Background Communication and information are part of the Sexual and Reproductive Health and Rights (SRHR). Various studies show that successful communication between birthing person and health care professionals (HCP) has a positive impact on birth and lowers risk of traumatic birth experience for women. Since information and communication is a major challenge for both forced migrant women (FMW) and health workers during birth, we investigated experiences of both sides in qualitative study. Methods Qualitative interviews were conducted with 7 maternal HCPs (midwifes, physicians, social workers) and with 7 FMW 1-9 months after the birth of their child in 3 regions in Germany. The refugee sample included new mothers from 6 countries of origins, 14 languages, and an average of three years living in Germany. The interviews were analyzed via framework analysis. Results The majority of the interviewed FMW had no or little knowledge about SRHR. Good communication is one of the main factors allowing a safe and trustful environment with the birthing women. If verbal communication is not possible nonverbal communication helps to create and maintain a care relationship with the women is given. However, due to lack of staff, time and interpreters FMW with little German language proficiencies receive hardly any relevant information and had a poorer accompaniment during birth. Conclusions To provide for equity and SRHRs in maternal health and care there is an urgent need for reliable professional interpretation and easily accessible information in relevant languages material about giving birth, medical possibilities, procedures and interventions. Additionally, further training on heterogeneous needs and life contexts is necessary, to improve professional care during birth in maternity wards. HCPs 1:1 support is strongly recommended. Key messages • Information on SRHR and communication are a fundamental part of birth work and should be made possible for all women including FMW to prevent discrimination and traumatic birth experiences. • If given, 1:1 support by HCPs during birth can comensate missing communication.
Background Housing is a major social determinant and contextual factor of health. Forced migrants are restricted in their freedom of choosing and shaping their housing conditions. This qualitative study highlights the impact of housing restrictions on reproductive and maternal health from the lived experience of forced migrant women who recently gave birth to a child. Methods Qualitative problem-centered interviews were conducted with 33 refugee mothers (Mage = 31 years) 1-9 month postpartum. Interviewees came from 19 countries of origins, spoke 22 languages, and had lived in Germany for an average of three years. The mothers’ perspectives were complemented by 75 qualitative interviews with maternal health care professionals, (HCPs: midwives, gynecologists, social workers). Interview transcripts were analyzed via framework method regarding (1) type of housing: shared accommodation vs. private apartment, (2) region: rural vs. urban, (3) exhausting and supporting conditions as well as (4) consequences on maternal health. Results Interviewees living in shared accommodations reported exhausting conditions hindering self-determined upbringing of their newborn, e.g., confined living spaces, racism of staff, shared kitchen and bathrooms, lack of privacy, mobility, access to medical care, hygiene. Reported consequences on maternal health ranged from physical stress to social stress and mental stress (e.g., sleeping problems, depression, fear, worrying about health of the newborn). Interviewees living in private apartments showed higher autonomy and contentment. HCPs reported missing time and staff to provide adequate support. Conclusions Both refugee women and HCPs reported housing as main stressor during pregnancy and childbed, resulting in higher physical, social, and mental stress. Strategic social support for finding suitable private apartments for new families is needed as well as comprehensive visiting midwifery care in accommodations. Key messages • Living conditions in shared accommodations are unacceptable from a public health and human rights perspective, especially for women during pregnancy and childbed. • Negative effects on maternal health and self-determination of families were shown.
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