Exploring the Healthcare Concerns of Pregnant Women and New Mothers Seeking Asylum in the UK

Problem

Women account for over a quarter of all asylum claims and the limited studies available estimate that 13% are already pregnant on arrival. Of the remainder, a large proportion are of childbearing age therefore it is not unrealistic to expect many more to become pregnant upon entering the UK. Migrant women have a greater risk of postnatal depression, pregnancy complications and both maternal and infant death when compared with native mothers. Traumatic reasons for asylum claim, language difficulties, cultural differences, and limited financial support all combine to make asylum seekers a relatively unique subset of patients posing new challenges for healthcare providers. The experiences of asylum seeker and refugee mothers are largely underrepresented in the literature, warranting further attention. This project set out to explore the healthcare concerns of this population with a focus on pregnancy and postnatal care. We aimed to assess knowledge of the services available and how to access these effectively.

Approach

Eight migrant women and three health professionals were interviewed by a single researcher. Criteria for migrant participation was residency in the UK for less than 5 years, either current pregnancy or a birth in the UK within the last 2 years, and engagement with the asylum system, at any stage. Professional participants were required to have supported someone fitting migrant criteria within the last two years. The interviews were recorded and professionally transcribed into qualitative data before undergoing thematic analysis to draw out key topics. Interpreters were used where necessary allowing participants to communicate in their chosen language.

Findings

Participants felt their health was impacted by social isolation, financial constraints and accommodation issues. Participants talked of losing their entire support network, not being able to afford to clothe their children and, in one case, being left stranded in a hotel room with a new born baby. Barriers to engagement with healthcare identified include cultural differences, language barriers and interpreter issues. Women reported having questions dismissed, feeling rushed through appointments and avoiding seeing a doctor for fear of the stress that comes with not being understood. One women was unable to report domestic violence to her GP due to their willingness to allow her husband to interpret.

Consequences

NICE guidelines in the management of postnatal depression must be updated to acknowledge migrant women as a vulnerable group. Primary care physicians must commit to adhere to guidance, use interpreters wherever necessary and allow this vulnerable group of patients to truly have their voices heard. These findings have been used to inform the creation of a charity support group for new migrant mothers; this aims to replace lost support networks, provide a platform for health education and an opportunity to practice English.