International Journal of Nursing Studies
Volume 90, 2019, Pages 31-45

Refugee women's experiences negotiating motherhood and maternity care in a new country: A meta-ethnographic review (Review)

Pangas J. , Ogunsiji O. , Elmir R. , Raman S. , Liamputtong P. , Burns E. , Dahlen H.G. , Schmied V.*
  • a School of Nursing and Midwifery, Western Sydney UniversityNSW, Australia
  • b School of Nursing and Midwifery, Western Sydney UniversityNSW, Australia
  • c School of Nursing and Midwifery, Western Sydney UniversityNSW, Australia, Ingham Institute for health and Medical research, Liverpool, NSW, Australia
  • d Community Paediatrics, South Western Sydney Local Health District, Sydney, Australia, School of Community Health, University of New South Wales, Australia
  • e School of Science and Health, Western Sydney UniversityNSW, Australia
  • f School of Nursing and Midwifery, Western Sydney UniversityNSW, Australia
  • g School of Nursing and Midwifery, Western Sydney UniversityNSW, Australia, Ingham Institute for health and Medical research, Liverpool, NSW, Australia
  • h School of Nursing and Midwifery, Western Sydney UniversityNSW, Australia, Maternal and Infant Nutrition and Nurture Unit, School of Community Health and Midwifery, University of Central Lancashire, United Kingdom

Abstract

Objectives: The aim of this meta-ethnographic review was to examine refugee women's experiences negotiating motherhood and maternity services in a new country with a view to identifying the specific needs of refugee women accessing maternity care in high income countries. Design: A meta-ethnographic synthesis of qualitative research. Data sources: Five databases were searched for papers published in English between January 2000 and January 2017. Review methods: The synthesis process was guided by the seven steps of meta-ethnography. The quality of included studies was assessed using the COREQ tool. Results: One overarching theme and three major themes emerged from the synthesis. The overarching theme “Living between two cultures” conveyed women's experience of feeling “in between” cultures and described refugee women's experience of striving to maintain a strong cultural identity from their country of origin while simultaneously adapting to their new context and country. This theme permeated the following three major themes: 1) “Constructing maternal identity across cultures” which discusses the cultural conflict experienced by refugees accessing maternity services in their host country; 2) “Understanding in practice” which describes reciprocal issues in communication between women and health professionals; and 3) “Negotiating care” which illustrates a mix of coping mechanisms which refugee women utilise to navigate health services in the context of high income countries. Conclusion: Liminality is a ubiquitous experience for refugee women seeking maternity care in high income countries. It impacts feelings of belonging and connection to services and society. It is often a challenging experience for many women and a time in which they reformulate their identity as a citizen and a mother. This review found that the experience of liminality could be perpetuated by social factors, and inequality of healthcare provision, where communication and cultural barriers prevented women accessing care that was equal, accessible, and meaningful. Findings revealed both positive and negative experiences with maternity care. Continuity, culturally appropriate care, and healthcare relationships played an important role in the positive experiences of women. The review also revealed the damaging effects of disparities in care experienced by refugee women. © 2018

Author Keywords

maternal health Refugee identity liminality language barriers Health services Asylum seeker reproductive health Re-traumatisation maternity Refugee Limited English proficiency

Index Keywords

maternal care human synthesis social aspect language qualitative research high income country asylum seeker case report female ethnography Review clinical article identity adult mother human experiment Reproductive Health transcultural care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058704922&doi=10.1016%2fj.ijnurstu.2018.10.005&partnerID=40&md5=d55610f192ea0d3961d7910f38fd6862
DOI: 10.1016/j.ijnurstu.2018.10.005
ISSN: 00207489
Cited by: 4
Original Language: English