Abstract
OBJECTIVE: To explore the expectations and experiences of migrant women, including international students, in using maternity care services and describe factors affecting their access and use of these services. DESIGN: This is a qualitative participatory research study. METHODS: Data were collected through 12 photo-elicitation workshops and 20 semi-structured in-depth interviews. We conducted inductive reflexive thematic analysis in a collaborative process with participants, community partners and academic researchers. SETTING: Melbourne, Australia. SAMPLE: Twenty-one migrant women who had been pregnant or given birth since 2021 and were either international students, and/or born in Vietnam or Indonesia. RESULTS: Key challenges migrant women faced accessing and navigating Australian maternity care included costly services, inadequate language services, limited continuity of care and limited health information sharing from health workers. Lack of culturally and linguistically appropriate care hindered women's ability to transition from passive to active participants in decision-making. When provided, social and community support, along with respectful care from health workers, improved access and experiences. Practical enablers included accessible transportation, health insurance information sessions, waivers for insurance waiting periods for maternity coverage and language-concordant care. CONCLUSION: Migrant women showed pragmatism when navigating maternity care challenges but faced structural barriers that limited their decision-making and access to healthcare. Strengthening shared decision-making and woman-centred care is essential for addressing health system inequities.