Reaching the Right Care: Migrant Women’s Experiences of Perinatal Mental Health Support in Australia

Reaching the Right Care: Migrant Women’s Experiences of Perinatal Mental Health Support in Australia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Reaching the Right Care: Migrant Women’s Experiences of Perinatal Mental Health Support in Australia Areni Altun, Andrea Reupert, Melissa Oxlad, Rochelle Hine, Levita D’Souza, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8536985/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background: Migrant women experience disproportionately high rates of perinatal mental health difficulties, shaped by intersecting cultural, social, and systemic barriers. Despite the increasing role of digital technologies in healthcare delivery, their potential to support equitable perinatal mental health care remains underexplored and often fail to reflect the complex realities of migrant women’s lives. This study examined how migrant women in Australia navigate perinatal mental health care across clinical, community, and digital settings, and how digital tools interact with cultural, social, and structural factors to influence help-seeking and engagement. Methods: Qualitative data were collected through online focus groups and individual interviews with women from Chinese-, Arabic-, and Indian-language speaking backgrounds who had given birth in Australia. A semi-structured, culturally adapted interview guide explored women’s experiences of mental health support, barriers and facilitators to access, cultural beliefs, and the role of digital tools in finding/interpreting information. Interviews were conducted with interpreter support and analysed using reflexive thematic analysis to identify patterns across women’s narratives. Results: Three overarching themes, each with related subthemes, were developed: (1) Accessing Perinatal Care captured fragmented systems and difficulties navigating services that felt culturally unresponsive; (2) Cultural and Socio-Emotional Context of Mental Health reflected how stigma, traditional beliefs, and disrupted family networks shaped women’s emotional wellbeing, help-seeking, and comfort disclosing distress; and (3) Support Seeking illustrated how women turned to digital platforms for connection, and guidance but were constrained by language barriers, and varying levels of digital literacy and access. Conclusions: Migrant women navigate fragmented perinatal mental health pathways shaped by cultural, social, and structural barriers. Digital tools can support help-seeking, but only when designed to address cultural relevance, language needs, and digital inequities. Equity-focused, co-designed approaches are essential to ensure digital solutions genuinely enhance perinatal mental health care for migrant women. Perinatal health Mental health Migrant women Digital equity Health equity Text Box 1. Contributions to the literature Provides novel population-level insight into how migrant women in Australia experience and navigate perinatal mental health across healthcare, family, community and digital settings. Demonstrates how fragmented services, limited cultural responsiveness, and stigma interact to delay help-seeking. Highlights the central role of social support, including family networks, peer communities, and digital platforms, in supporting perinatal mental wellbeing among migrant women. Extends evidence by showing how migration-related disruptions shape mental health needs during pregnancy and postpartum. Informs policy and service design by highlighting the importance of perinatal mental health support that brings together clinical care, social and emotional wellbeing, and digital resources. Background Over the past five decades, global migration has increased steadily, with international migrants now comprising over 3.6% of the world’s population [ 1 ]. Today, more women than ever are living in countries different from where they were born, navigating maternity and health systems far removed from their cultural context and usual support networks. Migrant women often face unique challenges in the perinatal period (pregnancy, birth, and the first year postpartum), including systemic barriers, cultural dislocation, and unfamiliar care structures that are difficult to navigate [ 2 , 3 ]. These, along with other socioeconomic factors, contribute to persistent disparities in perinatal health outcomes for women from migrant communities [ 4 – 6 ]. This study will explore how migrant women navigate transition to parenthood during the perinatal period with particular attention to the role of digital health in shaping their pathways to support. By examining how women engage with, interpret, and experience digital tools within broader social and structural contexts, the study aims to understand both the opportunities and limitations of digital health as a means of reaching more equitable perinatal care. Globally, perinatal mental health conditions affect up to 20% of women [ 7 , 8 ]. However, women from refugee and migrant backgrounds face an even higher risk of perinatal mental health conditions, up to 40%, due to stressors experienced before, during, and after migration [ 7 , 9 ]. These stressors include the challenges of resettlement, adapting to new health systems, building social networks, and balancing competing settlement priorities, which often take precedence over women’s health [ 10 , 11 ]. Migrant women also experience barriers in navigating perinatal care, including language and health literacy challenges, difficulties navigating complex and unclear health system pathways, financial constraints, cultural beliefs that may conflict with mainstream practices, limited access to culturally responsive care, and increasing challenges associated with digital literacy and navigating online health platforms [ 12 – 15 ]. Navigating care in the perinatal context for refugee and migrant women involves a complex interplay between formal healthcare services (e.g., General Practitioners (GPs), hospitals, child and family health services) and informal or community-based support systems [ 16 ]. Increasingly, women also engage with digital health (the use of digital tools), including telehealth, web-based platforms, and mobile applications, to improve health outcomes [ 17 ]. Digital technologies, such as telehealth, health information websites, and social media, have become increasingly important, offering information, connection, and access to services outside current settings [ 18 ]. However, health and digital literacy, access to devices and internet connectivity, language accessibility, trust in services, and cultural relevance influence the uptake of digital technologies [ 19 ]. Digital technologies have become integral to modern healthcare, providing accessible solutions for the prevention, diagnosis, treatment, and ongoing self-management of health conditions [ 3 , 19 , 20 ]. These tools potentially empower individuals to actively engage in their healthcare, offering convenient access to medical consultations, personalised health information, and self-monitoring resources that can enhance health outcomes and improve overall health experiences [ 21 ]. Digital resources can also help to establish a comprehensive network of community connections, particularly for individuals living outside urban centres and/or facing systematic marginalisation [ 22 , 23 ]. The global burden of mental health conditions, including perinatal depression, highlights the urgent need for accessible and scalable management and support options [ 24 ]. While both psychotherapy and pharmacotherapy have been shown to be effective interventions for depression [ 25 ], many people face significant barriers to accessing in-person clinical services [ 26 ]. These barriers include a shortage of trained mental health professionals, lengthy waitlists, the stigma associated with help seeking and the high cost of care [ 26 , 27 ]. While digital technologies offer an increasingly practical solution for migrant mothers during the perinatal period, significant barriers can limit their use and sustained engagement [ 20 , 23 ]. Past negative experiences with healthcare systems may further discourage help-seeking, alongside concerns around privacy, security, and the reliability of unregulated online resources [ 14 , 15 ]. Financial constraints, such as a lack of access to personal devices, unstable internet connectivity, or a lack of private spaces to engage with digital technologies, also remain key challenges [ 14 , 15 ]. While these barriers limit the effectiveness of digital resources, addressing issues such as accessibility, cultural relevance, and trust could enable these tools to become a valuable resource for mothers during the perinatal period, a time when support and care are especially critical [ 28 ] and may have lifelong implications for infants and families. Recent Australian studies have underscored the complex interplay between culture, service design, and social support in shaping migrant women’s perinatal experiences [ 3 ]. Evidence highlights the benefits of culturally responsive models of care, yet systemic barriers, such as language and cost, limited eligibility, and lack of culturally appropriate resources, continue to constrain equitable access and engagement [ 3 , 29 ]. These studies also reveal that social isolation and disrupted support networks further amplify migrant women’s vulnerability, with many turning to digital and virtual forms of connection to bridge these gaps [ 29 – 31 ]. Consequently, there is an ongoing need for models of care that extend beyond traditional health settings and respond to the dynamic ways migrant women seek and experience support. However, while existing research has illuminated the importance of service accessibility and social support, less is known about how migrant women actively navigate, interpret, and engage with perinatal mental health care across clinical, community, and digital settings, and how digital resources intersect with these broader care journeys. The intersection of digital health, cultural identity, and structural inequities remains underexplored, particularly in understanding how women make sense of and utilise digital tools to support their perinatal wellbeing within the broader healthcare landscape. In Australia, migrant women’s pathways to perinatal care are shaped not only by the structure of the healthcare system but also by global geopolitical factors, broad settlement experiences and community networks. This current study explores how migrant women who have given birth in Australia navigate perinatal mental health care across clinical, community, and digital settings. We examine the strategies women use, the barriers they face, and the potential role of digital resources alongside other forms of support. Understanding these pathways is essential for co-designing culturally responsive, accessible, and integrated models of perinatal care that address the unique needs of migrant women in Australia. Method Study Design This study, reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines [ 32 ], employed a qualitative research design using semi-structured interviews and reflexive thematic analysis to explore migrant women’s experiences with digital resources for perinatal mental health support [ 33 ]. The study methodology was co-designed in collaboration with a Community and Consumer Involvement (CCI) Advisory Group to ensure cultural and linguistic appropriateness. The CCI Advisory Group included one woman from each of the three cultural groups in focus—Chinese-, Arabic-, and Indian-language speaking backgrounds. We use the terms 'Chinese-', ‘Arabic-’, and ‘Indian-language speaking backgrounds’ to broadly refer to the range of languages commonly spoken in China, Arabic-speaking countries, and India, while acknowledging the significant linguistic diversity that exists within each of these groups. We selected these groups due to their demographic significance and documented health inequities. India is currently the leading country of birth for migrants to Australia, while Mandarin and Arabic are the most commonly spoken languages at home after English [ 34 ]. Women from these communities have also been shown to experience notable disparities in perinatal mental health outcomes and service access [ 35 – 39 ]. We recruited Advisory Group members through partnerships with multicultural health organisations, community networks, and maternal health services to ensure diverse representation across migration pathways (e.g., recent migrants, refugees), parity, English proficiency, and digital literacy levels. The Advisory Group were central in shaping the study design, refining culturally sensitive interview guides, and advising on inclusive recruitment strategies. Advisory Group members attended research meetings and were reimbursed for their time and expertise in line with national consumer participation guidelines [ 40 ]. The Monash University Human Research Ethics Committee provided ethical approval in June 2024 (Project ID 43519). Participants and Recruitment Through a process of discussion and voting and in line with the most commonly spoken language, the research team and the Advisory Group identified three priority populations: women of Chinese, Arabic, and Indian-language speaking backgrounds. Eligibility criteria included being a woman aged 18 years or older, residing in Melbourne, who had migrated to Australia via skilled, family, or humanitarian visa pathways, and who had given birth in the past five years and self-reported a history of perinatal mental health challenges. Participants were required to be conversant in Arabic, Mandarin, Hindi (or another Indian language), and/or English, and willing to engage with a professional interpreter if needed. Women who required language support could choose to participate in individual interviews or language-specific focus groups, conducted in Arabic, Mandarin, or an Indian language such as Hindi. Professional interpreters were arranged through a certified health translation service accredited by the National Accreditation Authority for Translators and Interpreters (NAATI), and joined via secure video conferencing. In each case, only one interpreter per group or interview was used to maintain consistency and confidentiality. Interpreters supported communication by facilitating introductions, translating participants' responses, clarifying questions or culturally specific terms, and assisting with written consent processes when necessary. The Advisory Group supported recruitment by reviewing and advising on the cultural appropriateness and clarity of recruitment materials (e.g., flyers, emails, social media posts), recommending trusted community organisations and platforms for dissemination, and advertising within their own networks. Several members facilitated introductions to community leaders and helped organise language-specific focus groups to ensure safe and culturally responsive environments. We employed a purposive sampling strategy to recruit 10 women from each cultural group, aiming to achieve diversity in age, length of time in Australia, visa pathways, English proficiency, and recency of childbirth. During recruitment, participants were asked whether they had ever experienced emotional or mental health challenges during pregnancy or in the year following childbirth. To ensure that participation did not place additional burden on women currently experiencing distress, potential participants were also asked whether they were presently receiving support or felt comfortable discussing their experiences. Women who disclosed current high levels of distress were provided with information on relevant support services and were not invited to take part until they felt ready to do so. We also employed passive snowball sampling to reach women within each community, including those less familiar with health or digital services. Recruitment materials, available in Arabic, Mandarin, Hindi, and English, were distributed through Advisory members, trusted community organisations, and at multicultural community events. Interested women could contact the designated researcher (AA) directly or give permission to Advisory Group members to be contacted by AA via telephone or email. All participants received a plain language statement and provided written informed consent prior to participation. Women were informed that participation was voluntary and they could choose not to answer any question or stop the interview at any time. Each participant received a $ 30 AUD grocery voucher for their time. During interviews and focus groups, participants were invited to reflect on their awareness of, and engagement with, perinatal mental health care in Australia, including whether, how, and where they sought information or support online, if at all. Discussions explored women’s experiences navigating care across different settings, including but not limited to digital platforms (e.g., online searches, apps, social media) and community-based sources of information. Collectively, these narratives provided insight into how migrant women perceive support, and how cultural norms, language accessibility, and systemic structures shape these pathways. Data Collection We use the term migrant background to refer to women who were born overseas or who speak a language other than English at home. Informed by our consumer involvement approach, we did not collect refugee status, as this information can be sensitive, potentially retraumatising, and may have introduced legal or ethical complications beyond the scope of this study We used a combination of semi-structured individual interviews and focus groups. To ensure inclusive engagement, participants could choose their preferred format based on comfort, availability, and communication preferences. Using both formats enabled us to respect participants’ choice while also enriching the data by capturing both individual and group perspectives. To ensure cultural and contextual relevance, the interview guide (see Supplementary Material) was informed by previous research on migrant women’s perinatal mental health, healthcare navigation, and digital health equity, and refined in consultation with clinical researchers and the Advisory Group. Throughout data collection, we adapted the guide iteratively to support conversational flow and cultural appropriateness. Interviews and focus groups explored women’s experiences seeking and accessing perinatal mental health support in Australia, with a particular focus on their engagement with digital resources, community-based services, and healthcare providers. Participants were asked how they locate, evaluate, and use online information, the barriers and enablers influencing help-seeking, and the types of support they find most useful before, during, and after pregnancy. Questions also examined how cultural beliefs, language, trust, and digital access shape women’s engagement with perinatal mental health care. For example, participants were asked: “What do you think can best help migrant women with their mental wellbeing before, during and after pregnancy?” and “Do you think there are any cultural beliefs that influence how women access online information or services?” Women were encouraged to share examples from their own or peers’ experiences, reflecting on both positive and challenging encounters to capture diverse perspectives across communities. Data collection occurred between June and October 2024. Thirty women participated, across eight focus groups and three individual interviews. Focus group sizes ranged from two to four participants. The mean duration was 70 minutes for focus groups (range: 60–90 minutes) and 55 minutes for individual interviews (range: 45–65 minutes). All sessions were conducted online via teleconference (Zoom) and facilitated by a trained qualitative researcher (AA). Where required, NAATI-accredited interpreters fluent in Arabic and Mandarin supported communication. Interpreters were briefed prior to each session and worked alongside the interviewer to ensure linguistic accuracy and cultural appropriateness (see Table 1 ). Translation was conducted in real time, with both the interviewer and interpreter actively engaged throughout the discussion. Table 1 Summary of participant engagement by language group and interview format Cultural-Linguistic Group Interview Type Interpreter Used Arabic-speaking Focus Groups A (n = 2) ✓ Focus Groups B (n = 4) X Focus Groups C (n = 4) ✓ Chinese-speaking Individual Interview X Individual Interview X Focus Groups A (n = 4) X Focus Groups B (n = 4) ✓ Hindi/Indian-speaking Individual Interview X Focus Groups A (n = 3) X Focus Groups B (n = 3) X Focus Groups C (n = 3) X All interviews and focus groups were audio-recorded and transcribed verbatim into English. For non-English sessions, transcripts were