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Women from a refugee background are at increased risk of poor maternal and perinatal outcomes.

They are more likely to have a baby that is stillborn or that dies soon after birth compared with Australian-born women (Gibson‐Helm et al. 2015; Davies-Tuck et al. 2017; Heslehurst et al. 2018).

The Clinical Practice Guidelines: Pregnancy Care identifies antenatal groups as having the potential to meet the needs of populations vulnerable to poor outcomes, including women of refugee background (Department of Health 2018).

Healthy Happy Beginnings was named by and co-designed with Karen community members (women and men predominantly from refugee camps on the Thai/Burma border) and healthcare providers and refugee settlement services. The Karen community said they wanted to:

  • access pregnancy care close to home (due to transport barriers);
  • access professional interpreters;
  • meet other people from the community also having a baby;
  • learn about what to do to have a healthy pregnancy; and
  • find out what to expect from labour and childbirth in a hospital setting.

A local partnership group was established to enable collaboration between Werribee Mercy Hospital, Wyndham City Council maternal and child health service, VicSEG New Futures and the Karen community.

Using the feedback provided by the Karen community, the group developed an innovative model of community-based antenatal and postnatal care located in Werribee, an outer suburb of Melbourne. The Murdoch Children’s Research Institute provides facilitation support and is coordinating an evaluation.

Healthy Happy Beginnings provides culturally appropriate clinical and preventive healthcare, information and support in the women’s own language during pregnancy in a group setting, with follow-up after birth.

Reflections from staff:

“ … we have noticed that word of mouth travels fast, with the woman attending the group only days after arriving in this country. This supports the idea that our program provides pregnant women of Burma with a safe place to access their maternity care…

 It is our goal to ensure these women feel as safe as possible and empower them to have a voice. As the saying goes, ‘it takes a village to raise a child’. HHB has created a village that provides a pathway to genuine improvements in maternity care for refugee women” (Midwife).

“When a refugee comes to Australia she soon learns that her pregnancy experience will be quite different. She does not have the benefit of family and community living close to her for support…She feels isolated and alone, and she is confused by all the things she is expected to do. The Healthy Happy Beginnings program has been designed to improve these problems by running fortnightly groups to focus on physical, social and emotional issues of refugee mothers and their young children” (Bicultural Refugee Family Resource Mentor).

In an evaluation, Karen women reported that the program made them feel confident and reassured about their pregnancy, labour and birth and going home with a new baby (Riggs et al. 2017).

Further information can be found on the website:

For more information please contact: Dr Elisha Riggs, Senior Research Fellow, Intergenerational Health, Murdoch Children’s Research Institute and Senior Fellow, Department of General Practice, The University of Melbourne Murdoch Children’s Research Institute, Victoria.



Davies-Tuck, M.L., Davey M.A., and Wallace, E.M. 2017. Maternal region of birth and stillbirth in Victoria, Australia 2000-2011: A retrospective cohort study of Victorian perinatal data. PLoS One 12(6): e0178727.

Department of Health. 2018. Clinical Practice Guidelines: Pregnancy Care. Canberra, Australia, Australian Government Department of Health.

Gibson Helm, M.E., Teede, H.J., Cheng, I.H., Block, A.A., Knight, M., East, C.E., Wallace, E.M., and Boyle, J.A. 2015. Maternal health and pregnancy outcomes comparing migrant women born in humanitarian and nonhumanitarian source countries: A retrospective, observational study. Birth 42(2): 116-124.

Heslehurst, N., Brown, H., Pemu, A., Coleman, H. and Rankin, J. 2018. Perinatal health outcomes and care among asylum seekers and refugees: A systematic review of systematic reviews. BMC Med 16(1): 89.

Riggs, E., Muyeen, S., Brown, S., Dawson, W., Petschel, P., Tardiff, W., Norman, F., Vanpraag, D., Szwarc, J. and Yelland, J. 2017. Cultural safety and belonging for refugee background women attending group pregnancy care: An Australian qualitative study. Birth 44(4): 145-152.