"We were left to our own devices": Midwives' experiences of providing maternity care to Ukrainian women in Poland after the outbreak of the full-scale war in Ukraine.

BACKGROUND: After the outbreak of the full-scale war in Ukraine, about 2 million people sought protection in Poland. Providing high-quality care for migrants and refugees, especially in times of significant arrivals, can be particularly challenging. AIM: To learn about the experiences and strategies of midwives providing maternity care to Ukrainian migrant women in Poland after the outbreak of the full-scale war in Ukraine. METHODS: Five focus group interviews with 32 midwives providing maternity care in Poland were conducted. The interviews were thematically analysed. RESULTS: We identified the barriers experienced by midwives in providing high quality care to migrants to be mainly on the individual and interpersonal levels and levels of management and organization. First, at the individual and interpersonal level, we have identified: fear for life and well-being related to the threat of war in a neighbouring country, depleting resources and post-pandemic fatigue, language barriers, lack of knowledge on caring for women fleeing war. Second, at the management and organizational level we have identified: lack of organizational support, and interpreting services. In the first months after the outbreak of the full-scale war in Ukraine, most strategies to improve the provision of maternity care for women fleeing the war took the form of grassroots initiatives by the staff of individual care units. CONCLUSIONS: The Polish health care services need systemic solutions prepared jointly by state and local authorities and taking into account the voices of midwives to support the provision of high-quality care to migrant population.

Challenges to medical ethics in the context of detention and deportation: Insights from a French postcolonial department in the Indian Ocean.

Owing to a growing policing of borders, healthcare professionals become increasingly involved in the biopolitical management of migrants' mobility. While their presence on sites of migration control and detention is necessary to ensure migrants' access to healthcare, their role risks being instrumentalized to ensure the sustainability of detention and swiftness of deportations. This article analyses the practice and ethics of midwives' medical expertise in processes of migration control in the French overseas department of Mayotte in the Indian Ocean. Midwives in this setting are required to assess the health of pregnant women intercepted at sea by the police in order to determine whether they can be detained. The article traces how midwives come to be invested with a power to police patients' mobility. In the face of such unwelcome responsibilities, midwives resorted to emotional distancing while suspicion on both sides impeded the possibility of genuine relations of care. The article analyses how midwives framed the ethical dilemmas at hand and examines how they perceived their decision-making responsibility. I argue that midwives are socialized into the logics of border enforcement and gradually brought to implement a minimal version of care as a result of migration control's inroads into care. The article thus questions the function and meaning of biopolitics within migration control and aims at initiating a conversation around the necessary conditions for ensuring medical personnel's independence in these extraordinary care settings. The article draws on a three-months fieldwork completed in Mayotte between mid-April and mid-July 2017 during which I conducted 40 interviews with healthcare professionals in perinatal health services and 15 interviews with officers from stakeholder organizations, from local and international NGOs to health institutions. This article draws in particular on interviews with the medical team that was required to attend to migrant women intercepted at sea by the police.

Shifting vulnerabilities: gender and reproductive care on the migrant trail to Europe.

The reproductive care of pregnant migrants entering the European Union via its Mediterranean borders represents an under-examined topic, despite a growing scholarly emphasis on female migrants and the gendered aspects of migration in the past three decades. This article uses ethnographic data gathered in Greece, Italy, and Spain to examine pregnant migrants' experiences of crossing, first reception, and reproductive care. We discuss our findings through the conceptual lens of vulnerability, which we understand as a shifting and relational condition attributed to, or dynamically endorsed by, migrant patients within given social contexts and encounters. We focus on two principal aspects of migrant women's experiences. First, we shed light on their profiles, their journeys to Europe via the three main Mediterranean routes, and the conditions of first reception. Through ethnographic vignettes we examine the diverse ways in which pregnant migrants become vulnerable within these contexts. Second, we turn to the reproductive healthcare they receive in EU borderlands. We explore how declinations of ideas of vulnerability shape the medical encounter between healthcare professionals and migrant women and how vulnerability is dynamically used or contested by migrant patients to engage in meaningful social relations in unpredictable and unstable borderlands.