based on the real-time English interpretation provided by the interpreter during interviews or focus groups, which was audio-recorded and then transcribed verbatim. Literal translations were prioritised where possible, and we reviewed culturally significant terminology in consultation with the Advisory Group to ensure accurate interpretation of meaning [ 25 ]. For non-English sessions, transcripts were based on the real-time English interpretation provided by the interpreter during interviews or focus groups, which was audio-recorded and then transcribed verbatim. Credibility of the translation process was enhanced through researcher debriefing, detailed field notes, and peer review among the multilingual research team. We adopted the principle of meaning saturation [ 41 ], whereby data collection continued until sufficient depth and diversity of perspectives were obtained to support meaningful interpretation, in line with our purposive sample of 30 women across three cultural-linguistic groups. Data Analysis All transcripts were imported into NVivo version 14 to assist data management and facilitate the coding process. Data were analysed using reflexive thematic analysis [ 41 ], following an inductive and iterative approach to ensure interpretations remained grounded in participants’ accounts. AA independently completed initial reading, data familiarisation and open coding of the transcripts. Codes were subsequently organised into themes, each representing a coherent and recurring pattern of meaning. To support thematic development and contextualise findings, field notes and memos were also closely read. Throughout the analysis, attention was given to identifying potential variations in experiences across the three cultural groups, as well as by participants’ age, time in Australia, and language proficiency. While the overarching themes were broadly consistent, nuanced differences were noted in the way participants described cultural expectations, help-seeking preferences, and comfort with digital technologies and these are noted in the results. Themes were iteratively revised in consultation with the wider research team and Advisory Group members, ensuring that the final interpretations accurately reflected participants’ experiences and culturally specific perspectives. To enhance analytical rigour, a double-coding process was used in which two researchers independently coded the same transcripts. While this approach can risk reducing interpretive richness or oversimplifying meaning, it supports transparency and consistency [ 27 ]. Discrepancies were discussed collaboratively and by returning to the transcripts, allowing for deep reflection and shared understanding before reaching consensus. Reflexivity The intersecting identities and relationships between participants and researchers played a meaningful role in shaping this project [ 28 ]. Members of the research team brought relevant clinical, academic, and lived experience expertise in migrant health, perinatal mental health, and qualitative research. AA, a research fellow and clinical osteopath; JB, an academic gynaecologist and obstetrician; and RH, a social worker with extensive experience in women’s health and rural and mental health care, contributed diverse clinical and academic perspectives. The broader research team included researchers from disciplines such as public health, psychology, digital health, and implementation science, who contributed to study conceptualisation, design, and interpretation. These included AR, LD, MO, and MK. While not directly involved in data collection, these team members played critical roles in shaping the study’s aims, providing analytical feedback, and ensuring alignment with health equity and culturally inclusive research principles. Importantly, the Advisory Group (MK, SS and LM) comprised women with lived experience of perinatal mental health challenges and migration. Regular reflexive team meetings were held to surface and discuss positionalities, potential biases, and interpretive influences. These discussions informed analytic decisions and ensured that the analysis remained grounded in participants’ experiences rather than researchers’ expectations. AA, who led both data collection and analysis, brought important contextual insight to the study. As a woman born to migrant parents, AA shared cultural touchpoints with many participants. This shared background facilitated rapport-building and created a culturally safe (enough) environment, enabling participants to comfortably discuss sensitive topics including trauma, mental health challenges and their experiences with digital resources during the perinatal period. While this closeness enhanced depth and richness in the data, it also required ongoing critical reflection to balance empathy and analytic distance. These relational dynamics contributed to an understanding of participants' lived experiences while reinforcing the importance of reflexivity and methodological rigour throughout the study. We acknowledge that no migration studies specialist was part of the team, which may have foregrounded a culturalist lens; this was mitigated through engagement with relevant migration studies literature [ 2 ] and iterative reflexive discussions to situate participants’ experiences within broader social and structural contexts. Findings Participant Characteristics A total of 30 women participated in the study, with equal representation across the three language groups (10 participants per group). Most participants lived in metropolitan areas within Victoria, with a smaller subset residing in rural regions (n = 7). Ages ranged from 25 to 55 years, with the largest group falling within the 25–34 (n = 14) and 35–44 (n = 13) age brackets. Participants had lived in Australia for varying durations, from as short as six months to over 29 years. Educational backgrounds ranged from early high school qualifications to university degrees, with many having tertiary-level qualifications (n = 26). Most participants were married or in a relationship (n = 27), with family sizes ranging from one to four or more children. Additional demographic characteristics of the study participants are outlined in Table 2. Table 2: Demographic characteristics Chinese-language speaking Participant Age Country of birth Speaks English Years lived in Australia State Metropolitan city or Rural regions Education Relationship status Number of children P1 35 – 44 China Yes 8 VIC Metropolitan city Postgraduate degree Married or in a relationship 2 – 3 P2 25 – 34 China Yes 6 VIC Metropolitan city Postgraduate degree Married or in a relationship 2 – 3 P3 35 – 44 China Yes 16 VIC Metropolitan city Bachelor’s degree Married or in a relationship 1 – 2 P4 25 – 34 China Yes 10 VIC Metropolitan city Bachelor’s degree Married or in a relationship 1 P5 35 – 44 China Yes 22 VIC Metropolitan city Postgraduate degree Married or in a relationship 2 – 3 P6 25 – 34 China Yes 11 VIC Metropolitan city Postgraduate degree Married or in a relationship 2 – 3 P7 25 – 34 China No 10 VIC Metropolitan city Postgraduate degree Married or in a relationship 1 P8 25 – 34 China No 15 VIC Metropolitan city TAFE/vocational degree Separated or divorced 2 – 3 P9 35 – 44 China No 16 VIC Metropolitan city Bachelor’s degree Married or in a relationship 2 – 3 P10 35 – 44 China No 19 VIC Rural region Postgraduate degree Separated or divorced 1 Indian-language speaking Participant Age Country of birth Speaks English Years lived in Australia State Metropolitan city or Rural regions Education Relationship status Number of children P1 25 – 34 India Yes 10 VIC Metropolitan city Postgraduate degree Married or in a relationship 1 P2 35 – 44 India Yes 10 VIC Rural region Postgraduate degree Married or in a relationship 1 P3 35 – 44 India Yes 7 VIC Metropolitan city Bachelor’s degree Married or in a relationship 2 – 3 P4 45 – 55 India Yes 7 SA Metropolitan city Postgraduate degree Separated or divorced 1 P5 25 – 34 India Yes 8 VIC Rural region Postgraduate degree Married or in a relationship 1 P6 25 – 34 India Yes 5 VIC Metropolitan city Postgraduate degree Married or in a relationship 1 P7 25 – 34 India Yes 5 VIC Metropolitan city Bachelor’s degree Married or in a relationship 1 P8 25 – 34 India Yes 7 VIC Metropolitan city TAFE/vocational degree Married or in a relationship 2 – 3 P9 45 – 55 India Yes 15 VIC Metropolitan city Postgraduate degree Married or in a relationship 2 – 3 P10 35 – 44 Bahrain Yes 11 VIC Metropolitan city Bachelor’s degree Married or in a relationship 1 Arabic-language speaking Participant Age Country of birth Speaks English Years lived in Australia State Metropolitan city or Rural regions Education Relationship status Number of children P1 25 – 34 Palestine No 7.5 months VIC Rural regions Bachelor’s degree Married or in a relationship 2 – 3 P2 25 – 34 Palestine No 6 months VIC Rural regions Bachelor’s degree Married or in a relationship 1 P3 35 – 34 Palestine No 9 months VIC Rural regions Bachelor’s degree Married or in a relationship 2 – 3 P4 25 – 34 Palestine No 8 months VIC Rural regions Bachelor’s degree Married or in a relationship 1 P5 25 – 34 Palestine No 4 months VIC Metropolitan city Bachelor’s degree Married or in a relationship 2 – 3 P6 35 – 44 Netherlands Yes 17 years VIC Metropolitan city Postgraduate degree Married or in a relationship 1 P7 35 – 44 Iraq No 9 years VIC Metropolitan city Year 12 Married or in a relationship 1 P8 35 – 44 Iraq No 29 years VIC Metropolitan city Year 12 Married or in a relationship 4 or more P9 35 – 44 Iraq No 13 years VIC Metropolitan city Grade 11 or less Married or in a relationship 2 – 3 P10 45 – 55 Iraq No 29 years VIC Metropolitan city Grade 11 or less Married or in a relationship 4 or more Themes Three overarching themes, and related subthemes captured migrant women’s experiences of perinatal mental health care in Australia (Table 3 ). Theme 1 Accessing Perinatal Care described women’s experiences with fragmented services, limited attention to maternal mental health within routine care, and their preferred ways of engaging with services and support networks. Theme 2 Cultural and Socio-Emotional Context of Mental Health reflected how stigma, cultural expectations, and disrupted support networks shaped wellbeing and help-seeking. Theme 3 Support Seeking illustrated how women turned to digital platforms to navigate information, connect with peers, and rebuild community in the absence of familial supports. Table 3 Summary of themes and sub-themes Theme Sub-theme 1. Accessing perinatal care System gaps and fragmented care Lack of prioritisation for maternal mental health Preferred methods of connection 2. Cultural and Socio-Emotional Context of Mental Health Stigma and mental health disclosure Negotiating different cultural practices Cultural Inclusivity in healthcare Motherhood without a village 3. Support Seeking Navigating digital health information Digital networks as spaces of care and connection Theme 1: Accessing Perinatal Care This theme captures how women encountered a fragmented and often confusing perinatal care system, highlighting three interconnected subthemes. First, system gaps and fragmented care left women navigating inconsistent information, unclear referral pathways, and limited communication between providers. Second, the lack of prioritisation for maternal mental health meant that women’s emotional needs were often overlooked in favour of infant-focused care, leaving many unaware of symptoms or support options. Third, women described their preferred methods of connection, emphasising the importance of trusted interpersonal contact – whether through family, peers, or phone-based support. Sub-theme: System Gaps and Fragmented Care Many women described navigating perinatal care as overwhelming, citing fragmented services, conflicting information, and unclear referral pathways. These systemic challenges often left participants feeling unsupported, particularly when in-person care was limited to referrals rather than guided assistance. As one participant explained, “Sometimes the staff… they won’t give too much emotional support. They just say, ‘Oh, you need to find a psychiatrist or other professional.’ But if I could find them, why would I call you?” (Chinese-speaking 1:1 interview) While all participants described difficulty navigating fragmented pathways, the severity of this challenge varied across groups. Arabic-speaking women—who often had lower English proficiency and required interpreter support—reported more uncertainty about where to go for help and described greater reliance on community contacts or Arabic-language websites. For some, even accessing online information was difficult due to limited literacy, as one participant stated, “ Some of them… don’t know how to go on internet… do search and find what they’re looking for because they don’t even read or write in Arabic ” (Arabic-speaking FGC). In contrast, many Chinese and Indian/Hindi-speaking participants – most of whom were tertiary educated and fluent in English – were able to search independently but still struggled with inconsistent guidance, unfamiliar systems, and unclear referral pathways. Participants also highlighted gaps in communication across care providers. Despite frequent interactions with obstetricians, GPs, and midwives, women were often unaware of other supports, particularly online resources. One Chinese-speaking (FGB) participant explained, “I’ve visited my obstetrician, my GP, my midwife… not a single one of them actually mentioned [perinatal] websites. Is it possible for the government to communicate with medical practitioners to actively advocate for these resources?” One participant reflected on her second pregnancy, noting that support for mothers beyond the first pregnancy was often overlooked. She described receiving “hardly any resources” because “you’re a second-time mum, you know everything,” emphasising that “each delivery is unique… information should be given whether first-, second-, or third-time mum.” (Indian-speaking participant FGC) For many, recognising their need for support occurred only by chance, as systematic screening for perinatal mental health concerns rarely occurred. A Chinese-speaking (FGA) participant explained that it was only during a six-week appointment that she realised she was struggling, noting that “Most people wouldn’t know [they need help] until someone points it out.” Language barriers and the lack of translated materials compounded these challenges. Another participants described missing crucial information, remarking that having leaflets available in Arabic at GP clinics “would have definitely attracted my attention.” (Arabic-speaking participant FGB) Financial constraints and long wait times further fragmented access to care. A participant noted, “Financial condition also would be very important… if the service can be bulk billed, it will… reduce the barrier for the migrant mum to access those resources.” (Chinese-speaking 1:1 interview) Sub-theme: Lack of Prioritisation for Maternal Mental Health Participants consistently reported that maternal mental health was often deprioritised in perinatal care, with clinical interactions focused predominately on the baby rather than the mother’s wellbeing. Many described feeling overlooked during routine appointments, where their emotional or mental health needs were rarely discussed. One Indian speaking participant (FGC) reflected, “[when] a pregnant lady goes to the check-up, the nurses always talk about the baby… but it would be really great if they asked about us too”. Similarly, another participant noted that follow-up care focused solely on the infant “After the first two weeks, all other MCH [maternal child health] appointments were for the kid. There wasn’t any follow-up for the mother (Indian-speaking FGC). Women often only recognised their own struggles in hindsight. One participant shared, “When I had my first born… we were both exhausted… we didn’t know we need help” (Chinese-speaking FGA). Others were unaware of their own symptoms: “So many times the mums don’t even know that they’re going through postnatal depression or anything. They may not be aware,” (Indian-speaking FGB). Sub-theme: Preferred Methods of Connection Women described diverse preferences for accessing perinatal mental health support, balancing the convenience of online information with a desire for personal, trusted connections. Across focus groups, participants described turning first to family for reassurance and guidance for both emotional wellbeing and maternal health decisions. One Arabic-speaking (FGB) participant shared, “If I want advice I go to my mum… even when I'm in Australia I still call them and ask them many advice”. Likewise, health decisions were often guided by those seen as “senior” family members, and whose lived experience and authority carried weight in shaping perinatal and parenting choices: “In our community we all follow our family members or whatever experiences, our senior sisters or brother, like sister-in-law, we talk with them… they have the experience, so we value their guidance for our health decisions” (Indian-speaking FGA). While family networks remained central, women also used digital resources for quick guidance or reassurance when professional help was not immediately available. One participant noted “The first thing I go [to is] the internet, it’s easier, faster…[it] guides me until I’ll get medical help” (Arabic-speaking FGA). However, online resources were rarely viewed as sufficient on their own as one participant shared, “I would rather call somebody if I need help rather than searching the website…” (Chinese-speaking 1:1 interview) Some described positive experiences with telephone counselling, which they regarded as a bridge between impersonal online information and face-to-face interaction: “I actually spoke with one of the counsellors… we had a couple of sessions over the phone, which was great” (Indian-speaking 1:1 interview). Others preferred interactive peer workshops that allowed collective learning and sharing: “If they make [a] workshop with migrant [women], pregnant or having had a baby… this give us idea more than the website… this is the best for us” (Arabic-speaking FGA). For women experiencing heightened stress, particularly in the postpartum period, immediacy and locality were critical. One participant described how a friend “didn’t have the time and energy to go on a website and ask for help… if she had access to a contact person she could reach out to… every mum needs a very immediate local help close to her, especially in emergency time” (Indian-speaking FGA). Participants suggested practical ways to improve access, including translated pamphlets and posters with QR codes in hospitals, so information “goes directly to the website” (Indian-speaking FGB). Theme 2: Cultural and Socio-Emotional Context of Mental Health This theme reflects how cultural norms, social expectations, and disrupted support networks shaped women’s emotional wellbeing and decisions about seeking help. The subtheme of s tigma and mental health disclosure revealed how shame, fear of judgement, and ideals of maternal strength constrained women’s ability to acknowledge distress. Negotiating different cultural practices captured the tensions women navigated between traditional beliefs and Western healthcare advice, particularly around confinement, breastfeeding, diet, and infant care. The subtheme of cultural inclusivity in healthcare illustrated gaps in cultural understanding among providers, leaving women feeling unseen or misunderstood when their practices were dismissed or not accommodated. Finally, motherhood without a village highlighted the emotional and practical consequences of migration, including isolation, loss of intergenerational care, and the compounding impacts of transnational grief. Sub-theme: Stigma and Mental Health Disclosure Across all groups, women described mental health as a sensitive and, at times, taboo topic, one that was often met with discomfort or silence, regardless of cultural background. While participants recognised that stigma around mental health exists more broadly in society, many felt that cultural expectations and community norms intensified these challenges after migration. One participant explained, “You don’t want people to think you are weak… so you just keep it to yourself” (Arabic-speaking (FGA). Several participants reflected that such stigma persisted even after moving to Australia, as attitudes within close-knit circles often mirrored those in their community. “Mental health still would be not an open topic in China,” one participant observed, “so around some Chinese population here, I think other friends I know still have some stigma to talk about it” (Chinese-speaking 1:1 interview). Within some communities, motherhood was idealised as a period of fulfilment and resilience, leaving little room to express vulnerability. Mothers were expected to “just cope” without complaint, as one participant described: “In our culture … we have pressure on the mother not to [ask for help]… It's normal to hear, ‘You are a mother, you have to just go on… we all have this journey.’ Sometimes you just want a little bit of support, but we don’t have this in our culture actually.” (Arabic-speaking FGB). Likewise, expressions of sadness or anxiety were sometimes interpreted as a sign of spiritual deficiency, or ingratitude as one participant shared: “Sometimes mistakenly, you know depression or anxiety are classified as a lack of gratefulness, gratefulness towards God… traditionally if you’re just saying, you know, ‘I’m feeling low’ or ‘I’m feeling depressed’, you are just told ‘Okay, just be grateful for everything you’ve got in life,’ and that’s not a very helpful attitude” (Arabic-speaking FGB). These beliefs created pressure to conceal distress, to “appear fine, even if you are feeling sad,” as one participant added that she would “keep smiling so people don’t ask questions” (Chinese-speaking 1:1 interview). The expectation that new mothers should feel only joy after childbirth compounded this silence, as acknowledging sadness or anxiety could be seen as incompatible with being a “good mother”. One participant shared “If you’re feeling sad and anxious, there might be cultural reasons where you don’t feel it’s okay to feel sad and anxious, because you’ve just had a baby and that should be good news” (Arabic-speaking (FGB). Underlying these fears was a deep anxiety about how disclosure might affect their role as caregivers. Though less commonly expressed, some women highlighted that admitting to mental health difficulties could invite judgement about their parenting capacity: “If you tell people, they might think you can’t look after your baby… and then what will happen?” (Arabic-speaking FGB). Sub-theme: Negotiating Different Cultural Practices Participants frequently described the perinatal period as a site of negotiation between their own culturally grounded practices and the expectations of the Australian healthcare system. Despite differing cultural practices across groups, many women shared a common experience of feeling torn between family guidance – shaped by traditions around postpartum recovery, diet, infant care, and broader cultural norms – and the often contrasting advice provided by healthcare professionals. For some, these tensions were particularly pronounced when longstanding practices were not acknowledged or were dismissed as irrelevant. As participant described, “The Chinese traditional postnatal, prenatal process is very different from the Western culture… The first challenge you actually face is what your Mum and Grandmum tell you – it’s very different from what nurses and doctors tell you” (Chinese-speaking FGA). These competing and at times contradictory messages were particularly evident in relation to diet and postpartum recovery. Cultural beliefs, such as avoiding certain foods, were often absent from mainstream medical advice, leaving women unsure how to reconcile both perspectives. One participant reflected, “In Asian culture, my mum always used to tell me to avoid a lot of papaya because it generates heat… These kinds of beliefs are missing on professional websites. Unless there is a scientific reason, I wouldn’t immediately believe them, but at the same time I would listen to my Mum. Websites should acknowledge these practices while giving medical reasoning, so women can make their own informed choice” (Indian-speaking FGA). Similar tensions surrounded breastfeeding, where cultural norms and familial expectations could amplify pressure on new mothers. One participant explained, “The mums and the mother-in-law, all the time just to try many times [but] the babies refuse to take the [breast], but in our culture you want to breastfeed the baby, this is in our culture, [it] makes a pressure.” (Arabic-speaking FGB). For some, these negotiations generated strain within families, where differing intergenerational expectations around newborn care often clashed: “When my baby caught a cold, my mother-in-law talked about a lot of traditional Chinese beliefs. I said, ‘I’ve read all this information online from Royal Children’s Hospital,’ but she replied, ‘You can read those, but you still need to believe traditional Chinese ways from years of experience.’ Sometimes it’s really hard to look after the baby together, especially when we’re open to both Chinese and Western ways, but they’re not always open-minded” (Chinese-speaking FGA). Such moments of disagreement added strain to an already emotional and demanding period. One participant noted, “They’re already emotional, looking after a newborn, and then they have to deal with a barrier created with their own Mum or parents. That’s hard.” (Chinese-speaking participant FGA) Others noted that mainstream parenting advice often failed to reflect the realities of culturally diverse families. One Arabic-speaking (FGB) participant explained, “it would be helpful to have resources that “merge” cultural and Western perspectives, with websites offering “different perspectives… that would be more relevant to a parent like me.” Accordingly, many participants expressed the need for culturally tailored and bilingual resources that could help them mediate these differences and avoid conflict with family members. A Chinese-speaking (FGA) participant suggested, “I feel like a certain section on the website or even just a small handout available in Chinese may be helpful to show the elders, say ‘Look, this is from a reputable website.’ … It’s about how we do confinement in a modern way. Not the traditional way, no shower, no drinking cold water for a whole month. That’s quite unrealistic” Sub-theme: Cultural Inclusivity in Healthcare For many recently arrived participants, parenting within a new cultural environment brought both emotional and practical challenges. Participants described the difficulty of reconciling their cultural values with those of Australian society, particularly when raising children in bicultural settings. An Arabic-speaking (FGB) participant reflected, “The most important thing for me… is how we can raise our children in this different culture. I don’t want them to feel different…so I want advice from people here, especially because I just came a few months ago”. These tensions were heightened by a lack of culturally informed guidance from healthcare providers. Standardised tools such as growth charts and developmental milestones were often perceived as not reflecting the diversity of different population groups. One participant described, “Indian babies tend to be smaller compared to Aussie babies… For their genetics, the baby is of normal size, but since all babies are measured in one single frame, they tend to judge the baby as too small or too big, which adds a lot of stress” (Indian-speaking 1:1 interview). Participants emphasised that cultural inclusivity in care extended beyond providing translated materials; it required healthcare professionals who could engage with and respect diverse cultural traditions. One Chinese-speaking participant (FGB) explained, “It is better if the person you talk to understands our traditions… otherwise you have to explain so much”. When cultural understanding was absent, women felt unseen and fatigued by the constant need to justify their practices, reinforcing a sense of disconnection from the healthcare system. Sub-theme: Motherhood Without a Village For many participants, migration profoundly reshaped the social supports they typically relied on during the perinatal period. The loss of these familiar networks of care intensified feelings of vulnerability and emotional strain. One participant highlighted, “In our culture, at least the mother or mother-in-law can come and take care of the new mother and baby. But because we are migrants, most of the time it does not happen due to visa restrictions, or they cannot stay longer because they have to go back home” (Indian-speaking FGB) Without familiar support, women described the transition to caring for a newborn as overwhelming and emotionally destabilising: “After that, you suddenly had a mother taking care of you for six months, and now suddenly you’re alone taking care of the baby. That can be extremely overwhelming because you’ve been so dependent on them… that’s when you would need help, [for] mental health especially” (Indian-speaking FGB). Global conflicts, humanitarian crises, and transnational grief reverberated deeply within diasporic communities, compounding emotional distress during an already vulnerable time. One Arabic-speaking (FGB) participant shared: “A lot of women are experiencing vicarious trauma within the diaspora, whether we’re from Palestine, Iraq, Iran… My friend, who’s pregnant with twins, has been inconsolable because of what’s happening in Lebanon. These feelings of intense sadness and despair can’t be healthy during pregnancy, but I couldn’t see any mention of this on maternal health websites”. Theme 3: Support seeking This theme explores how migrant women navigated and constructed support systems without always having formal guidance. In the subtheme navigating digital health information , women described both the opportunities and overwhelm of online health content, emphasising the difficulty of identifying credible sources amid conflicting advice. In digital networks as spaces of care and connection , women highlighted the importance of culturally familiar online communities (particularly in their first language) as sources of reassurance, collective wisdom, and emotional support. These digital spaces sometimes functioned as informal ‘villages’ that helped fill gaps left by fragmented health systems and absent family networks. Sub-theme: Navigating Digital Health Information Participants described being overwhelmed by the abundance of online information, with “so much conflicting information” (Arabic-speaking FGB), creating confusion and uncertainty about what and who to trust. Likewise, the digital environment was simultaneously a space of opportunity and overload. As one participant reflected, “I tried to find a few things on Google and sometimes I find more than one opinion… sometimes these opinions are opposites to each other, and you are lost” (Arabic-speaking FGA). While many participants actively searched for information online, few felt confident distinguishing reliable advice from opinion. Some described a gap between information access and meaningful understanding: “I do not know about these kind of websites where parents get help… people just say you’re going to get cranky after delivery, but they don’t say why, or how to cope with it when you are in that situation” (Indian-speaking FGC). For others, professional endorsement was key to navigating this uncertainty. “Sometimes too much information makes you puzzled… the correct information should come from the correct group of people. My reference was the GP or the community, instead of Google” (Indian-speaking FGA). Yet, identifying credible sources depended on understanding digital language, and even knowing the “right” search terms: “If you just put the word ‘pregnancy,’ lots of information comes up. But correct information from the right people is what’s really helpful” (Indian-speaking FGA). Sub-theme: Digital Networks as Spaces of Care and Connection Women across all groups turned to digital networks to supplement fragmented formal care, but the type of platforms they relied on differed markedly according to cultural and linguistic needs. These digital spaces offered immediacy, shared language, and a sense of belonging. As one Arabic-speaking woman noted, “That is really nice to find a community online and to see that, okay, I'm not the only one who struggles with this” (Arabic-speaking FGB). For women with limited English, digital networks in their first language served as accessible entry points for both advice and solidarity. “I just imagine for women with limited English… I would just ask a question in the WeChat group… the quickest, easiest way… there are hundreds of mums there” (Chinese-speaking FGA). Another Chinese participant described how these networks often became the primary source of prenatal support: “But prenatal, all the supports that I had mostly come from the WeChat mums’ group” (Chinese-speaking FGA). Culturally familiar perspectives shared by trusted professionals were especially valued. “I also follow some OBGYNs (Obstetricians and Gynaecologists)… because they speak in Arabic and then I can hear it from an Arabic or an Islamic perspective” (Arabic-speaking FGB). Contrastingly, for some Indian-speaking participants preferred “word-of mouth” referral rather than digital platforms. One participant explained: “I think [support] would mostly have to do with social circles, like a women’s group, mother’s group or like friends referring to friends. Because I think we’re more likely to, at least I am more likely to take information coming from a person that I trust or I know." (Hindi-speaking Focus Group B) However, these platforms also carried risks. The open nature of some social media spaces could amplify misinformation or tensions. One Chinese-speaking participant explained, “Anyone can post, so you don’t know whether it’s true or not… my mother-in-law uses this a lot… ‘These people say this, so I’m right.’ It’s a little, you need to follow my suggestion… it’s tricky” (Chinese-speaking FGA). Despite these limitations, most participants engaged with social media as a key touchpoint for information: “If it pops up on my Instagram or Facebook… if that information is relevant to me I would click on it” (Indian-speaking FGB). Culturally specific apps also supported community building and continuity of cultural practices. One Chinese participant shared: “As a new immigrant from China, there is a popular app called Red… it has everything… sometimes people post mother groups on there. So I joined the mother group from this app” (Chinese-speaking 1:1 interview). Over time, these digital communities often evolved into informal “villages” of care. “In the WeChat mother’s group… if they’re talking about feeling depressed… or even family violence, it becomes a space for support” (Chinese-speaking FGA). Discussion This study provides insights into migrant women’s experiences navigating perinatal mental health support in Australia. Findings demonstrate the dynamic interplay between family networks, healthcare systems, and cultural beliefs, particularly surrounding shame and stigma, and how this shapes support-seeking behaviours. While women actively sought information and valued social connection, their experiences were often constrained by fragmented services, limited cultural inclusivity, and the persistence of stigma around mental health disclosure. Importantly, participants identified social support, whether through family, peer groups, or digital platforms, as central to their wellbeing, highlighting the need for integrated approaches that bridge clinical care with culturally relevant community and social supports. Family networks particularly partners, mothers, and mothers-in-law were often the first and most trusted sources of support. These relationships provided emotional reassurance and practical guidance, helping women interpret their distress. However, reliance on family could also delay professional intervention, especially when traditional beliefs conflicted with medical recommendations. These findings echo previous research by Small et al. (2003), which linked limited English proficiency and short migration history with higher risks of maternal depression among migrant women in Victoria, Australia [ 42 ]. Migration-related disruptions, such as visa restrictions preventing extended family visits, left many women without their primary support networks during the postpartum period. Women described this abrupt withdrawal of familial support as both isolating and overwhelming, underscoring a stressor unique to migrant women. These findings align with recent evidence from a Canadian qualitative study of migrant mothers, which found that social isolation was closely tied to the loss of familiar family and cultural networks, while loneliness reflected feelings of aloneness in a new country without dependable supports [ 43 ]. The protective role of social support for maternal mental health is well established for all women, with evidence showing that emotional reassurance, practical assistance, and continuity of care from family and community networks reduce the risk of perinatal depression and anxiety [ 44 , 45 ]. However, while social support is universally important, women from migrant backgrounds often face unique disruptions to these networks. When women lack access to trusted and consistent support, whether due to family distance, migration-related separation, or limited local social connections, they are more likely to experience distress, delayed help-seeking, and poorer engagement with healthcare systems [ 44 , 45 ]. The sudden absence of family support therefore removes a critical buffer against the stresses of new motherhood, exacerbating challenges that are already present for many women and underscoring that perinatal wellbeing is tightly shaped by social environments. Consistent with these findings, Zlotnick et al. (2022) demonstrated that social support, whether from family, peers, or healthcare professionals, is universally protective against postpartum depression among both migrant and non-migrant mothers [ 46 ]. In our study, women similarly used both digital and in-person networks to make sense of their experiences, normalise distress, and identify when professional help was needed. These forms of connection served as key coping mechanisms in the context of migration-related isolation and the sudden absence of familiar support systems. This highlights the importance of integrating culturally responsive, digitally mediated resources with community-based supports to strengthen the social scaffolding that underpins perinatal wellbeing. Participants highlighted significant systemic gaps in perinatal care. Despite frequent contact with healthcare professionals including GPs, midwives and maternal child health nurses, mental health issues were often missed, minimised, or deprioritised. Many women experienced fragmented care, inconsistent advice, and unclear referral pathways which left them feeling unsupported. These gaps were intensified by structural barriers including language challenges, a limited number of culturally responsive practitioners, and the scarcity of translated or culturally adapted resources, factors well-documented in prior research to intensify inequities in access and quality of care [ 47 – 49 ]. Crucially, participants perceived that their own wellbeing was routinely overshadowed by an institutional focus on the infant. Postnatal checks were described as largely oriented toward the baby’s growth, feeding, and development, with minimal inquiry into maternal emotional health. This aligns with evidence from New Zealand and other high-income settings showing that routine perinatal care tends to under-recognise maternal mental distress, particularly for women from migrant and minority backgrounds [ 50 ]. Beyond service fragmentation, our findings illustrate that migrant women’s perinatal experiences are deeply shaped by the interplay between culture, social structure, and migration histories. Participants described how the absence of culturally anchored ‘villages’ of care, the emotional burden of distant crises, and the need to recreate collective support through online communities shaped both their wellbeing and help-seeking. These accounts show that women’s needs cannot be understood solely at the individual level but reflect collective identities, transnational responsibilities, and culturally integrated expectations of care [ 51 ]. Within this context, cultural humility which recognises difference, avoids assumptions, and invites partnership, becomes essential in supporting migrant women effectively [ 51 , 52 ]. Participants highlighted that shared language or nationality alone did not guarantee feeling understood; what mattered was providers who listened actively, acknowledged cultural differences without stereotyping, and adapted support to women’s personal and structural circumstances [ 51 ]. This approach aligns with what women in our study implicitly shared that a desire for relational, equity-centred care that recognises the impact of migration, social determinants, and disrupted support networks on their capacity to engage with services. Integrating cultural humility with attention to structural factors may help make visible the privilege held by dominant groups and create opportunities to identify and dismantle systemic discrimination within perinatal