The experiences of pregnancy and NHS maternity care for women who have been trafficked: A qualitative study.

PROBLEM: Little is known about the maternity experiences of women who have been trafficked and further investigation is needed to better inform midwifery practice and to ensure that the voices of women are heard when developing guidance. BACKGROUND: People who have been trafficked experience a range of health problems that could impact on pregnancy. AIM: The aim of this study was to explore the experiences of pregnancy and NHS maternity care for women who have been trafficked, as well as increasing understanding of social and health factors that may impact on pregnancy outcomes. METHODS: A qualitative interview study was conducted. Participants (professionals and service users) were recruited using purposive sampling. Data were analysed using thematic analysis. FINDINGS: Seventeen interviews were conducted (5 service users and 12 professionals). Five themes were identified: 'One Size Fits All', 'Loss of Control', 'Social Complexity', 'Bridging Gaps', and 'Emotional Load'. DISCUSSION: Our findings identify that women are expected to fit into a standardised model of maternity care that does not always recognise their complex individual physical, emotional or social needs, or provide them with control. Support workers play a vital role in helping women navigate and make sense of their maternity care. CONCLUSION: Despite the issues identified, our research highlighted the positive impact of individualised care, particularly when women received continuity of care. A joined-up, trauma-informed approach between midwives and support workers could help improve care for women who have been trafficked.

Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors.

Postnatal depression (PND) is recognised as a common maternal health problem, but little evidence examines PND among refugee, asylum seeker and immigrant women in developed country settings. This review aimed to identify the rates of PND and highlight common risk factors among this group of women. An iterative and dynamic literature search was conducted across ten databases to identify published articles on PND among immigrant, asylum-seeking and refugee women in developed country settings. Medical Subject Headings (MeSH) and 'free text' search terms, as well as thesaurus terms, acronyms and truncation were used where appropriate. Findings suggest that PND may affect up to 42% of migrant women, compared to around 10-15% of native-born women. Common risk factors for PND among migrant women include history of stressful life events, lack of social support and cultural factors. With a growing number of babies born to immigrant mothers, greater awareness of PND among this group is needed in order to respond to their particular maternal mental health needs. Maternity care providers should regard all recent immigrants as at high risk of PND and give closer observation and support as necessary.