Wellbeing in the First 1000 Days for Syrian and Afghan refugee women living in Australia: a qualitative study

The First 1000 Days (from conception to a child's second birthday) is a key developmental period, with implications for the child across the lifespan. However, while an emerging body of research demonstrates the impact of maternal wellbeing on child wellbeing and development, to date, little research has focused on the wellbeing of women with refugee backgrounds during the First 1000 Days. The present qualitative study aimed to explore the experiences and impacts to wellbeing for women from Syria and Afghanistan living in South Australia in the First 1000 Days.

A total of 43 participants were included in the study. Fourteen Syrian women, 14 Afghan women, and 15 healthcare providers participated in group and individual semi-structured interviews, recruited through community and service networks and snowball sampling. Data were analysed using reflexive thematic analysis.

Four themes were identified: 'Autonomy and decision-making' which included decision making around family planning and choosing care; 'Accessing care' including knowing what care was available and the need for culturally responsive care; 'Navigating relationships and accessing family supports in a new environment' which included shifts in marital relationships and engaging with broader social support; and 'Parenting in a new country' which included cultural differences in parenting and maintaining wellbeing while parenting.

Together, these themes identified significant challenges to new mothers in navigating the First 1000 Days and accessing appropriate formal and informal supports over this time of significant change, with impacts on wellbeing. The findings demonstrate the need for relevant and responsive, holistic perinatal and early childhood services that meet the biological, psychological, and social needs of this group of women. Specifically, services should ensure women maintain autonomy in decision-making, are informed of their options and referred to relevant services, and that their unique cultural and resettlement contexts are understood.