care systems [ 53 – 55 ]. Another salient theme was the tension women experienced when navigating traditional cultural practices and Western medical advice. Women reported receiving conflicting guidance from family elders and clinicians on postpartum care, nutrition, and infant feeding. While family advice carried emotional and cultural significance, clinical recommendations often differed, leaving women caught between competing expectations. This dissonance created stress and, at times, intergenerational conflict, particularly when women’s choices were perceived as deviating from cultural expectations. Similar patterns have been reported elsewhere and where culturally discordant advice can undermine women’s trust in healthcare providers and discourage disclosure of distress [ 51 , 56 ]. Likewise, Zhi et al. (2024) found that Chinese migrant mothers in Australia sought to integrate both cultural and Western evidence-based practices, yet tensions commonly arose when their preferences conflicted with the views of mothers, mothers-in-law, or peers [ 57 ]. Participants suggested that culturally inclusive resources explaining both traditional practices and medical rationales could help bridge conflicting advice and support informed decision-making during the perinatal period. Whilst stigma is not only experienced by migrant women [ 58 ], stigma emerged as a consistent barrier across cultural groups. Women described internalising expectations to appear strong and coping, even when struggling, and feared being judged as unfit, ungrateful, or inadequate mothers [ 59 ]. While participants did not explicitly describe fears of child removal, this apprehension about being seen as an unfit mother contributed to women’s hesitancy to seek help or disclose distress. These concerns were intensified by cultural taboos surrounding mental illness and broader societal ideals of motherhood [ 59 , 60 ]. As a result, many delayed or avoided help-seeking and international evidence reflects similar patterns. Ford et al. (2019) found that fear and stigma were the strongest barriers to disclosing perinatal mental health problems in primary care, outweighing practical challenges such as appointment access [ 61 ]. In the UK, up to 70% of women hide or minimise symptoms due to stigma and limited awareness, contributing to under-recognition and under-treatment [ 62 , 63 ]. These findings underscore that stigma, both cultural and societal, remains a central barrier to timely identification and support for perinatal mental health. Similarly, perinatal screening recommendations, assessment tools, and referral pathways often diverge from women’s cultural expectations and understandings of mental health, creating further barriers to effective early detection [ 59 , 60 ]. Previous research shows that the intersection of stigma and limited mental health literacy further complicates help-seeking, with women often struggling to recognise symptoms or discern the relevance of available supports [ 59 , 60 ]. Findings suggest that interventions to improve perinatal mental health outcomes for migrant women must not only enhance accessibility and cultural appropriateness of services, but also actively address stigma, promote mental health literacy, and create safe spaces where women feel permitted to disclose distress without fear of judgement. Participants actively sought both digital and in-person connections to make sense of their experiences and find reassurance. Digital platforms, culturally specific apps, and online peer groups provided accessible spaces for sharing and support, often in women’s first languages. In-person support networks, such as community workshops or culturally tailored parenting groups, offered relational continuity and validation. These social spaces also facilitate knowledge exchange, helping women recognise perinatal mental health symptoms, normalise their experiences, and identify when professional care is needed [ 64 ]. Limitations Several limitations should be noted. Although this study included participants from Chinese-, Arabic-, and Indian-speaking backgrounds, our results do not capture the full diversity of migrant women's experiences in Australia. Within-group differences such as visa status, length of stay, acculturation levels, or socioeconomic background may shape experiences in ways not reflected in this sample. Additionally, participants tended to have higher educational attainment and well-developed health system navigation skills, potentially underrepresenting the perspectives of women facing greater marginalisation, including those with low health literacy and/or less formal education opportunities. Women with lower health or mental health literacy, limited formal education, or more acute social disadvantage may face different or heightened barriers to disclosure and help-seeking, yet may have been underrepresented in our sample. Reports of domestic and family violence were limited. While the interview guide explored emotional wellbeing, safety, and sources of stress, it did not directly ask about domestic and family violence. This may have contributed to women not raising the issue explicitly, despite strong evidence that migrant and refugee women experience heightened risk during the perinatal period [ 65 , 66 ]. This absence likely reflects both the sensitivity of the topic in group discussions and the recruitment strategies, rather than an absence of risk. Future research design would benefit from trauma-informed and culturally responsive methodologies, such as one-on-one interviews, anonymous participation formats, or recruitment through specialist support services, to more safely explore the intersections of stigma, cultural norms, family dynamics, and violence in shaping perinatal mental health experiences. Conclusion This study underscores the complex ways in which cultural and social norms, stigma, systemic healthcare barriers, digital literacy and migration-related disruptions shape the perinatal mental health experiences of migrant women in Australia. While family and peer networks offer vital support, women often find themselves navigating fragmented services and conflicting cultural expectations without clear guidance or safe spaces for disclosure. Despite these barriers, participants identified social support, whether through family, peer or professionally facilitated workshops, or digital platforms, as a critical protective factor that fostered reassurance, knowledge exchange, and connection. These findings point to the need for integrated, culturally responsive models of care that integrate routine maternal mental health screening, strengthen social supports, and address stigma through safe and empowering spaces for disclosure. Combining digitally mediated resources with community-based initiatives may help bridge cultural dissonance, promote maternal mental health literacy, and support equitable perinatal mental health outcomes for migrant women in Australia. Abbreviations CCI Consumer and Community Involvement COREQ Consolidated Criteria for Reporting Qualitative Research GP General Practitioner MCH Maternal Child Health NAATI National Accreditation Authority for Translators and Interpreters WHRTN National Women's Health Research, Translation and Impact Network Declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board of Monash University Human Research Ethics Committee (Project ID 43519). Informed consent was obtained from all the subjects involved in the study. Consent for publication Yes Availability of data and materials The data used and/or analysed during the current study are available upon reasonable request. Access to the data may be granted to those who provide a justified request for research purposes. To request access, please contact [email protected] Competing interests The authors declare no competing interests. Funding This research received funding from The Australian Health Research Alliance WHRTN. Authors' contributions AA: Conceptualization, Methodology, Formal analysis, Writing – original draft and editing. JB: Conceptualization, Supervision, Writing – review and editing. MO, RH, AR, LDS: Writing – review and editing. AA, AR, MK: Methodology, Writing – review and editing. MK: Consumer Co-Investigators – contributing lived experience insights to study design and interpretation. Acknowledgements This research was supported by the Women’s Health Research, Translation and Impact Network through a Co-production Partnership Grant without which this work was not possible. We would like to thank Giang Tran and Delaram Ansari from the Multicultural Centre for Women’s Health for her invaluable support and contributions throughout the project. We are also grateful to Mary Li and Shazia Syed for their guidance and input as part of our consumer involvement, which helped ensure the findings were informed by lived experiences and community perspectives. Lastly, the authors would like to also thank Rahma Health for their support with recruitment. References United Nations, International migration . 2024, UN: Geneva. Phillimore, J., Migrant maternity in an era of superdiversity: New migrants' access to, and experience of, antenatal care in the West Midlands, UK. Social Science & Medicine, 2016. 148 : p. 152-159. 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Journal of Clinical Nursing, 2023. 32 (7-8): p. 1316-1326. Olcoń, K., D. Rambaldini-Gooding, and C. Degeling, Implementation gaps in culturally responsive care for refugee and migrant maternal health in New South Wales, Australia. BMC Health Services Research, 2023. 23 (1): p. 42. Barrio-Ruiz, C., et al., Language and Cultural Barriers and Facilitators of Sexual and Reproductive Health Care for Migrant Women in High-Income European Countries: An Integrative Review. J Midwifery Womens Health, 2024. 69 (1): p. 71-90. Lurgain, J.G., et al., Exploring cultural competence barriers in the primary care sexual and reproductive health centres in Catalonia, Spain: perspectives from immigrant women and healthcare providers. International Journal for Equity in Health, 2024. 23 (1): p. 206. Clapham, B., et al., Missed Opportunities for Addressing Maternal Mental Health: A Thematic Analysis of Mothers’ Experiences of Using the Well Child Tamariki Ora Service in Aotearoa NZ. Health & Social Care in the Community, 2024. 2024 (1): p. 5890641. Rambaldini-Gooding, D., et al., Cultural Humility in Action: Learning From Refugee and Migrant Women and Healthcare Providers to Improve Maternal Health Services in Australia. Health Expectations, 2024. 27 . Tervalon, M. and J. Murray-Garcia, Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of health care for the poor and underserved, 1998. 9 (2): p. 117-125. Gardner, A., S. Oduola, and B. Teague, Culturally Sensitive Perinatal Mental Health Care: Experiences of Women From Minority Ethnic Groups. Health Expect, 2024. 27 (4): p. e14160. Fassin, D., Another Politics of Life is Possible. Theory, Culture & Society, 2009. 26 (5): p. 44-60. Fassin, D., The Biopolitics of Otherness: Undocumented Foreigners and Racial Discrimination in French Public Debate. Anthropology Today, 2001. 17 (1): p. 3-7. Shorey, S., E. Ng, and S. Downe, Cultural competence and experiences of maternity health care providers on care for migrant women: A qualitative meta‐synthesis. Birth, 2021. 48 . Zhi, X., K. McKenzie-McHarg, and D.L. Mai, Investigating cultural conflicts in everyday self-care among Chinese first-time pregnant migrants in Australia. Midwifery, 2024. 135 : p. 104038. Health–Europe, T.L.R., Support not stigma: redefining perinatal mental health care. The Lancet Regional Health-Europe, 2024. 40 : p. 100930. Reupert, A., et al., Stigma in relation to families living with parental mental illness: An integrative review. International Journal of Mental Health Nursing, 2021. 30 (1): p. 6-26. Hine, R.H., D.J. Maybery, and M.J. Goodyear, Identity in recovery for mothers with a mental illness: A literature review. Psychiatr Rehabil J, 2018. 41 (1): p. 16-28. Ford, E., et al., Understanding barriers to women seeking and receiving help for perinatal mental health problems in UK general practice: development of a questionnaire. Prim Health Care Res Dev, 2019. 20 : p. e156. The Lancet Regional, H.-E., Support not stigma: redefining perinatal mental health care. Lancet Reg Health Eur, 2024. 40 : p. 100930. Daehn, D., et al., Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public – a systematic review. BMC Pregnancy and Childbirth, 2022. 22 (1): p. 574. Balaam, M.-C., C. Kingdon, and M. Haith-Cooper, A Systematic Review of Perinatal Social Support Interventions for Asylum-seeking and Refugee Women Residing in Europe. Journal of Immigrant and Minority Health, 2022. 24 (3): p. 741-758. Hulley, J., et al., Intimate Partner Violence and Barriers to Help-Seeking Among Black, Asian, Minority Ethnic and Immigrant Women: A Qualitative Metasynthesis of Global Research. Trauma, Violence, & Abuse, 2023. 24 (2): p. 1001-1015. Gonçalves, M. and M. Matos, Prevalence of Violence against Immigrant Women: A Systematic Review of the Literature. Journal of Family Violence, 2016. 31 (6): p. 697-710. Additional Declarations No competing interests reported. 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Contributions to the literature","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 601px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eProvides novel population-level insight into how migrant women in Australia experience and navigate perinatal mental health across healthcare, family, community and digital settings.\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 601px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDemonstrates how fragmented services, limited cultural responsiveness, and stigma interact to delay help-seeking.\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 601px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eHighlights the central role of social support, including family networks, peer communities, and digital platforms, in supporting perinatal mental wellbeing among migrant women.\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 601px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eExtends evidence by showing how migration-related disruptions shape mental health needs during pregnancy and postpartum.\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 601px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eInforms policy and service design by highlighting the importance of perinatal mental health support that brings together clinical care, social and emotional wellbeing, and digital resources.\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Background","content":"\u003cp\u003eOver the past five decades, global migration has increased steadily, with international migrants now comprising over 3.6% of the world’s population [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Today, more women than ever are living in countries different from where they were born, navigating maternity and health systems far removed from their cultural context and usual support networks. Migrant women often face unique challenges in the perinatal period (pregnancy, birth, and the first year postpartum), including systemic barriers, cultural dislocation, and unfamiliar care structures that are difficult to navigate [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These, along with other socioeconomic factors, contribute to persistent disparities in perinatal health outcomes for women from migrant communities [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e–\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This study will explore how migrant women navigate transition to parenthood during the perinatal period with particular attention to the role of digital health in shaping their pathways to support. By examining how women engage with, interpret, and experience digital tools within broader social and structural contexts, the study aims to understand both the opportunities and limitations of digital health as a means of reaching more equitable perinatal care.\u003c/p\u003e \u003cp\u003eGlobally, perinatal mental health conditions affect up to 20% of women [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, women from refugee and migrant backgrounds face an even higher risk of perinatal mental health conditions, up to 40%, due to stressors experienced before, during, and after migration [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. These stressors include the challenges of resettlement, adapting to new health systems, building social networks, and balancing competing settlement priorities, which often take precedence over women’s health [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Migrant women also experience barriers in navigating perinatal care, including language and health literacy challenges, difficulties navigating complex and unclear health system pathways, financial constraints, cultural beliefs that may conflict with mainstream practices, limited access to culturally responsive care, and increasing challenges associated with digital literacy and navigating online health platforms [\u003cspan additionalcitationids=\"CR13 CR14\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e–\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNavigating care in the perinatal context for refugee and migrant women involves a complex interplay between formal healthcare services (e.g., General Practitioners (GPs), hospitals, child and family health services) and informal or community-based support systems [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Increasingly, women also engage with digital health (the use of digital tools), including telehealth, web-based platforms, and mobile applications, to improve health outcomes [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Digital technologies, such as telehealth, health information websites, and social media, have become increasingly important, offering information, connection, and access to services outside current settings [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, health and digital literacy, access to devices and internet connectivity, language accessibility, trust in services, and cultural relevance influence the uptake of digital technologies [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDigital technologies have become integral to modern healthcare, providing accessible solutions for the prevention, diagnosis, treatment, and ongoing self-management of health conditions [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. These tools potentially empower individuals to actively engage in their healthcare, offering convenient access to medical consultations, personalised health information, and self-monitoring resources that can enhance health outcomes and improve overall health experiences [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Digital resources can also help to establish a comprehensive network of community connections, particularly for individuals living outside urban centres and/or facing systematic marginalisation [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe global burden of mental health conditions, including perinatal depression, highlights the urgent need for accessible and scalable management and support options [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. While both psychotherapy and pharmacotherapy have been shown to be effective interventions for depression [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], many people face significant barriers to accessing in-person clinical services [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. These barriers include a shortage of trained mental health professionals, lengthy waitlists, the stigma associated with help seeking and the high cost of care [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. While digital technologies offer an increasingly practical solution for migrant mothers during the perinatal period, significant barriers can limit their use and sustained engagement [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Past negative experiences with healthcare systems may further discourage help-seeking, alongside concerns around privacy, security, and the reliability of unregulated online resources [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Financial constraints, such as a lack of access to personal devices, unstable internet connectivity, or a lack of private spaces to engage with digital technologies, also remain key challenges [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. While these barriers limit the effectiveness of digital resources, addressing issues such as accessibility, cultural relevance, and trust could enable these tools to become a valuable resource for mothers during the perinatal period, a time when support and care are especially critical [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] and may have lifelong implications for infants and families.