Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Box 457, 405 30, Gothenburg, Sweden.
School of Psychology, Institute of Psychology, Health, and Society, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
BMC Pregnancy Childbirth. 2018 Jun 7;18(1):217. doi: 10.1186/s12884-018-1851-9.
Studies from around the world have shown that women living as undocumented migrants have limited and deficient access to perinatal care, increasing their risks of both physical and psychological complications during pregnancy and childbirth. Failures to provide equal access to healthcare have been criticized extensively by the United Nations. In 2013, undocumented migrants' rights to healthcare in Sweden were expanded to include full access to perinatal care. Research surrounding clinical encounters involving women living as undocumented migrants remains largely lacking. The present study aimed to provide a composite description of women's experiences of clinical encounters throughout pregnancy and childbirth, when living as undocumented migrants in Sweden.
Taking an inductive approach, qualitative content analysis was implemented. Thirteen women from ten different countries were interviewed. Meaning-units were extracted from the data collected in order to identify emergent overarching themes.
In clinical encounters where healthcare professionals displayed empathic concern and listening behaviours, women felt empowered, acknowledged, and encouraged, leading them to trust clinicians, diminishing fears relating to seeking healthcare services. Conversely, when neglectful behaviour on part of healthcare professionals was perceived in encounters, anxiousness and fear intensified. Vulnerability and distress induced by the women's uncertain living circumstances were apparent across themes, and appeared exacerbated by traumatic memories, difficulties in coping with motherhood, and fears of deportation.
The present study contributes unique and important knowledge surrounding women's experience of being pregnant and giving birth when living as undocumented migrants. The overarching findings indicated that the needs of undocumented migrant women were largely similar to those of all expectant mothers, but that due to vulnerabilities relating to their circumstances, flexible and informed care provision is essential. Being knowledgeable on undocumented migrants' rights to healthcare is vital, as clinical encounters appeared highly consequential to the women's well-being and help-seeking behaviours. Negative encounters inflicted emotional distress and fear. Contrastingly, positive encounters promoted trust in clinicians, personal empowerment, and relief. Positive clinical encounters could provide rare opportunities to assist an otherwise elusive population at increased risk for both physical and psychological complications, highlighting the crucial need for adherence to ethical principles in clinical practice.
世界各地的研究表明，作为无证移民的女性获得围产期护理的机会有限且不足，这增加了她们在怀孕和分娩期间出现身体和心理并发症的风险。联合国广泛批评未能平等获得医疗保健。2013 年，瑞典将无证移民获得医疗保健的权利扩大到包括全面获得围产期护理。关于涉及无证移民女性的临床接触的研究仍然很大程度上缺乏。本研究旨在提供在瑞典作为无证移民的女性在整个怀孕和分娩期间的临床接触经历的综合描述。
采用归纳法，实施了定性内容分析。来自十个不同国家的 13 名女性接受了采访。从收集的数据中提取出意义单位，以确定出现的总体主题。
在医疗保健专业人员表现出同理心和倾听行为的临床接触中，女性感到被赋予权力、被认可和受到鼓励，从而信任临床医生，减少对寻求医疗服务的恐惧。相反，当在接触中感知到医疗保健专业人员的疏忽行为时，焦虑和恐惧加剧。在主题中明显出现了女性不确定的生活环境所带来的脆弱性和困扰，并且由于创伤记忆、应对母亲身份的困难以及对驱逐出境的恐惧而加剧。
本研究提供了有关作为无证移民的女性怀孕和分娩经历的独特而重要的知识。总体发现表明，无证移民女性的需求与所有孕妇的需求大致相似，但由于与她们的处境相关的脆弱性，灵活和知情的护理提供至关重要。了解无证移民获得医疗保健的权利至关重要，因为临床接触对女性的幸福感和寻求帮助的行为具有高度的决定性。负面接触会造成情绪困扰和恐惧。相比之下，积极的接触会促进对临床医生的信任、个人赋权和缓解。积极的临床接触可以为那些面临身体和心理并发症风险增加的难以捉摸的人群提供难得的帮助机会，突出了在临床实践中遵守伦理原则的迫切需要。
