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Violence and reproductive health preceding flight from war: accounts from Somali born women in Sweden
Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.ORCID-id: 0000-0002-1713-6014
Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.ORCID-id: 0000-0002-8947-2949
2014 (engelsk)Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, artikkel-id 892Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden.

Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied.

Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war.

Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and

sted, utgiver, år, opplag, sider
2014. Vol. 14, artikkel-id 892
Emneord [en]
Somali-born women, maternity care, qualitative, thematic analysis, violence, wellbeing, Sweden
HSV kategori
Forskningsprogram
Hälsa och välfärd, Kvinnor och mäns erfarenheter och upplevelser av könsrelaterat våld i väpnade konflikter
Identifikatorer
URN: urn:nbn:se:du-20501DOI: 10.1186/1471-2458-14-892OAI: oai:DiVA.org:du-20501DiVA, id: diva2:886291
Tilgjengelig fra: 2015-12-22 Laget: 2015-12-22 Sist oppdatert: 2017-12-01bibliografisk kontrollert
Inngår i avhandling
1. 'Moving On' and Transitional Bridges: Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden
Åpne denne publikasjonen i ny fane eller vindu >>'Moving On' and Transitional Bridges: Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden
2015 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.

sted, utgiver, år, opplag, sider
Uppsala: Acta Universitatis Upsaliensis, 2015. s. 92
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from teh Faculty of Medicine, ISSN 1651-6206 ; 1127
Emneord
Somali-born women, violence, transition, migration, childbearing, midwife, maternal health, perinatal health, wellbeing, qualitative, case-control
HSV kategori
Forskningsprogram
Hälsa och välfärd, Kvinnor och mäns erfarenheter och upplevelser av könsrelaterat våld i väpnade konflikter
Identifikatorer
urn:nbn:se:du-20502 (URN)978-91-554-9302-8 (ISBN)
Disputas
2015-10-01, Universitetshuset Sal IX, Uppsala, 11:08 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2015-12-22 Laget: 2015-12-22 Sist oppdatert: 2019-06-26bibliografisk kontrollert

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