\u003c/p\u003e \u003cp\u003eRecent Australian studies have underscored the complex interplay between culture, service design, and social support in shaping migrant women’s perinatal experiences [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Evidence highlights the benefits of culturally responsive models of care, yet systemic barriers, such as language and cost, limited eligibility, and lack of culturally appropriate resources, continue to constrain equitable access and engagement [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. These studies also reveal that social isolation and disrupted support networks further amplify migrant women’s vulnerability, with many turning to digital and virtual forms of connection to bridge these gaps [\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e–\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Consequently, there is an ongoing need for models of care that extend beyond traditional health settings and respond to the dynamic ways migrant women seek and experience support. However, while existing research has illuminated the importance of service accessibility and social support, less is known about how migrant women actively navigate, interpret, and engage with perinatal mental health care across clinical, community, and digital settings, and how digital resources intersect with these broader care journeys. The intersection of digital health, cultural identity, and structural inequities remains underexplored, particularly in understanding how women make sense of and utilise digital tools to support their perinatal wellbeing within the broader healthcare landscape.\u003c/p\u003e \u003cp\u003eIn Australia, migrant women’s pathways to perinatal care are shaped not only by the structure of the healthcare system but also by global geopolitical factors, broad settlement experiences and community networks. This current study explores how migrant women who have given birth in Australia navigate perinatal mental health care across clinical, community, and digital settings. We examine the strategies women use, the barriers they face, and the potential role of digital resources alongside other forms of support. Understanding these pathways is essential for co-designing culturally responsive, accessible, and integrated models of perinatal care that address the unique needs of migrant women in Australia.\u003c/p\u003e "},{"header":"Method","content":"\u003ch3\u003eStudy Design\u003c/h3\u003e\u003cp\u003eThis study, reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], employed a qualitative research design using semi-structured interviews and reflexive thematic analysis to explore migrant women’s experiences with digital resources for perinatal mental health support [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The study methodology was co-designed in collaboration with a Community and Consumer Involvement (CCI) Advisory Group to ensure cultural and linguistic appropriateness. The CCI Advisory Group included one woman from each of the three cultural groups in focus—Chinese-, Arabic-, and Indian-language speaking backgrounds. We use the terms 'Chinese-', ‘Arabic-’, and ‘Indian-language speaking backgrounds’ to broadly refer to the range of languages commonly spoken in China, Arabic-speaking countries, and India, while acknowledging the significant linguistic diversity that exists within each of these groups. We selected these groups due to their demographic significance and documented health inequities. India is currently the leading country of birth for migrants to Australia, while Mandarin and Arabic are the most commonly spoken languages at home after English [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Women from these communities have also been shown to experience notable disparities in perinatal mental health outcomes and service access [\u003cspan additionalcitationids=\"CR36 CR37 CR38\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e–\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. We recruited Advisory Group members through partnerships with multicultural health organisations, community networks, and maternal health services to ensure diverse representation across migration pathways (e.g., recent migrants, refugees), parity, English proficiency, and digital literacy levels.\u003c/p\u003e\u003cp\u003eThe Advisory Group were central in shaping the study design, refining culturally sensitive interview guides, and advising on inclusive recruitment strategies. Advisory Group members attended research meetings and were reimbursed for their time and expertise in line with national consumer participation guidelines [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. The Monash University Human Research Ethics Committee provided ethical approval in June 2024 (Project ID 43519).\u003c/p\u003e\u003ch2\u003eParticipants and Recruitment\u003c/h2\u003e\u003cp\u003eThrough a process of discussion and voting and in line with the most commonly spoken language, the research team and the Advisory Group identified three priority populations: women of Chinese, Arabic, and Indian-language speaking backgrounds. Eligibility criteria included being a woman aged 18 years or older, residing in Melbourne, who had migrated to Australia via skilled, family, or humanitarian visa pathways, and who had given birth in the past five years and self-reported a history of perinatal mental health challenges. Participants were required to be conversant in Arabic, Mandarin, Hindi (or another Indian language), and/or English, and willing to engage with a professional interpreter if needed.\u003c/p\u003e\u003cp\u003eWomen who required language support could choose to participate in individual interviews or language-specific focus groups, conducted in Arabic, Mandarin, or an Indian language such as Hindi. Professional interpreters were arranged through a certified health translation service accredited by the National Accreditation Authority for Translators and Interpreters (NAATI), and joined via secure video conferencing. In each case, only one interpreter per group or interview was used to maintain consistency and confidentiality. Interpreters supported communication by facilitating introductions, translating participants' responses, clarifying questions or culturally specific terms, and assisting with written consent processes when necessary.\u003c/p\u003e\u003cp\u003eThe Advisory Group supported recruitment by reviewing and advising on the cultural appropriateness and clarity of recruitment materials (e.g., flyers, emails, social media posts), recommending trusted community organisations and platforms for dissemination, and advertising within their own networks. Several members facilitated introductions to community leaders and helped organise language-specific focus groups to ensure safe and culturally responsive environments. We employed a purposive sampling strategy to recruit 10 women from each cultural group, aiming to achieve diversity in age, length of time in Australia, visa pathways, English proficiency, and recency of childbirth. During recruitment, participants were asked whether they had ever experienced emotional or mental health challenges during pregnancy or in the year following childbirth. To ensure that participation did not place additional burden on women currently experiencing distress, potential participants were also asked whether they were presently receiving support or felt comfortable discussing their experiences. Women who disclosed current high levels of distress were provided with information on relevant support services and were not invited to take part until they felt ready to do so. We also employed passive snowball sampling to reach women within each community, including those less familiar with health or digital services.\u003c/p\u003e\u003cp\u003eRecruitment materials, available in Arabic, Mandarin, Hindi, and English, were distributed through Advisory members, trusted community organisations, and at multicultural community events. Interested women could contact the designated researcher (AA) directly or give permission to Advisory Group members to be contacted by AA via telephone or email. All participants received a plain language statement and provided written informed consent prior to participation. Women were informed that participation was voluntary and they could choose not to answer any question or stop the interview at any time. Each participant received a \u003cspan\u003e$\u003c/span\u003e30 AUD grocery voucher for their time.\u003c/p\u003e\u003cp\u003eDuring interviews and focus groups, participants were invited to reflect on their awareness of, and engagement with, perinatal mental health care in Australia, including whether, how, and where they sought information or support online, if at all. Discussions explored women’s experiences navigating care across different settings, including but not limited to digital platforms (e.g., online searches, apps, social media) and community-based sources of information. Collectively, these narratives provided insight into how migrant women perceive support, and how cultural norms, language accessibility, and systemic structures shape these pathways.\u003c/p\u003e\u003ch3\u003eData Collection\u003c/h3\u003e\u003cp\u003eWe use the term migrant background to refer to women who were born overseas or who speak a language other than English at home. Informed by our consumer involvement approach, we did not collect refugee status, as this information can be sensitive, potentially retraumatising, and may have introduced legal or ethical complications beyond the scope of this study\u003c/p\u003e\u003cp\u003eWe used a combination of semi-structured individual interviews and focus groups. To ensure inclusive engagement, participants could choose their preferred format based on comfort, availability, and communication preferences. Using both formats enabled us to respect participants’ choice while also enriching the data by capturing both individual and group perspectives.\u003c/p\u003e\u003cp\u003eTo ensure cultural and contextual relevance, the interview guide (see Supplementary Material) was informed by previous research on migrant women’s perinatal mental health, healthcare navigation, and digital health equity, and refined in consultation with clinical researchers and the Advisory Group. Throughout data collection, we adapted the guide iteratively to support conversational flow and cultural appropriateness.\u003c/p\u003e\u003cp\u003eInterviews and focus groups explored women’s experiences seeking and accessing perinatal mental health support in Australia, with a particular focus on their engagement with digital resources, community-based services, and healthcare providers. Participants were asked how they locate, evaluate, and use online information, the barriers and enablers influencing help-seeking, and the types of support they find most useful before, during, and after pregnancy. Questions also examined how cultural beliefs, language, trust, and digital access shape women’s engagement with perinatal mental health care.\u003c/p\u003e\u003cp\u003eFor example, participants were asked: “What do you think can best help migrant women with their mental wellbeing before, during and after pregnancy?” and “Do you think there are any cultural beliefs that influence how women access online information or services?” Women were encouraged to share examples from their own or peers’ experiences, reflecting on both positive and challenging encounters to capture diverse perspectives across communities.\u003c/p\u003e\u003cp\u003eData collection occurred between June and October 2024. Thirty women participated, across eight focus groups and three individual interviews. Focus group sizes ranged from two to four participants. The mean duration was 70 minutes for focus groups (range: 60–90 minutes) and 55 minutes for individual interviews (range: 45–65 minutes).\u003c/p\u003e\u003cp\u003eAll sessions were conducted online via teleconference (Zoom) and facilitated by a trained qualitative researcher (AA). Where required, NAATI-accredited interpreters fluent in Arabic and Mandarin supported communication. Interpreters were briefed prior to each session and worked alongside the interviewer to ensure linguistic accuracy and cultural appropriateness (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Translation was conducted in real time, with both the interviewer and interpreter actively engaged throughout the discussion.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of participant engagement by language group and interview format\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCultural-Linguistic Group\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInterview Type\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInterpreter Used\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic-speaking\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups A (n = 2)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e✓\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups B (n = 4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups C (n = 4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e✓\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChinese-speaking\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndividual Interview\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndividual Interview\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups A (n = 4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups B (n = 4)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e✓\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHindi/Indian-speaking\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndividual Interview\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups A (n = 3)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups B (n = 3)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFocus Groups C (n = 3)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003eAll interviews and focus groups were audio-recorded and transcribed verbatim into English. For non-English sessions, transcripts were based on the real-time English interpretation provided by the interpreter during interviews or focus groups, which was audio-recorded and then transcribed verbatim. Literal translations were prioritised where possible, and we reviewed culturally significant terminology in consultation with the Advisory Group to ensure accurate interpretation of meaning [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. For non-English sessions, transcripts were based on the real-time English interpretation provided by the interpreter during interviews or focus groups, which was audio-recorded and then transcribed verbatim. Credibility of the translation process was enhanced through researcher debriefing, detailed field notes, and peer review among the multilingual research team. We adopted the principle of meaning saturation [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], whereby data collection continued until sufficient depth and diversity of perspectives were obtained to support meaningful interpretation, in line with our purposive sample of 30 women across three cultural-linguistic groups.\u003c/p\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eAll transcripts were imported into NVivo version 14 to assist data management and facilitate the coding process. Data were analysed using reflexive thematic analysis [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], following an inductive and iterative approach to ensure interpretations remained grounded in participants’ accounts. AA independently completed initial reading, data familiarisation and open coding of the transcripts. Codes were subsequently organised into themes, each representing a coherent and recurring pattern of meaning. To support thematic development and contextualise findings, field notes and memos were also closely read.\u003c/p\u003e\u003cp\u003eThroughout the analysis, attention was given to identifying potential variations in experiences across the three cultural groups, as well as by participants’ age, time in Australia, and language proficiency. While the overarching themes were broadly consistent, nuanced differences were noted in the way participants described cultural expectations, help-seeking preferences, and comfort with digital technologies and these are noted in the results.\u003c/p\u003e\u003cp\u003eThemes were iteratively revised in consultation with the wider research team and Advisory Group members, ensuring that the final interpretations accurately reflected participants’ experiences and culturally specific perspectives. To enhance analytical rigour, a double-coding process was used in which two researchers independently coded the same transcripts. While this approach can risk reducing interpretive richness or oversimplifying meaning, it supports transparency and consistency [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Discrepancies were discussed collaboratively and by returning to the transcripts, allowing for deep reflection and shared understanding before reaching consensus.\u003c/p\u003e\u003ch3\u003eReflexivity\u003c/h3\u003e\u003cp\u003eThe intersecting identities and relationships between participants and researchers played a meaningful role in shaping this project [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Members of the research team brought relevant clinical, academic, and lived experience expertise in migrant health, perinatal mental health, and qualitative research. AA, a research fellow and clinical osteopath; JB, an academic gynaecologist and obstetrician; and RH, a social worker with extensive experience in women’s health and rural and mental health care, contributed diverse clinical and academic perspectives.\u003c/p\u003e\u003cp\u003eThe broader research team included researchers from disciplines such as public health, psychology, digital health, and implementation science, who contributed to study conceptualisation, design, and interpretation. These included AR, LD, MO, and MK. While not directly involved in data collection, these team members played critical roles in shaping the study’s aims, providing analytical feedback, and ensuring alignment with health equity and culturally inclusive research principles. Importantly, the Advisory Group (MK, SS and LM) comprised women with lived experience of perinatal mental health challenges and migration. Regular reflexive team meetings were held to surface and discuss positionalities, potential biases, and interpretive influences. These discussions informed analytic decisions and ensured that the analysis remained grounded in participants’ experiences rather than researchers’ expectations.\u003c/p\u003e\u003cp\u003eAA, who led both data collection and analysis, brought important contextual insight to the study. As a woman born to migrant parents, AA shared cultural touchpoints with many participants. This shared background facilitated rapport-building and created a culturally safe (enough) environment, enabling participants to comfortably discuss sensitive topics including trauma, mental health challenges and their experiences with digital resources during the perinatal period. While this closeness enhanced depth and richness in the data, it also required ongoing critical reflection to balance empathy and analytic distance. These relational dynamics contributed to an understanding of participants' lived experiences while reinforcing the importance of reflexivity and methodological rigour throughout the study.\u003c/p\u003e\u003cp\u003eWe acknowledge that no migration studies specialist was part of the team, which may have foregrounded a culturalist lens; this was mitigated through engagement with relevant migration studies literature [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] and iterative reflexive discussions to situate participants’ experiences within broader social and structural contexts.\u003c/p\u003e"},{"header":"Findings","content":"\u003cp\u003eParticipant Characteristics\u003c/p\u003e\u003cp\u003eA total of 30 women participated in the study, with equal representation across the three language groups (10 participants per group). Most participants lived in metropolitan areas within Victoria, with a smaller subset residing in rural regions (n = 7). Ages ranged from 25 to 55 years, with the largest group falling within the 25–34 (n = 14) and 35–44 (n = 13) age brackets. Participants had lived in Australia for varying durations, from as short as six months to over 29 years. Educational backgrounds ranged from early high school qualifications to university degrees, with many having tertiary-level qualifications (n = 26). Most participants were married or in a relationship (n = 27), with family sizes ranging from one to four or more children. Additional demographic characteristics of the study participants are outlined in Table\u0026nbsp;2.