Charrissa Makowharemahihi & Zara HaleThrive Teen Parent Conference

24-25 September 2014Auckland

E Hine: The voice of Young Māori Mothers in a

Māori teen pregnancy study

Women’s Health Research CentreResearch making a difference to women

A Gardeners Tale – Camara Jones

A Gardeners Tale – An allegory of racism

Institutionalised racism

Structural barriers, differential access, inaction in face of need, privilege

Personally-mediated racism

Intentional or unintentional, commission, omission

Internalised racism

Erodes individual sense of value

Who is the gardener?

Power to make decisions, to act, control resources, not concerned with equity

Ref: Jones CP. Levels of racism: a theoretic framework and a gardeners tale. Am J Public Health. 2000 August; 90(8): 1212–1215.

E Hine

Kaupapa Maori qualitative study exploring the lived realities young Māori women through pregnancy, motherhood, and early childhood

Within the context of policy environment

Disparities in Māori Maternal and Child Health

Women’s Health Research CentreResearch making a difference to women

Methods/Participants• 44 Participants (41n at end of study)• Two case study sites (HB; WN)• Between 14 – 20 at time of birth• Retrospective & Prospective Cohorts • Between 2 – 5 interviews• In-depth interviews

Data summary:• 160 participant interviews (includes 16 birth interviews)• 69 whanau interviews• 17 Sector interviews

E Hine

Bridging what we do, with the lives of our people

Rōpū

MāmāInvolve young Maori mothers in the study development & implementation

Credibility with participants they feel their korero is received and used in context of their own worldview

Ensure advice, recommendations, and subsequent policy decisions impacting on them are informed by their perspectives

Permission of image use by Robyn Kahukiwa

Findings - publishedFinding out – Finding a Midwife• Majority of participants confirmed their pregnancy in the first trimester• Early interaction with primary care services• Proactive• Pregnancy tests

Barriers• Identifying, confirming and enrolling with an LMC problematic• Lack of information and support about pathways• Over expectation on young pregnant women• Limited resources and knowledge to navigate system

Structural & service changes to ensure a seamless maternity care pathway

Makowharemahihi C, Lawton B, Cram F, Ngata T, Robson B, Brown S. 2014. Initiation of maternity care for young Māori women <20 years. New Zealand Medical Journal. 127(1393)

Preliminary Findings – unpublished

Contraception Before pregnancy• Majority (88%) had a contraception interaction with a

health professional prior to pregnancy• Long term contraception methods (64% / 34%)• Quality of health interactions

“have a little rest then hop back on it” (CCHB01.1 – age 18 at birth).

Contraception After Pregnancy• Few received contraception from LMC (9%)• WellChild/Tamariki Ora advising only • Evidence of piggy backing to avoid cost

NGA MIHI

Advisory Groups

Roopu Mama

Kaumatua Kāhui

Funders

Ministry Youth Development - RM

Health Research Council – Preg –1 yr

Ministry of Health – Year 2

Research Team

Dr Bev Lawton, Tina Ngata, Selina Brown - WHRC

Fiona Cram, Katoa Ltd

Bridget Robson, Eru Pomare

Acknowledgements

Nuki Takao

Robyn Kahukiwa