Ethnicity or cultural group identity of pregnant women in Sydney, Australia: is country of birth a reliable proxy measure?

Abstract

Background: Australia has one of the most ethnically and culturally diverse maternal populations in the world. Routinely few variables are recorded in clinical data or health research to capture this diversity. This paper explores and how pregnant women, Australian-born and overseas-born, respond to survey questions on ethnicity or a cultural group identity, and whether country of birth is a reliable proxy measure. Methods: Frequency tabulations and inductive qualitative analysis of data from two questions on country of birth, and identification with an ethnicity or cultural group from a larger survey of pregnant women attending public antenatal clinics across four hospitals in Sydney, Australia. Results: Responses varied widely among the 762 with 75 individual cultural groups or ethnicities and 68 countries of birth reported. For Australian-born women (n=293), 23% identified with a cultural group or ethnicity, and 77% did not. For overseas-born women (n=469), 44% identified with a cultural group or ethnicity and 56% did not. Responses were coded under five emerging themes. Conclusions: Ethnicity and cultural group identity are complex concepts; women across and within countries of birth identified differently. Over three quarters of Australian-born, and over half of over-seas born women, reported no ethnicity or cultural group identity, indicating country of birth is not a reliable measure for identifying diversity. Researchers should scrutinise research questions and data usage, policy makers consider the complexity of ethnicity or cultural group identity, and the limitations of a single variable measure to identify ethnically and culturally diverse pregnant women and deliver woman-centred care.