Avoiding obstetrical interventions among US-based Somali migrant women: a qualitative study

Area of Science:

• Sociology
• Public Health
• Qualitative Research

Background:

• Somali refugee women exhibit poorer health-seeking behaviors and higher adverse pregnancy outcomes than US-born women.
• Mechanisms Somali refugee women use to avoid obstetric interventions remain largely unexplored.

Purpose of the Study:

• To identify perceived protective mechanisms Somali refugee women employ to avoid obstetric interventions.
• To understand the factors influencing Somali refugee women's aversion to obstetric interventions during pregnancy and childbirth.

Main Methods:

• A descriptive, exploratory qualitative study.
• Purposive sampling and snowball technique for recruiting Somali refugee women in Franklin County, Ohio.
• Individual interviews and focus groups conducted in English and Somali, analyzed thematically.

Main Results:

• Forty Somali refugee women (aged 18-42) participated.
• Four primary avoidance mechanisms identified: misleading prenatal care, changing providers/hospitals, delayed labor arrival, and refusal of care.
• Underlying factors included fear of interventions, perceived lack of choice, cultural/religious beliefs, feeling judged, and lack of privacy.

Conclusions:

• Somali women's right to choose or refuse care must be respected.
• Improving access and experiences requires building trust, addressing fears, and respecting cultural beliefs.
• Bridging provider-patient gaps is essential for advancing health equity for this population.