Abstract
Asylum seekers have been highlighted as a particularly vulnerable group of expectant mothers due to complex medical and psychosocial needs, as well as the difficulties they may face in accessing care. Our aim was to examine if there were differences in the antenatal care and perinatal outcomes for asylum seeking women when compared to age- and ethnicity-matched controls delivering at the same hospital. Two age- and ethnicity-matched non-asylum seeking controls were identified for each asylum-seeking woman. Electronic patient records were analysed to determine the amount of antenatal care received and neonatal outcomes. Thirty-four asylum-seeking women were identified who had term born infants. The median number of antenatal care episodes at the delivering hospital was significantly fewer amongst asylum-seeking women compared to controls (three vs. nine, p<0.0001). The median number of antenatal ultrasound examinations at the delivering hospital amongst asylum-seeking women was one (IQR 1-2), compared to three (IQR 3-4) in the controls (p<0.0001). The postnatal length of stay was significantly longer for infants of asylum-seeking women (median three vs. twodays, p=0.002). Thirty-seven percent of asylum seeking women but none of the controls required assistance from social services. There was a significant correlation between antenatal and postnatal costs for asylum seeking women (r=0.373, p=0.042), but not for controls (r=0.171, p=0.181). The increased postnatal length of stay in the infants of asylum seeking mothers may reflect their mother's reduced antenatal care and hence insufficient discharge planning for mothers and infants with increased social needs.
Highlights
Asylum applications have been increasing in the UK, 35,566 applications were lodged in the UK in 2019 [1]; 24% were women [2]
Asylum seekers have been highlighted as a vulnerable group of expectant mothers due to complex medical and psychosocial needs, as well as the difficulties they may face in accessing care
Asylum seekers in the UK have been highlighted as a vulnerable group of expectant mothers due to their complex medical and psychosocial needs, as well as the difficulties they may face in accessing care [5,6,7]
Summary
Asylum applications have been increasing in the UK, 35,566 applications were lodged in the UK in 2019 (an increase of 21% from the previous year) [1]; 24% were women [2]. Asylum seekers in the UK have been highlighted as a vulnerable group of expectant mothers due to their complex medical and psychosocial needs, as well as the difficulties they may face in accessing care [5,6,7]. Asylum seeking women are eligible for free NHS maternity care [8]. In accordance with national guidance, efforts should be made to provide asylum seeking women with appropriate interpreters and ensure they understand their right to maternity care [9]. Our recently reported review [11] demonstrated that, despite better health care
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