Abstract
BackgroundViolence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence.MethodsQualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis.ResultsThe midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women’s’ strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman’s access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women.ConclusionFocus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives’ ability to identify Somali born woman’s resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the midwife can be a bridge and contribute to increased awareness of rights and support for Somali-born women in a new society.
Highlights
Violence against women is associated with serious health problems, including adverse maternal and child health
The motivation for including routine questions about violence in health care visits is based on scientific evidence indicating that violence against women is associated with serious health problems, such as adverse maternal and child health [4,5]
Approaching violence in the care encounter The first theme highlighted three components of importance for the midwives when approaching the issue of violence in their care encounter with Somali born women
Summary
Violence against women is associated with serious health problems, including adverse maternal and child health. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. The aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence. There are increasing recommendations to include routine questions about exposure to violence during health care visits, both in Sweden and internationally [1]. The motivation for including routine questions about violence in health care visits is based on scientific evidence indicating that violence against women is associated with serious health problems, such as adverse maternal and child health [4,5]. Violence is associated with stigma worldwide and through asking questions within the health care system, society makes the public health problem visible, signals that violence is unacceptable, and that support can be offered [13]
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