Maternal health care for refugee women - A qualitative review

OBJECTIVE: The number of forced migrants increased worldwide, while pregnant refugee women are considered a vulnerable group, concerning their physical and mental health. How do maternal health care professionals manage their maternal health care? The aim is to review the current evidence regarding the interaction between migrant refugee women and professionals in maternal health care provision after resettlement and in high-income host countries. DESIGN: We conducted a systematic qualitative review and searched the databases PubMed (MEDLINE); CINAHL; PSYNDEX, PsycINFO and Cochrane Library. Studies were judged for eligibility: a study had to address maternal health care provision for asylum seeking refugee (and migrant) women. FINDINGS: 16 primary studies were included. Heterogeneity of the included studies exists regarding e.g. origin of the women, reasons for migration and receiving country. Nevertheless, synthesis provides valuable information on challenges and chances within interactions in maternal health care for asylum seeking refugee (and migrant) women: Finding one's way in the unknown health care system is a barrier for women, which professionals meet by informing the women and coordinating their care. The perceived diversity of women may lead to conflicts in care. While some studies recommend "cultural recipes", others emphasize the individuality of women and prefer holistic care approaches. KEY CONCLUSIONS: Maternal health care professionals face different barriers when providing maternal health care to refugee (and migrant) women such as communication barriers, coordinating care and handling women's diversity. IMPLICATIONS FOR PRACTICE: Initiating and enhancing public health activities such as training courses for professionals that convey general principles such as woman-centered care or communication techniques are valuable opportunities to improve asylum seeking refugee (and migrant) women's maternal health care.