Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, United Kingdom.
Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom.
BMC Pregnancy Childbirth. 2023 Nov 13;23(1):789. doi: 10.1186/s12884-023-06054-x.
Many women seeking asylum during pregnancy and after childbirth have ill-health but detection and assessment of all physical, psychological, and social health needs (maternal multimorbidity) are often difficult as part of routine maternity care. Healthcare providers are key for the early identification and management of vulnerable pregnant women who have additional physical, psychological, and social health needs. We sought to explore the impact of the asylum-seeking process, understanding of wellbeing, expressed health needs (in terms of maternal multimorbidity), and the experiences of maternity care of women seeking asylum during pregnancy and after childbirth in Liverpool, United Kingdom. Enabling factors and barriers to access woman-centred care were also explored.
Key informant interviews (n = 10) and one focus group discussion (n = 4) were conducted with women attending a non-profit charitable pregnancy support group. Transcribed interviews were coded by topic and then grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.
The asylum-seeking process negatively impacted women making them feel anxious and depressed with little control or choice over their future. Women reported feeling stressed regarding poor standard of accommodation, low income, dispersal and the uncertainty of their asylum application outcome. Wellbeing during pregnancy and after childbirth was understood to be multifactorial and women understood that their physical health needs were interlinked and negatively impacted by complex psychological and social factors. Women reported that their expectations of maternity services were often exceeded, but information giving, and the use of language interpreters needed to be improved. Women expressed the need for more psychological and social support throughout pregnancy and after childbirth.
A multidisciplinary team, with links and effective referral pathways to maternal mental health and social services, are necessary for women seeking asylum, to ensure a more integrated, comprehensive assessment of maternal multimorbidity and to provide maternity care in a way that meets all health needs.
许多在怀孕期间和分娩后寻求庇护的妇女健康状况不佳，但在常规产科护理中，通常难以发现和评估所有身体、心理和社会健康需求（产妇多种疾病）。医疗保健提供者是早期识别和管理有额外身体、心理和社会健康需求的脆弱孕妇的关键。我们旨在探索寻求庇护过程、对幸福感的理解、表达的健康需求（就产妇多种疾病而言）以及在利物浦寻求庇护的孕妇和分娩后妇女的产科护理体验对她们的影响。还探讨了获得以妇女为中心的护理的有利因素和障碍。
对参加非营利性怀孕支持团体的妇女进行了 10 次重点人物访谈（n=10）和一次焦点小组讨论（n=4）。对访谈记录进行了主题编码，然后分为类别。采用主题框架分析法确定了新出现的主题。
寻求庇护过程对妇女产生了负面影响，使她们感到焦虑和沮丧，对未来几乎没有控制或选择。妇女报告说，她们对住宿条件差、收入低、分散和庇护申请结果的不确定性感到压力。怀孕和分娩后的幸福感被认为是多因素的，妇女理解她们的身体健康需求相互关联，并受到复杂的心理和社会因素的负面影响。妇女报告说，她们对产科服务的期望经常超出，但需要改进信息提供和使用语言翻译。妇女表示，在怀孕期间和分娩后需要更多的心理和社会支持。
对于寻求庇护的妇女来说，需要一个多学科团队，与孕产妇心理健康和社会服务建立联系并建立有效的转介途径，以确保更全面、更综合地评估产妇多种疾病，并以满足所有健康需求的方式提供产科护理。
