E Hine - Thrive - teen parent support trust

E Hine:
The voice of Young Māori
Mothers in a Māori teen
pregnancy study
Charrissa Makowharemahihi & Zara Hale
Thrive Teen Parent Conference
24-25 September 2014
Women’s Health Research Centre
Research 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
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
Within the context of policy environment
Disparities in Māori Maternal and
Child Health
Women’s Health Research Centre
Research making a difference to women
• 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
Health &
Bridging what we do, with the
lives of our people
Involve 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
Permission of image use by
Robyn Kahukiwa
Findings - published
Finding out – Finding a Midwife
• Majority of participants confirmed their pregnancy in the first trimester
• Early interaction with primary care services
• Proactive
• Pregnancy tests
• 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
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Preliminary Findings – unpublished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
Advisory Groups
Roopu Mama
Kaumatua Kāhui
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
Nuki Takao
Robyn Kahukiwa

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