\u003c/p\u003e\u003cp\u003e \u003cb\u003eTable\u0026nbsp;2: Demographic characteristics\u003c/b\u003e \u003c/p\u003e\u003cp\u003eChinese-language speaking\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"695\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eParticipant\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eAge\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eCountry of birth\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eSpeaks English\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYears lived in Australia\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eState\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city or Rural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eEducation\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRelationship status\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNumber of children\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP3\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e16\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1 – 2\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e10\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e22\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e11\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP7\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e10\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e15\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eTAFE/vocational degree\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eSeparated or divorced\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP9\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e16\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP10\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eChina\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e19\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRural region\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eSeparated or divorced\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIndian-language speaking\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"699\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003eParticipant\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eAge\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eCountry of birth\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eSpeaks English\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYears lived in Australia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eState\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city or Rural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eEducation\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eRelationship status\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eNumber of children\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP1\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e25 – 34\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e10\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP2\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e35 – 44\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e10\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eRural region\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP3\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e35 – 44\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e7\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP4\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e45 – 55\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e7\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eSA\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eSeparated or divorced\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP5\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e25 – 34\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e8\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eRural region\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP6\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e5\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP7\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e5\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP8\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e7\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eTAFE/vocational degree\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP9\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e45 – 55\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eIndia\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e15\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003eP10\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e35 – 44\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eBahrain\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e11\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eArabic-language speaking\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"709\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eParticipant\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eAge\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eCountry of birth\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eSpeaks English\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYears lived in Australia\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eState\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city or Rural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eEducation\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRelationship status\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNumber of children\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePalestine\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e7.5 months\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePalestine\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e6 months\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP3\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 34\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePalestine\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e9 months\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePalestine\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e8 months\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eRural regions\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e25 – 34\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePalestine\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e4 months\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eBachelor’s degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNetherlands\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e17 years\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003ePostgraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP7\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44 \u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eIraq\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e9 years\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYear 12\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eIraq\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e29 years\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eYear 12\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e4 or more\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP9\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e35 – 44\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eIraq\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e13 years\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eGrade 11 or less\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e2 – 3\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003eP10\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e45 – 55\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eIraq\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e29 years\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eVIC\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMetropolitan city\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eGrade 11 or less\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003eMarried or in a relationship\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e4 or more\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\u003cp\u003eThemes\u003c/p\u003e\u003cp\u003eThree overarching themes, and related subthemes captured migrant women’s experiences of perinatal mental health care in Australia (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Theme 1 \u003cem\u003eAccessing Perinatal Care\u003c/em\u003e described women’s experiences with fragmented services, limited attention to maternal mental health within routine care, and their preferred ways of engaging with services and support networks. Theme 2 \u003cem\u003eCultural and Socio-Emotional Context of Mental Health\u003c/em\u003e reflected how stigma, cultural expectations, and disrupted support networks shaped wellbeing and help-seeking. Theme 3 \u003cem\u003eSupport Seeking\u003c/em\u003e illustrated how women turned to digital platforms to navigate information, connect with peers, and rebuild community in the absence of familial supports.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of themes and sub-themes\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheme\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSub-theme\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Accessing perinatal care\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSystem gaps and fragmented care\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLack of prioritisation for maternal mental health\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreferred methods of connection\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Cultural and Socio-Emotional Context of Mental Health\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStigma and mental health disclosure\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegotiating different cultural practices\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCultural Inclusivity in healthcare\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMotherhood without a village\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. Support Seeking\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNavigating digital health information\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDigital networks as spaces of care and connection\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003eTheme 1: Accessing Perinatal Care\u003c/p\u003e\u003cp\u003eThis theme captures how women encountered a fragmented and often confusing perinatal care system, highlighting three interconnected subthemes. First, \u003cem\u003esystem gaps and fragmented care\u003c/em\u003e left women navigating inconsistent information, unclear referral pathways, and limited communication between providers. Second, the \u003cem\u003elack of prioritisation for maternal mental health\u003c/em\u003e meant that women’s emotional needs were often overlooked in favour of infant-focused care, leaving many unaware of symptoms or support options. Third, women described their preferred methods of connection, emphasising the importance of trusted interpersonal contact – whether through family, peers, or phone-based support.\u003c/p\u003e\u003cp\u003eSub-theme: System Gaps and Fragmented Care\u003c/p\u003e\u003cp\u003eMany women described navigating perinatal care as overwhelming, citing fragmented services, conflicting information, and unclear referral pathways. These systemic challenges often left participants feeling unsupported, particularly when in-person care was limited to referrals rather than guided assistance. As one participant explained, “Sometimes the staff… they won’t give too much emotional support. They just say, ‘Oh, you need to find a psychiatrist or other professional.’ But if I could find them, why would I call you?” (Chinese-speaking 1:1 interview)\u003c/p\u003e\u003cp\u003eWhile all participants described difficulty navigating fragmented pathways, the severity of this challenge varied across groups. Arabic-speaking women—who often had lower English proficiency and required interpreter support—reported more uncertainty about where to go for help and described greater reliance on community contacts or Arabic-language websites. For some, even accessing online information was difficult due to limited literacy, as one participant stated, \u003cem\u003e“\u003c/em\u003eSome of them… don’t know how to go on internet… do search and find what they’re looking for because they don’t even read or write in Arabic\u003cem\u003e”\u003c/em\u003e (Arabic-speaking FGC). In contrast, many Chinese and Indian/Hindi-speaking participants – most of whom were tertiary educated and fluent in English – were able to search independently but still struggled with inconsistent guidance, unfamiliar systems, and unclear referral pathways.\u003c/p\u003e\u003cp\u003eParticipants also highlighted gaps in communication across care providers. Despite frequent interactions with obstetricians, GPs, and midwives, women were often unaware of other supports, particularly online resources. One Chinese-speaking (FGB) participant explained, “I’ve visited my obstetrician, my GP, my midwife… not a single one of them actually mentioned [perinatal] websites. Is it possible for the government to communicate with medical practitioners to actively advocate for these resources?”\u003c/p\u003e\u003cp\u003eOne participant reflected on her second pregnancy, noting that support for mothers beyond the first pregnancy was often overlooked. She described receiving “hardly any resources” because “you’re a second-time mum, you know everything,” emphasising that “each delivery is unique… information should be given whether first-, second-, or third-time mum.” (Indian-speaking participant FGC)\u003c/p\u003e\u003cp\u003eFor many, recognising their need for support occurred only by chance, as systematic screening for perinatal mental health concerns rarely occurred. A Chinese-speaking (FGA) participant explained that it was only during a six-week appointment that she realised she was struggling, noting that “Most people wouldn’t know [they need help] until someone points it out.” Language barriers and the lack of translated materials compounded these challenges. Another participants described missing crucial information, remarking that having leaflets available in Arabic at GP clinics “would have definitely attracted my attention.” (Arabic-speaking participant FGB)\u003c/p\u003e\u003cp\u003eFinancial constraints and long wait times further fragmented access to care. A participant noted, “Financial condition also would be very important… if the service can be bulk billed, it will… reduce the barrier for the migrant mum to access those resources.” (Chinese-speaking 1:1 interview)\u003c/p\u003e\u003cp\u003eSub-theme: Lack of Prioritisation for Maternal Mental Health\u003c/p\u003e\u003cp\u003eParticipants consistently reported that maternal mental health was often deprioritised in perinatal care, with clinical interactions focused predominately on the baby rather than the mother’s wellbeing. Many described feeling overlooked during routine appointments, where their emotional or mental health needs were rarely discussed. One Indian speaking participant (FGC) reflected, “[when] a pregnant lady goes to the check-up, the nurses always talk about the baby… but it would be really great if they asked about us too”. Similarly, another participant noted that follow-up care focused solely on the infant “After the first two weeks, all other MCH [maternal child health] appointments were for the kid. There wasn’t any follow-up for the mother (Indian-speaking FGC).\u003c/p\u003e\u003cp\u003eWomen often only recognised their own struggles in hindsight. One participant shared, “When I had my first born… we were both exhausted… we didn’t know we need help” (Chinese-speaking FGA). Others were unaware of their own symptoms: “So many times the mums don’t even know that they’re going through postnatal depression or anything. They may not be aware,” (Indian-speaking FGB).\u003c/p\u003e\u003cp\u003eSub-theme: Preferred Methods of Connection\u003c/p\u003e\u003cp\u003eWomen described diverse preferences for accessing perinatal mental health support, balancing the convenience of online information with a desire for personal, trusted connections. Across focus groups, participants described turning first to family for reassurance and guidance for both emotional wellbeing and maternal health decisions. One Arabic-speaking (FGB) participant shared, “If I want advice I go to my mum… even when I'm in Australia I still call them and ask them many advice”. Likewise, health decisions were often guided by those seen as “senior” family members, and whose lived experience and authority carried weight in shaping perinatal and parenting choices: “In our community we all follow our family members or whatever experiences, our senior sisters or brother, like sister-in-law, we talk with them… they have the experience, so we value their guidance for our health decisions” (Indian-speaking FGA).\u003c/p\u003e\u003cp\u003eWhile family networks remained central, women also used digital resources for quick guidance or reassurance when professional help was not immediately available. One participant noted “The first thing I go [to is] the internet, it’s easier, faster…[it] guides me until I’ll get medical help” (Arabic-speaking FGA). However, online resources were rarely viewed as sufficient on their own as one participant shared, “I would rather call somebody if I need help rather than searching the website…” (Chinese-speaking 1:1 interview)\u003c/p\u003e\u003cp\u003eSome described positive experiences with telephone counselling, which they regarded as a bridge between impersonal online information and face-to-face interaction: “I actually spoke with one of the counsellors… we had a couple of sessions over the phone, which was great” (Indian-speaking 1:1 interview). Others preferred interactive peer workshops that allowed collective learning and sharing: “If they make [a] workshop with migrant [women], pregnant or having had a baby… this give us idea more than the website… this is the best for us” (Arabic-speaking FGA).\u003c/p\u003e\u003cp\u003eFor women experiencing heightened stress, particularly in the postpartum period, immediacy and locality were critical. One participant described how a friend “didn’t have the time and energy to go on a website and ask for help… if she had access to a contact person she could reach out to… every mum needs a very immediate local help close to her, especially in emergency time” (Indian-speaking FGA). Participants suggested practical ways to improve access, including translated pamphlets and posters with QR codes in hospitals, so information “goes directly to the website” (Indian-speaking FGB).\u003c/p\u003e\u003cp\u003eTheme 2: Cultural and Socio-Emotional Context of Mental Health\u003c/p\u003e\u003cp\u003eThis theme reflects how cultural norms, social expectations, and disrupted support networks shaped women’s emotional wellbeing and decisions about seeking help. The subtheme of s\u003cem\u003etigma and mental health disclosure\u003c/em\u003e revealed how shame, fear of judgement, and ideals of maternal strength constrained women’s ability to acknowledge distress. \u003cem\u003eNegotiating different cultural practices\u003c/em\u003e captured the tensions women navigated between traditional beliefs and Western healthcare advice, particularly around confinement, breastfeeding, diet, and infant care. The subtheme of \u003cem\u003ecultural inclusivity in healthcare\u003c/em\u003e illustrated gaps in cultural understanding among providers, leaving women feeling unseen or misunderstood when their practices were dismissed or not accommodated. Finally, \u003cem\u003emotherhood without a village\u003c/em\u003e highlighted the emotional and practical consequences of migration, including isolation, loss of intergenerational care, and the compounding impacts of transnational grief.\u003c/p\u003e\u003cp\u003eSub-theme: Stigma and Mental Health Disclosure\u003c/p\u003e\u003cp\u003eAcross all groups, women described mental health as a sensitive and, at times, taboo topic, one that was often met with discomfort or silence, regardless of cultural background. While participants recognised that stigma around mental health exists more broadly in society, many felt that cultural expectations and community norms intensified these challenges after migration. One participant explained, “You don’t want people to think you are weak… so you just keep it to yourself” (Arabic-speaking (FGA).