207945 An exploratory study of Somali refugee women's experiences with labor and delivery practices in the United States

Monday, November 9, 2009

Ryan Borg, MPH , Department of Health Sciences, Northeastern University, Boston, MA
Maithri Amereskere, MSc, MD candidate , School of Medicine, Tufts University, Boston, MA
Jamie Frederick, MSW, MPH Candidate , Department of International Health, Boston University School of Public Health, Boston, MA
Kelley Saia, RN, MD , Department of Obstetrics and Gynecology, Boston Medical Center, Boston, MA
Background: Refugee women often face significant challenges when seeking obstetric and gynecological care in the U.S. Prior experiences and circumstances may have implications for their reproductive health. For example, many women are victims of sexual violence and torture. Now in the U.S., they must negotiate unfamiliar prenatal and birthing practices that may be discordant with their cultural and religious beliefs. The purpose of this study is to identify the needs of refugee patients and make recommendations that will enable providers to offer quality and culturally competent obstetrical care.

Methods: Structured in-depth one-on-one interviews were conducted with a convenience sample of 23 U.S. based refugee women of Somali origin that are patients at a refugee health center in Boston, Massachusetts. Beliefs and perceptions about prenatal care, labor and delivery practices and medial interventions were explored. Content analysis will be used to interpret the data.

Results: Analysis will focus on comparing the birthing experiences in Somalia to birthing experiences in the U.S. in order to describe the extent refugee women understand U.S. labor and delivery practices. It will report on the women's perceptions of medical interventions, specifically cesarean sections. The role of religious and cultural beliefs as they pertain to reproductive health needs will be explored, as will the effect of past traumatic experiences.

Conclusions: We anticipate the results to suggest that Western contemporary intervention oriented approaches may not be appropriate for this population. Refugee women may prefer a model of labor and delivery that more closely mirrors native experiences

Learning Objectives:
1. Compare refugee patients birthing experiences in Somalia to their birthing experiences in the United States. 2. Describe the attitudes, beliefs and perceptions refugee patients have towards U.S. labor and delivery practices as well as medical procedures and interventions. 3. Identify ways to improve obstetrical care to better meet the needs of refugee patients.

Keywords: Refugees, Reproductive Health Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a student, I am working on this study to gain experience in qualitative research methods. I assisted with the development of the interview guide and conducted interviews with study participants. I will assist in the analysis and interpretation of the data and with writing the paper. I prepared this abstract as well.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.