Date of Defense:
May 11, 2011
Somalia has been in political turmoil since 1991, resulting in a wide-cast Somali diaspora of immigrants in Europe, Australia, Canada, and the United States. Many host countries have experienced cross-cultural health-care challenges integrating standard medical care of women, including pregnancy, labor, and delivery, with traditional Somali traditions and expectations. A Pubmed search of articles that elicited the perspectives of Somali immigrant women on prenatal care in a variety of host countries was conducted.
Themes common to women in all parts of the world included a perceived lack of knowledge about routine interventions including fetal heart monitoring, induction of labor, pain control in labor and cesarean sections; mistrust of provider’s ability to appropriately manage infibulations in labor; fear of cesarean sections; and significant feelings of isolation, loneliness and fear.
Recommendations to improve care for immigrant women include using trained interpreters or doulas, providing more information about what to expect at the hospital in advance of active labor, educating pregnant women about common problems in pregnancy and what interventions might be recommended; providing information in oral formats rather than written; including the woman’s partner in educational sessions; and learning how to manage a circumcised woman in labor. The particular challenges of providing safe, effective and culturally appropriate care to Somali women highlights a number of social issues including health care disparity; the local impact of international events and geopolitical upheaval; and the difficulty of integrating and honoring different religious, political and cultural practices of new immigrants into an established dominant culture.