Understanding Afghan Refugee Experiences With Obstetrical Care: A Qualitative Study [ID: 1381425

Abstract

INTRODUCTION: Providing equitable maternal care to refugees is a challenging task for hosting countries because of differences in personal experiences and health care systems. It is important to understand these unique needs because of the increased risk of poor pregnancy and birth outcomes for refugee patients. The aim of this study was to explore the experiences of obstetrical care among Afghan refugees in their native countries to mitigate that risk. METHODS: A qualitative study was conducted of 10 Afghan women. Institutional review board approval was obtained (UMKC #2092624). Face-to-face, semistructured, and in-depth interviews were conducted with certified interpreters. Interviews were analyzed using a thematic analytical method. RESULTS: All study participants were recent migrants within the past 6 months with no prior care within the U.S. health care system. Patients were pregnant in their second (n=8) or third trimester (n=2). Two were nulliparous. Three major themes were identified: insufficient prenatal and postpartum care, inadequate information, and decreased social support. None of the participants had regular prenatal care, ultrasounds, or labs. Most of the women (n=8) had previously delivered in a hospital, although they noted several differences: lack of private delivery rooms, fetal monitoring, and support during the process. There was no consent process, and the women were unaware of indications for delivery or cesarean delivery. CONCLUSION: With better understanding of the background and experiences of Afghan refugee patients, we can develop strategies to improve obstetric care and outcomes. This includes educational efforts geared towards introducing these women to a new health care model that closes the gaps they previously experienced.