\u003c/p\u003e\u003cp\u003eSeveral participants reflected that such stigma persisted even after moving to Australia, as attitudes within close-knit circles often mirrored those in their community. “Mental health still would be not an open topic in China,” one participant observed, “so around some Chinese population here, I think other friends I know still have some stigma to talk about it” (Chinese-speaking 1:1 interview).\u003c/p\u003e\u003cp\u003eWithin some communities, motherhood was idealised as a period of fulfilment and resilience, leaving little room to express vulnerability. Mothers were expected to “just cope” without complaint, as one participant described: “In our culture … we have pressure on the mother not to [ask for help]… It's normal to hear, ‘You are a mother, you have to just go on… we all have this journey.’ Sometimes you just want a little bit of support, but we don’t have this in our culture actually.” (Arabic-speaking FGB).\u003c/p\u003e\u003cp\u003eLikewise, expressions of sadness or anxiety were sometimes interpreted as a sign of spiritual deficiency, or ingratitude as one participant shared: “Sometimes mistakenly, you know depression or anxiety are classified as a lack of gratefulness, gratefulness towards God… traditionally if you’re just saying, you know, ‘I’m feeling low’ or ‘I’m feeling depressed’, you are just told ‘Okay, just be grateful for everything you’ve got in life,’ and that’s not a very helpful attitude” (Arabic-speaking FGB). These beliefs created pressure to conceal distress, to “appear fine, even if you are feeling sad,” as one participant added that she would “keep smiling so people don’t ask questions” (Chinese-speaking 1:1 interview).\u003c/p\u003e\u003cp\u003eThe expectation that new mothers should feel only joy after childbirth compounded this silence, as acknowledging sadness or anxiety could be seen as incompatible with being a “good mother”. One participant shared “If you’re feeling sad and anxious, there might be cultural reasons where you don’t feel it’s okay to feel sad and anxious, because you’ve just had a baby and that should be good news” (Arabic-speaking (FGB).\u003c/p\u003e\u003cp\u003eUnderlying these fears was a deep anxiety about how disclosure might affect their role as caregivers. Though less commonly expressed, some women highlighted that admitting to mental health difficulties could invite judgement about their parenting capacity: “If you tell people, they might think you can’t look after your baby… and then what will happen?” (Arabic-speaking FGB).\u003c/p\u003e\u003cp\u003eSub-theme: Negotiating Different Cultural Practices\u003c/p\u003e\u003cp\u003eParticipants frequently described the perinatal period as a site of negotiation between their \u003cem\u003eown\u003c/em\u003e culturally grounded practices and the expectations of the Australian healthcare system. Despite differing cultural practices across groups, many women shared a common experience of feeling torn between family guidance – shaped by traditions around postpartum recovery, diet, infant care, and broader cultural norms – and the often contrasting advice provided by healthcare professionals. For some, these tensions were particularly pronounced when longstanding practices were not acknowledged or were dismissed as irrelevant. As participant described, “The Chinese traditional postnatal, prenatal process is very different from the Western culture… The first challenge you actually face is what your Mum and Grandmum tell you – it’s very different from what nurses and doctors tell you” (Chinese-speaking FGA).\u003c/p\u003e\u003cp\u003eThese competing and at times contradictory messages were particularly evident in relation to diet and postpartum recovery. Cultural beliefs, such as avoiding certain foods, were often absent from mainstream medical advice, leaving women unsure how to reconcile both perspectives. One participant reflected, “In Asian culture, my mum always used to tell me to avoid a lot of papaya because it generates heat… These kinds of beliefs are missing on professional websites. Unless there is a scientific reason, I wouldn’t immediately believe them, but at the same time I would listen to my Mum. Websites should acknowledge these practices while giving medical reasoning, so women can make their own informed choice” (Indian-speaking FGA).\u003c/p\u003e\u003cp\u003eSimilar tensions surrounded breastfeeding, where cultural norms and familial expectations could amplify pressure on new mothers. One participant explained, “The mums and the mother-in-law, all the time just to try many times [but] the babies refuse to take the [breast], but in our culture you want to breastfeed the baby, this is in our culture, [it] makes a pressure.” (Arabic-speaking FGB).\u003c/p\u003e\u003cp\u003e For some, these negotiations generated strain within families, where differing intergenerational expectations around newborn care often clashed:\u003c/p\u003e\u003cp\u003e“When my baby caught a cold, my mother-in-law talked about a lot of traditional Chinese beliefs. I said, ‘I’ve read all this information online from Royal Children’s Hospital,’ but she replied, ‘You can read those, but you still need to believe traditional Chinese ways from years of experience.’ Sometimes it’s really hard to look after the baby together, especially when we’re open to both Chinese and Western ways, but they’re not always open-minded” (Chinese-speaking FGA). Such moments of disagreement added strain to an already emotional and demanding period. One participant noted, “They’re already emotional, looking after a newborn, and then they have to deal with a barrier created with their own Mum or parents. That’s hard.” (Chinese-speaking participant FGA)\u003c/p\u003e\u003cp\u003eOthers noted that mainstream parenting advice often failed to reflect the realities of culturally diverse families. One Arabic-speaking (FGB) participant explained, “it would be helpful to have resources that “merge” cultural and Western perspectives, with websites offering “different perspectives… that would be more relevant to a parent like me.” Accordingly, many participants expressed the need for culturally tailored and bilingual resources that could help them mediate these differences and avoid conflict with family members. A Chinese-speaking (FGA) participant suggested, “I feel like a certain section on the website or even just a small handout available in Chinese may be helpful to show the elders, say ‘Look, this is from a reputable website.’ … It’s about how we do confinement in a modern way. Not the traditional way, no shower, no drinking cold water for a whole month. That’s quite unrealistic”\u003c/p\u003e\u003cp\u003eSub-theme: Cultural Inclusivity in Healthcare\u003c/p\u003e\u003cp\u003eFor many recently arrived participants, parenting within a new cultural environment brought both emotional and practical challenges. Participants described the difficulty of reconciling their cultural values with those of Australian society, particularly when raising children in bicultural settings. An Arabic-speaking (FGB) participant reflected, “The most important thing for me… is how we can raise our children in this different culture. I don’t want them to feel different…so I want advice from people here, especially because I just came a few months ago”. These tensions were heightened by a lack of culturally informed guidance from healthcare providers. Standardised tools such as growth charts and developmental milestones were often perceived as not reflecting the diversity of different population groups. One participant described, “Indian babies tend to be smaller compared to Aussie babies… For their genetics, the baby is of normal size, but since all babies are measured in one single frame, they tend to judge the baby as too small or too big, which adds a lot of stress” (Indian-speaking 1:1 interview).\u003c/p\u003e\u003cp\u003eParticipants emphasised that cultural inclusivity in care extended beyond providing translated materials; it required healthcare professionals who could engage with and respect diverse cultural traditions. One Chinese-speaking participant (FGB) explained, “It is better if the person you talk to understands our traditions… otherwise you have to explain so much”. When cultural understanding was absent, women felt unseen and fatigued by the constant need to justify their practices, reinforcing a sense of disconnection from the healthcare system.\u003c/p\u003e\u003cp\u003eSub-theme: Motherhood Without a Village\u003c/p\u003e\u003cp\u003eFor many participants, migration profoundly reshaped the social supports they typically relied on during the perinatal period. The loss of these familiar networks of care intensified feelings of vulnerability and emotional strain. One participant highlighted, “In our culture, at least the mother or mother-in-law can come and take care of the new mother and baby. But because we are migrants, most of the time it does not happen due to visa restrictions, or they cannot stay longer because they have to go back home” (Indian-speaking FGB)\u003c/p\u003e\u003cp\u003eWithout familiar support, women described the transition to caring for a newborn as overwhelming and emotionally destabilising: “After that, you suddenly had a mother taking care of you for six months, and now suddenly you’re alone taking care of the baby. That can be extremely overwhelming because you’ve been so dependent on them… that’s when you would need help, [for] mental health especially” (Indian-speaking FGB). Global conflicts, humanitarian crises, and transnational grief reverberated deeply within diasporic communities, compounding emotional distress during an already vulnerable time. One Arabic-speaking (FGB) participant shared:\u003c/p\u003e\u003cp\u003e“A lot of women are experiencing vicarious trauma within the diaspora, whether we’re from Palestine, Iraq, Iran… My friend, who’s pregnant with twins, has been inconsolable because of what’s happening in Lebanon. These feelings of intense sadness and despair can’t be healthy during pregnancy, but I couldn’t see any mention of this on maternal health websites”.\u003c/p\u003e\u003cp\u003eTheme 3: Support seeking\u003c/p\u003e\u003cp\u003eThis theme explores how migrant women navigated and constructed support systems without always having formal guidance. In the subtheme \u003cem\u003enavigating digital health information\u003c/em\u003e, women described both the opportunities and overwhelm of online health content, emphasising the difficulty of identifying credible sources amid conflicting advice. In \u003cem\u003edigital networks as spaces of care and connection\u003c/em\u003e, women highlighted the importance of culturally familiar online communities (particularly in their first language) as sources of reassurance, collective wisdom, and emotional support. These digital spaces sometimes functioned as informal ‘villages’ that helped fill gaps left by fragmented health systems and absent family networks.\u003c/p\u003e\u003cp\u003eSub-theme: Navigating Digital Health Information\u003c/p\u003e\u003cp\u003eParticipants described being overwhelmed by the abundance of online information, with “so much conflicting information” (Arabic-speaking FGB), creating confusion and uncertainty about what and who to trust. Likewise, the digital environment was simultaneously a space of opportunity and overload. As one participant reflected, “I tried to find a few things on Google and sometimes I find more than one opinion… sometimes these opinions are opposites to each other, and you are lost” (Arabic-speaking FGA).\u003c/p\u003e\u003cp\u003e While many participants actively searched for information online, few felt confident distinguishing reliable advice from opinion. Some described a gap between information access and meaningful understanding: “I do not know about these kind of websites where parents get help… people just say you’re going to get cranky after delivery, but they don’t say why, or how to cope with it when you are in that situation” (Indian-speaking FGC).\u003c/p\u003e\u003cp\u003eFor others, professional endorsement was key to navigating this uncertainty. “Sometimes too much information makes you puzzled… the correct information should come from the correct group of people. My reference was the GP or the community, instead of Google” (Indian-speaking FGA). Yet, identifying credible sources depended on understanding digital language, and even knowing the “right” search terms: “If you just put the word ‘pregnancy,’ lots of information comes up. But correct information from the right people is what’s really helpful” (Indian-speaking FGA).\u003c/p\u003e\u003cp\u003eSub-theme: Digital Networks as Spaces of Care and Connection\u003c/p\u003e\u003cp\u003eWomen across all groups turned to digital networks to supplement fragmented formal care, but the type of platforms they relied on differed markedly according to cultural and linguistic needs. These digital spaces offered immediacy, shared language, and a sense of belonging. As one Arabic-speaking woman noted, “That is really nice to find a community online and to see that, okay, I'm not the only one who struggles with this” (Arabic-speaking FGB).\u003c/p\u003e\u003cp\u003eFor women with limited English, digital networks in their first language served as accessible entry points for both advice and solidarity. “I just imagine for women with limited English… I would just ask a question in the WeChat group… the quickest, easiest way… there are hundreds of mums there” (Chinese-speaking FGA). Another Chinese participant described how these networks often became the primary source of prenatal support: “But prenatal, all the supports that I had mostly come from the WeChat mums’ group” (Chinese-speaking FGA).\u003c/p\u003e\u003cp\u003eCulturally familiar perspectives shared by trusted professionals were especially valued. “I also follow some OBGYNs (Obstetricians and Gynaecologists)… because they speak in Arabic and then I can hear it from an Arabic or an Islamic perspective” (Arabic-speaking FGB). Contrastingly, for some Indian-speaking participants preferred “word-of mouth” referral rather than digital platforms. One participant explained:\u003c/p\u003e\u003cp\u003e“I think [support] would mostly have to do with social circles, like a women’s group, mother’s group or like friends referring to friends. Because I think we’re more likely to, at least I am more likely to take information coming from a person that I trust or I know.\" (Hindi-speaking Focus Group B)\u003c/p\u003e\u003cp\u003eHowever, these platforms also carried risks. The open nature of some social media spaces could amplify misinformation or tensions. One Chinese-speaking participant explained, “Anyone can post, so you don’t know whether it’s true or not… my mother-in-law uses this a lot… ‘These people say this, so I’m right.’ It’s a little, you need to follow my suggestion… it’s tricky” (Chinese-speaking FGA).\u003c/p\u003e\u003cp\u003eDespite these limitations, most participants engaged with social media as a key touchpoint for information: “If it pops up on my Instagram or Facebook… if that information is relevant to me I would click on it” (Indian-speaking FGB). Culturally specific apps also supported community building and continuity of cultural practices. One Chinese participant shared: “As a new immigrant from China, there is a popular app called Red… it has everything… sometimes people post mother groups on there. So I joined the mother group from this app” (Chinese-speaking 1:1 interview).\u003c/p\u003e\u003cp\u003eOver time, these digital communities often evolved into informal “villages” of care. “In the WeChat mother’s group… if they’re talking about feeling depressed… or even family violence, it becomes a space for support” (Chinese-speaking FGA).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study provides insights into migrant women\u0026rsquo;s experiences navigating perinatal mental health support in Australia. Findings demonstrate the dynamic interplay between family networks, healthcare systems, and cultural beliefs, particularly surrounding shame and stigma, and how this shapes support-seeking behaviours. While women actively sought information and valued social connection, their experiences were often constrained by fragmented services, limited cultural inclusivity, and the persistence of stigma around mental health disclosure. Importantly, participants identified social support, whether through family, peer groups, or digital platforms, as central to their wellbeing, highlighting the need for integrated approaches that bridge clinical care with culturally relevant community and social supports.\u003c/p\u003e \u003cp\u003eFamily networks particularly partners, mothers, and mothers-in-law were often the first and most trusted sources of support. These relationships provided emotional reassurance and practical guidance, helping women interpret their distress. However, reliance on family could also delay professional intervention, especially when traditional beliefs conflicted with medical recommendations. These findings echo previous research by Small et al. (2003), which linked limited English proficiency and short migration history with higher risks of maternal depression among migrant women in Victoria, Australia [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Migration-related disruptions, such as visa restrictions preventing extended family visits, left many women without their primary support networks during the postpartum period. Women described this abrupt withdrawal of familial support as both isolating and overwhelming, underscoring a stressor unique to migrant women. These findings align with recent evidence from a Canadian qualitative study of migrant mothers, which found that social isolation was closely tied to the loss of familiar family and cultural networks, while loneliness reflected feelings of aloneness in a new country without dependable supports [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe protective role of social support for maternal mental health is well established for all women, with evidence showing that emotional reassurance, practical assistance, and continuity of care from family and community networks reduce the risk of perinatal depression and anxiety [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. However, while social support is universally important, women from migrant backgrounds often face unique disruptions to these networks. When women lack access to trusted and consistent support, whether due to family distance, migration-related separation, or limited local social connections, they are more likely to experience distress, delayed help-seeking, and poorer engagement with healthcare systems [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. The sudden absence of family support therefore removes a critical buffer against the stresses of new motherhood, exacerbating challenges that are already present for many women and underscoring that perinatal wellbeing is tightly shaped by social environments.\u003c/p\u003e \u003cp\u003eConsistent with these findings, Zlotnick et al. (2022) demonstrated that social support, whether from family, peers, or healthcare professionals, is universally protective against postpartum depression among both migrant and non-migrant mothers [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. In our study, women similarly used both digital and in-person networks to make sense of their experiences, normalise distress, and identify when professional help was needed. These forms of connection served as key coping mechanisms in the context of migration-related isolation and the sudden absence of familiar support systems. This highlights the importance of integrating culturally responsive, digitally mediated resources with community-based supports to strengthen the social scaffolding that underpins perinatal wellbeing.