Aims

The aim is to conduct a qualitative study of the cultural and social differences in the pregnancy and childbirth of Somali health workers in the UK and to find out if a different approach is needed towards Somali women or other ethnic minority groups.

Methodology

The study used in-depth individual interviews with eight Somali women, ranged between 23 to 57 years old, who had worked in the health sector in the UK and/or in Somalia. Six of the eight women had given birth in the UK and they were all able to provide perspective as a health professional and as a mother. The study was conducted in London where all the participants were currently living. The interviews were held in English except for one where an interpreter was present. There were no pre-definite research questions and more in-dept research was done on Somali culture beforehand.

Key findings

Giving birth in the UK can be a distressing experience for Somali women because of the following issues:

The midwives and doctors were not familiar with and had not received training about Female Genital Mutilation [FGM], a practise which 95% of Somali women and 80% of Somali women in the UK have undergone.

There were communication barriers such as the use of ‘complicated language' and medical terminology, the lack of conversation between the staff and the patients and also the absence of physical contact and empathy e.g. gesturing, touching or truly listening to the patient. The lack of one permanent contact point was also confusing and lead to distrust and unfamiliarity. The importance of the Somalian ‘Oral culture' was not acknowledged.

The Somali women also found that they were being stereotyped by the health professionals and that some even held negative attitudes towards them.

Another important finding was the consequences and pressures of being a refugee. Isolation and depression, lack of family support, marriage failures and insecurity of personal identity are all feelings that arise because of their migration status.

Conclusions

The study showed a great consistency in the eight conducted interviews. All Somali women had undergone major difficulties with the culture difference in the UK. The findings demonstrate that there are major concerns around the mismanagement of circumcised women, several communication aspects, the continuity of care from a single practitioner and the attitudes of the health professionals. Other ethnic minority groups may also be experiencing these difficulties. 

Recommendations

A greater knowledge of and, if necessary, training about Female Genital Mutilation [FGM] could reduce possible complications during birth and could avoid caesareans. Doctors must enquire immediately if their patient has undergone FGM. A more verbal approach should be conducted; meaning that everything must be explained to the mothers verbally rather than with flyers or reports. Also efforts to maintain the same midwife and other health personnel must be made to gain the trust of the patient. Finally, an awareness of the difficulties encountered by the mothers due to the consequences of migration may help health professionals to relate and connect better to their patients. Further research about Female Genital Mutilation [FGM] is also needed.