Pregnancy, prenatal care, and delivery perceptions and beliefs of resettled African refugee women in the western US

Background: Thousands of African refugee women are resettled in the US each year, yet little research has been done to assess their decision-making in regards to pregnancy and delivery. We investigated knowledge, beliefs, and perceptions that might encourage/discourage the use of prenatal care services among African refugee women from a variety of nationalities and cultures resettled to the western US. This information can inform future interventions and mollify chief barriers to appropriate pregnancy care and birthing decisions. Methodology: Participants had at least one child and/or were pregnant. Interviewees had at least one birth in Africa and in US. A mixed-method approach resulted in the collection of 103 comprehensive surveys and 23 in-depth interviews from women representing 14 African countries. Quantitative and qualitative analyses were utilized. Results: Participants delayed prenatal care until the second or third trimester. The majority of the women reported cultural (29.3%), specifically female genital cutting (FGC), transport (32.6%), and language challenges (45.7%). FGC proved a major factor in delaying prenatal care due to feelings of embarrassment and conflict in birthing choices. Participants desired more education on reproductive anatomy with respect to cultural influence, stages of pregnancy, and nutritional needs of the baby and mother. Conclusions: The need for enhanced education and distribution of information on pregnancy to this group is recommended in a culturally appropriate manner. Further research is needed to address FGC and the potential need for enhanced education of healthcare personnel as they interact with this demographic relative to pregnancy care and birthing decisions.