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Somali women’s use of maternity health services and the outcome of their pregnancies: a descriptive study comparing Somali migrants with inborn Swedish Women
Falun Cent Hosp, Dept Obstet & Gynaecol, Falun, Sweden; Clin Res Ctr, Dalarna, Sweden. (CKF)
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Falun Cent Hosp, Dept Obstet & Gynaecol, Falun, Sweden; Dalarna Univ, Sch Hlth & Social Sci, Falun, Sweden.ORCID iD: 0000-0002-1713-6014
Falun Cent Hosp, Dept Obstet & Gynaecol, Falun, Sweden ; Clin Res Ctr, Dalarna, Sweden. (CKF)
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Inst, Dept Womens & Childrens Hlth, S-10401 Stockholm, Sweden.ORCID iD: 0000-0002-8947-2949
2013 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, Vol. 4, no 3, 99-106 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe how Somali immigrant women in a Swedish county access and use the antenatal care and health services, their reported and observed health problems and the outcome of their pregnancies.

Study design: Retrospective, descriptive study, comparing data obtained from the records of antenatal and obstetric care for Somali born women with the same data for parity matched women born in Sweden giving birth between 2001 and 2009.

Main outcome measures: Utilisation of antenatal health care (timing and number of visits), pregnancy complications (severe hyperemesis, anaemia, preeclampsia, urinary tract infections), mode of birth (normal vaginal, operative vaginal, caesarean), and infant outcomes (preterm birth, birth weight, and perinatal mortality)

Results: Compared to the 523 Swedish-born women the 262 Somali women booked later and made less visits for antenatal care. They were more likely to have anaemia, severe hyperemesis and recurrent urinary tract infection. Emergency caesarean section (OR 9.90, CI 1.16-3.10), especially before start of labour (OR 4.96, CI 1.73-14.22), high perinatal mortality  with seven versus one perinatal deaths and small for date infants (OR 2.95, CI 1.49-5.82) was also more prevalent.

Conclusion: Pregnant Somali immigrant women constitutes a vulnerable group that needs targeted attention. There is an increased risk for intrauterine foetal death, small for date and low birth weight infants as well as serious maternal morbidity.

 

 

 

Place, publisher, year, edition, pages
2013. Vol. 4, no 3, 99-106 p.
Keyword [en]
Maternal morbidity; Perinatal outcome; Somali women; Health care utilisation; Case control study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Hälsa och välfärd, Somaliska kvinnors graviditetsutfall och upplevelser av vård i samband med graviditet och förlossning – patienter och vårdgivares perspektiv
Identifiers
URN: urn:nbn:se:du-12650DOI: 10.1016/j.srhc.2013.06.001ISI: 000325387700004PubMedID: 24041730OAI: oai:DiVA.org:du-12650DiVA: diva2:633415
Available from: 2013-06-26 Created: 2013-06-26 Last updated: 2015-12-22Bibliographically approved
In thesis
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
Open this publication in new window or tab >>'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 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 92 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from teh Faculty of Medicine, ISSN 1651-6206 ; 1127
Keyword
Somali-born women, violence, transition, migration, childbearing, midwife, maternal health, perinatal health, wellbeing, qualitative, case-control
National Category
Health Sciences
Research subject
Health and Welfare, Kvinnor och mäns erfarenheter och upplevelser av könsrelaterat våld i väpnade konflikter
Identifiers
urn:nbn:se:du-20502 (URN)978-91-554-9302-8 (ISBN)
External cooperation:
Public defence
2015-10-01, Universitetshuset Sal IX, Uppsala, 11:08 (English)
Opponent
Supervisors
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2016-08-29Bibliographically approved

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