\u003c/p\u003e \u003cp\u003eParticipants highlighted significant systemic gaps in perinatal care. Despite frequent contact with healthcare professionals including GPs, midwives and maternal child health nurses, mental health issues were often missed, minimised, or deprioritised. Many women experienced fragmented care, inconsistent advice, and unclear referral pathways which left them feeling unsupported. These gaps were intensified by structural barriers including language challenges, a limited number of culturally responsive practitioners, and the scarcity of translated or culturally adapted resources, factors well-documented in prior research to intensify inequities in access and quality of care [\u003cspan additionalcitationids=\"CR48\" citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Crucially, participants perceived that their own wellbeing was routinely overshadowed by an institutional focus on the infant. Postnatal checks were described as largely oriented toward the baby\u0026rsquo;s growth, feeding, and development, with minimal inquiry into maternal emotional health. This aligns with evidence from New Zealand and other high-income settings showing that routine perinatal care tends to under-recognise maternal mental distress, particularly for women from migrant and minority backgrounds [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBeyond service fragmentation, our findings illustrate that migrant women\u0026rsquo;s perinatal experiences are deeply shaped by the interplay between culture, social structure, and migration histories. Participants described how the absence of culturally anchored \u0026lsquo;villages\u0026rsquo; of care, the emotional burden of distant crises, and the need to recreate collective support through online communities shaped both their wellbeing and help-seeking. These accounts show that women\u0026rsquo;s needs cannot be understood solely at the individual level but reflect collective identities, transnational responsibilities, and culturally integrated expectations of care [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Within this context, cultural humility which recognises difference, avoids assumptions, and invites partnership, becomes essential in supporting migrant women effectively [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Participants highlighted that shared language or nationality alone did not guarantee feeling understood; what mattered was providers who listened actively, acknowledged cultural differences without stereotyping, and adapted support to women\u0026rsquo;s personal and structural circumstances [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. This approach aligns with what women in our study implicitly shared that a desire for relational, equity-centred care that recognises the impact of migration, social determinants, and disrupted support networks on their capacity to engage with services. Integrating cultural humility with attention to structural factors may help make visible the privilege held by dominant groups and create opportunities to identify and dismantle systemic discrimination within perinatal care systems [\u003cspan additionalcitationids=\"CR54\" citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother salient theme was the tension women experienced when navigating traditional cultural practices and Western medical advice. Women reported receiving conflicting guidance from family elders and clinicians on postpartum care, nutrition, and infant feeding. While family advice carried emotional and cultural significance, clinical recommendations often differed, leaving women caught between competing expectations. This dissonance created stress and, at times, intergenerational conflict, particularly when women\u0026rsquo;s choices were perceived as deviating from cultural expectations. Similar patterns have been reported elsewhere and where culturally discordant advice can undermine women\u0026rsquo;s trust in healthcare providers and discourage disclosure of distress [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. Likewise, Zhi et al. (2024) found that Chinese migrant mothers in Australia sought to integrate both cultural and Western evidence-based practices, yet tensions commonly arose when their preferences conflicted with the views of mothers, mothers-in-law, or peers [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eParticipants suggested that culturally inclusive resources explaining both traditional practices and medical rationales could help bridge conflicting advice and support informed decision-making during the perinatal period. Whilst stigma is not only experienced by migrant women [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e], stigma emerged as a consistent barrier across cultural groups. Women described internalising expectations to appear strong and coping, even when struggling, and feared being judged as unfit, ungrateful, or inadequate mothers [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. While participants did not explicitly describe fears of child removal, this apprehension about being seen as an unfit mother contributed to women\u0026rsquo;s hesitancy to seek help or disclose distress. These concerns were intensified by cultural taboos surrounding mental illness and broader societal ideals of motherhood [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. As a result, many delayed or avoided help-seeking and international evidence reflects similar patterns. Ford et al. (2019) found that fear and stigma were the strongest barriers to disclosing perinatal mental health problems in primary care, outweighing practical challenges such as appointment access [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. In the UK, up to 70% of women hide or minimise symptoms due to stigma and limited awareness, contributing to under-recognition and under-treatment [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. These findings underscore that stigma, both cultural and societal, remains a central barrier to timely identification and support for perinatal mental health.\u003c/p\u003e \u003cp\u003eSimilarly, perinatal screening recommendations, assessment tools, and referral pathways often diverge from women\u0026rsquo;s cultural expectations and understandings of mental health, creating further barriers to effective early detection [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Previous research shows that the intersection of stigma and limited mental health literacy further complicates help-seeking, with women often struggling to recognise symptoms or discern the relevance of available supports [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Findings suggest that interventions to improve perinatal mental health outcomes for migrant women must not only enhance accessibility and cultural appropriateness of services, but also actively address stigma, promote mental health literacy, and create safe spaces where women feel permitted to disclose distress without fear of judgement.\u003c/p\u003e \u003cp\u003eParticipants actively sought both digital and in-person connections to make sense of their experiences and find reassurance. Digital platforms, culturally specific apps, and online peer groups provided accessible spaces for sharing and support, often in women\u0026rsquo;s first languages. In-person support networks, such as community workshops or culturally tailored parenting groups, offered relational continuity and validation. These social spaces also facilitate knowledge exchange, helping women recognise perinatal mental health symptoms, normalise their experiences, and identify when professional care is needed [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLimitations\u003c/p\u003e \u003cp\u003eSeveral limitations should be noted. Although this study included participants from Chinese-, Arabic-, and Indian-speaking backgrounds, our results do not capture the full diversity of migrant women's experiences in Australia. Within-group differences such as visa status, length of stay, acculturation levels, or socioeconomic background may shape experiences in ways not reflected in this sample. Additionally, participants tended to have higher educational attainment and well-developed health system navigation skills, potentially underrepresenting the perspectives of women facing greater marginalisation, including those with low health literacy and/or less formal education opportunities. Women with lower health or mental health literacy, limited formal education, or more acute social disadvantage may face different or heightened barriers to disclosure and help-seeking, yet may have been underrepresented in our sample.\u003c/p\u003e \u003cp\u003eReports of domestic and family violence were limited. While the interview guide explored emotional wellbeing, safety, and sources of stress, it did not directly ask about domestic and family violence. This may have contributed to women not raising the issue explicitly, despite strong evidence that migrant and refugee women experience heightened risk during the perinatal period [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]. This absence likely reflects both the sensitivity of the topic in group discussions and the recruitment strategies, rather than an absence of risk. Future research design would benefit from trauma-informed and culturally responsive methodologies, such as one-on-one interviews, anonymous participation formats, or recruitment through specialist support services, to more safely explore the intersections of stigma, cultural norms, family dynamics, and violence in shaping perinatal mental health experiences.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study underscores the complex ways in which cultural and social norms, stigma, systemic healthcare barriers, digital literacy and migration-related disruptions shape the perinatal mental health experiences of migrant women in Australia. While family and peer networks offer vital support, women often find themselves navigating fragmented services and conflicting cultural expectations without clear guidance or safe spaces for disclosure. Despite these barriers, participants identified social support, whether through family, peer or professionally facilitated workshops, or digital platforms, as a critical protective factor that fostered reassurance, knowledge exchange, and connection. These findings point to the need for integrated, culturally responsive models of care that integrate routine maternal mental health screening, strengthen social supports, and address stigma through safe and empowering spaces for disclosure. Combining digitally mediated resources with community-based initiatives may help bridge cultural dissonance, promote maternal mental health literacy, and support equitable perinatal mental health outcomes for migrant women in Australia.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConsumer and Community Involvement\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOREQ\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConsolidated Criteria for Reporting Qualitative Research\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGeneral Practitioner\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMCH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMaternal Child Health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNAATI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Accreditation Authority for Translators and Interpreters\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHRTN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Women's Health Research, Translation and Impact Network\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board of Monash University Human Research Ethics Committee\u0026nbsp;(Project ID 43519). Informed consent was obtained from all the subjects involved in the study.\u003c/p\u003e\n\u003ch2\u003eConsent for publication\u003c/h2\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e\n\u003cp\u003eThe data used and/or analysed during the current study are available upon reasonable request. Access to the data may be granted to those who provide a justified request for research purposes. To request access, please contact [email protected]\u003c/p\u003e\n\u003ch2\u003eCompeting interests\u003c/h2\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis research received funding from The Australian Health Research Alliance WHRTN.\u003c/p\u003e\n\u003ch2\u003eAuthors' contributions\u003c/h2\u003e\n\u003cp\u003eAA: Conceptualization, Methodology, Formal analysis, Writing – original draft and editing.\u003cbr\u003e\u0026nbsp;JB: Conceptualization, Supervision, Writing – review and editing.\u003cbr\u003e\u0026nbsp;MO, RH, AR, LDS: Writing – review and editing.\u003cbr\u003e\u0026nbsp;AA, AR, MK: Methodology, Writing – review and editing.\u003cbr\u003e\u0026nbsp;MK: Consumer Co-Investigators – contributing lived experience insights to study design and interpretation.\u003c/p\u003e\n\u003ch2\u003eAcknowledgements\u003c/h2\u003e\n\u003cp\u003eThis research was supported by the Women’s Health Research, Translation and Impact Network through a Co-production Partnership Grant without which this work was not possible. We would like to thank Giang Tran and Delaram Ansari from the Multicultural Centre for Women’s Health for her invaluable support and contributions throughout the project. We are also grateful to Mary Li and Shazia Syed for their guidance and input as part of our consumer involvement, which helped ensure the findings were informed by lived experiences and community perspectives. Lastly, the authors would like to also thank Rahma Health for their support with recruitment.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eUnited Nations, \u003cem\u003eInternational migration\u003c/em\u003e. 2024, UN: Geneva.\u003c/li\u003e\n\u003cli\u003ePhillimore, J., \u003cem\u003eMigrant maternity in an era of superdiversity: New migrants\u0026apos; access to, and experience of, antenatal care in the West Midlands, UK.\u003c/em\u003e Social Science \u0026amp; Medicine, 2016. \u003cstrong\u003e148\u003c/strong\u003e: p. 152-159.\u003c/li\u003e\n\u003cli\u003eYameogo, A.R., et al., \u003cem\u003eEffectiveness of Interventions to Improve Digital Health Literacy in Forced Migrant Populations: Mixed Methods Systematic Review.\u003c/em\u003e J Med Internet Res, 2025. \u003cstrong\u003e27\u003c/strong\u003e: p. e69880.\u003c/li\u003e\n\u003cli\u003eGagnon, A.J., et al., \u003cem\u003eMigration to western industrialised countries and perinatal health: a systematic review.\u003c/em\u003e Social science \u0026amp; medicine, 2009. \u003cstrong\u003e69\u003c/strong\u003e(6): p. 934-946.\u003c/li\u003e\n\u003cli\u003eScheppers, E., et al., \u003cem\u003ePotential barriers to the use of health services among ethnic minorities: a review.\u003c/em\u003e Family practice, 2006. \u003cstrong\u003e23\u003c/strong\u003e(3): p. 325-348.\u003c/li\u003e\n\u003cli\u003eReeske, A. and O. 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Goodyear, \u003cem\u003eIdentity in recovery for mothers with a mental illness: A literature review.\u003c/em\u003e Psychiatr Rehabil J, 2018. \u003cstrong\u003e41\u003c/strong\u003e(1): p. 16-28.\u003c/li\u003e\n\u003cli\u003eFord, E., et al., \u003cem\u003eUnderstanding barriers to women seeking and receiving help for perinatal mental health problems in UK general practice: development of a questionnaire.\u003c/em\u003e Prim Health Care Res Dev, 2019. \u003cstrong\u003e20\u003c/strong\u003e: p. e156.\u003c/li\u003e\n\u003cli\u003eThe Lancet Regional, H.-E., \u003cem\u003eSupport not stigma: redefining perinatal mental health care.\u003c/em\u003e Lancet Reg Health Eur, 2024. \u003cstrong\u003e40\u003c/strong\u003e: p. 100930.\u003c/li\u003e\n\u003cli\u003eDaehn, D., et al., \u003cem\u003ePerinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public \u0026ndash; a systematic review.\u003c/em\u003e BMC Pregnancy and Childbirth, 2022. \u003cstrong\u003e22\u003c/strong\u003e(1): p. 574.\u003c/li\u003e\n\u003cli\u003eBalaam, M.-C., C. Kingdon, and M. Haith-Cooper, \u003cem\u003eA Systematic Review of Perinatal Social Support Interventions for Asylum-seeking and Refugee Women Residing in Europe.\u003c/em\u003e Journal of Immigrant and Minority Health, 2022. \u003cstrong\u003e24\u003c/strong\u003e(3): p. 741-758.\u003c/li\u003e\n\u003cli\u003eHulley, J., et al., \u003cem\u003eIntimate Partner Violence and Barriers to Help-Seeking Among Black, Asian, Minority Ethnic and Immigrant Women: A Qualitative Metasynthesis of Global Research.\u003c/em\u003e Trauma, Violence, \u0026amp; Abuse, 2023. \u003cstrong\u003e24\u003c/strong\u003e(2): p. 1001-1015.\u003c/li\u003e\n\u003cli\u003eGon\u0026ccedil;alves, M. and M. Matos, \u003cem\u003ePrevalence of Violence against Immigrant Women: A Systematic Review of the Literature.\u003c/em\u003e Journal of Family Violence, 2016. \u003cstrong\u003e31\u003c/strong\u003e(6): p. 697-710.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"aoph","sideBox":"Learn more about [Archives of Public Health](http://archpublichealth.biomedcentral.com/)","snPcode":"13690","submissionUrl":"https://submission.nature.com/new-submission/13690/3","title":"Archives of Public Health","twitterHandle":"@Archpubhealth","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Perinatal health, Mental health, Migrant women, Digital equity, Health equity","lastPublishedDoi":"10.21203/rs.3.rs-8536985/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8536985/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eMigrant women experience disproportionately high rates of perinatal mental health difficulties, shaped by intersecting cultural, social, and systemic barriers. Despite the increasing role of digital technologies in healthcare delivery, their potential to support equitable perinatal mental health care remains underexplored and often fail to reflect the complex realities of migrant women\u0026rsquo;s lives. This study examined how migrant women in Australia navigate perinatal mental health care across clinical, community, and digital settings, and how digital tools interact with cultural, social, and structural factors to influence help-seeking and engagement.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eQualitative data were collected through online focus groups and individual interviews with women from Chinese-, Arabic-, and Indian-language speaking backgrounds who had given birth in Australia. A semi-structured, culturally adapted interview guide explored women\u0026rsquo;s experiences of mental health support, barriers and facilitators to access, cultural beliefs, and the role of digital tools in finding/interpreting information. Interviews were conducted with interpreter support and analysed using reflexive thematic analysis to identify patterns across women\u0026rsquo;s narratives.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThree overarching themes, each with related subthemes, were developed: (1) \u003cem\u003eAccessing Perinatal Care\u003c/em\u003e captured fragmented systems and difficulties navigating services that felt culturally unresponsive; (2) \u003cem\u003eCultural and Socio-Emotional Context of Mental Health\u003c/em\u003e reflected how stigma, traditional beliefs, and disrupted family networks shaped women\u0026rsquo;s emotional wellbeing, help-seeking, and comfort disclosing distress; and (3) \u003cem\u003eSupport Seeking\u003c/em\u003e illustrated how women turned to digital platforms for connection, and guidance but were constrained by language barriers, and varying levels of digital literacy and access.\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e \u003cp\u003eMigrant women navigate fragmented perinatal mental health pathways shaped by cultural, social, and structural barriers. Digital tools can support help-seeking, but only when designed to address cultural relevance, language needs, and digital inequities. Equity-focused, co-designed approaches are essential to ensure digital solutions genuinely enhance perinatal mental health care for migrant women.\u003c/p\u003e","manuscriptTitle":"Reaching the Right Care: Migrant Women’s Experiences of Perinatal Mental Health Support in Australia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-21 06:15:41","doi":"10.21203/rs.3.rs-8536985/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-17T07:16:41+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-12T17:41:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-08T08:38:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"261187698617281609961103625900900679994","date":"2026-03-02T17:24:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"223407052918996380261975300620808803202","date":"2026-02-26T16:39:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-24T08:49:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"226072436721494564407568199831637540309","date":"2026-02-14T09:03:48+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-19T00:41:04+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-10T07:56:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-10T07:55:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Public Health","date":"2026-01-07T04:59:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"aoph","sideBox":"Learn more about [Archives of Public Health](http://archpublichealth.biomedcentral.com/)","snPcode":"13690","submissionUrl":"https://submission.nature.com/new-submission/13690/3","title":"Archives of Public Health","twitterHandle":"@Archpubhealth","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"59bf6d93-92a2-4842-9969-2b81f3d15b2d","owner":[],"postedDate":"January 21st, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-29T12:23:12+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-21 06:15:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8536985","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8536985","identity":"rs-8536985","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}