Giving Birth in a Foreign Land: Exploring the Maternal Healthcare Experiences of Zimbabwean Migrant Women Living in Johannesburg, South Africa

Abstract

Maternal mortality in South Africa is unacceptably high, and interventions to address this are urgently needed. Whilst urban centres, such as Johannesburg, are home to significant numbers of non-national migrant women, little is known about their maternal healthcare experiences. In order to inform future research, an exploratory study investigating the maternal healthcare and help-seeking experiences of migrant women living in inner-city Johannesburg was undertaken. Intersections between migration, maternal health and life in the city were explored through semi-structured interviews with 15 Zimbabwean women who had engaged with the public healthcare system in Johannesburg during pregnancy and childbirth. Interviews were dominated by reports of verbal abuse from healthcare providers and delays in receiving careparticularly at the time of delivery. Participants attributed these experiences to their use of English-rather than other South African languages; further work comparing this with the experiences of nationals is required. Beyond the healthcare system, the study suggests that the well-being of these migrant women is compromised by their living and working conditions in the city: maintaining access to income-generating activities is prioritised over accessing antenatal care services. Migrant Zimbabwean women make use of their religious and social networks in the city to inform help-seeking decisions during pregnancy and delivery. Improving the maternal healthcare experiences of urban migrant women should contribute to reducing maternal mortality in South Africa. Further research is required to inform interventions to improve the maternal health of migrant women in the city, including the multiple determinants of urban health that operate outside the biomedical healthcare system.

Infant feeding practices in Soweto, South Africa: Implications for healthcare providers

“…Nationality was recorded, as discriminatory policies and practices against migrants have been noted. [15] Participants also were asked about breastfeeding promotion in relation to media. Descriptive analysis was conducted on all outcome, explanatory and confounding variables, followed by bivariate analysis to shortlist variables for inclusion in regression analysis, using t-test, χ 2 and Wald test statistics, with a cut-off of p<0.20.…”

Refusing cesarean sections to protect fertile futures:

“…Unlike contexts in which migrants are framed as a drain on health services (Goldade 2011;Makandwa and Vearey 2017;Willen 2012), Somalis were economically contributing to a plethora of clinics, pharmacies, and hospitals. Their roles as patient-consumers of medical services allowed them to circumnavigate the surveillance and management that is usually a mainstay of obstetric care.…”

After the handover: Exploring MSF’s role in the provision of health care to migrant farm workers in Musina, South Africa

“…Migrants, both cross-border and internal, face barriers to care, as systems do not take into account their mobility and temporary nature of residence, including the need for patients to be able to access medication, particularly chronic medication, as they move for work, due to ill-health, or simply return home for Christmas (Vearey et al, 2017). For cross-border migrants, access can be further undermined by their treatment at the hands of frontline staff at health care facilities, who often deny or delay care to foreign patients, verbally abuse and incorrectly charge them (Makandwa & Vearey, 2017; Vearey, 2014).…”