Emphasize the discreet nature of LARC methods, which can empower CALD women by reducing social disapproval and stigma associated with contraception.
Information on Cost and Accessibility: Provide clear information about the cost and accessibility of LARC options, particularly for CALD women who may not be eligible for government-subsidized contraception. This would be especially beneficial for international students and young women from CALD backgrounds.
Addressing Cultural Myths: Challenge cultural myths and beliefs surrounding contraception with scientific evidence. For example, educate Chinese women about the safety of hormone-based contraception and offer information on non-hormonal LARC alternatives like the copper IUD. Address Indian cultural beliefs regarding menstruation by providing information about the menstrual cycle and basic reproductive health.
Clarifying Misconceptions: Address misconceptions regarding LARC and its association with abortion, particularly among Middle Eastern women. Provide a clear explanation of the mechanism of action of LARC to alleviate concerns and promote understanding.
Involving Partners in Reproductive Decision-Making: Emphasize the importance of involving male partners in discussions about contraception and reproductive decision-making. Highlighting the benefits of shared responsibility and mutual understanding can lead to increased LARC uptake.
Female Doctor Representation: Consider delivering video content featuring a female doctor to address cultural sensitivity and enhance engagement among CALD women. This representation can help build trust and credibility, contributing to a more effective educational intervention.
To effectively reach CALD women with online contraception education, it is crucial to utilize social media platforms and government websites as channels for dissemination. These platforms can provide broad access to information and reach specific demographic groups effectively.
In conclusion, tailoring online contraception education for culturally diverse women is vital to improve uptake of LARC and reduce unintended pregnancies. By addressing knowledge gaps, dispelling myths, and considering cultural beliefs, the educational content can effectively empower CALD women to make informed reproductive choices.
Promoting online education through accessible platforms and involving male partners can further enhance the impact of these interventions. With targeted efforts, we can strive to reduce unintended pregnancies and improve the overall reproductive health and well-being of culturally diverse women.
The findings from this study emphasize the importance of culturally sensitive and tailored online contraception education for CALD women. By addressing the specific needs, knowledge gaps, and misconceptions within each cultural group, we can effectively enhance LARC preference and use, ultimately reducing the rate of unintended pregnancies.
The study highlights the significance of dispelling cultural myths and providing scientific evidence to challenge misconceptions. By educating CALD women about the safety and efficacy of LARC methods, particularly addressing concerns related to hormonal contraception, we can increase their confidence in choosing the most suitable contraceptive option for themselves.
Furthermore, recognizing and addressing the cultural significance of reproductive health topics is essential. By incorporating information about the menstrual cycle, basic reproductive health, and the diverse cultural beliefs surrounding contraception, we can ensure that CALD women feel seen, heard, and empowered to make informed decisions about their reproductive health.