Maternal mental healthcare needs of refugee women in a State Registration and Reception Centre in Germany: A descriptive study

Abstract

Pregnant refugees and new mothers are at high risk of developing mental health problems. Previous research has highlighted an increase in adverse pre‐, peri‐ and postpartum outcomes in refugee women and their newborns. This descriptive study aimed to present the characteristics and needs of refugee women who attended a psychosocial walk‐in clinic addressing pregnant refugees’ and new mothers’ maternity mental healthcare needs in a state registration and reception centre in Germany. We assessed all patients that consulted the clinic and received interventions during the first 28 weeks after it opened, collecting information on symptoms, diagnoses, attitudes towards and experience of pregnancy, birth, obstetric care and applied psychosocial interventions during consultations. Between November 2017 and May 2018, N = 120 pregnant refugees and new mothers attended the clinic. Most patients were diagnosed with post‐traumatic stress‐, adjustment‐ or depressive disorder. While 69.6% of the women reported physical and mental health problems during pregnancy, 87.4% experienced obstetric complications. Trauma‐informed and psychoeducational interventions were primarily used during counselling sessions. Our data underpin the glaring disparities in refugee maternal healthcare in Germany. Maternal care designed to meet the specific needs of pregnant refugees and mothers is essential. More targeted, evidence‐based and cost‐effective interventions are needed. Our psychosocial walk‐in clinic is a first step towards ensuring primary care delivery for refugee women during the particularly vulnerable period of pregnancy and early motherhood.

Psycho-rehabilitation adaptation of pregnant women and mothers in the postpartum period who experienced traumatic events during the war

“…When the inclusion criteria were taken into consideration, a total of 17 studies were found. Some studies shed light on the precarious situation that pregnant women find themselves in while they are migrants [22][23][24][25][26], while others emphasise the risk factors that are connected with it [11,[27][28][29][30][31][32][33]. In the context of psychological rehabilitation and adaptation for pregnant women and new moms, a number of research have proposed the application of social cognitive theory in order to adjust the participants' behaviour in the event of a dispute [34][35][36][37][38].…”

“…[ [31][32][33] Perinatal consequences such as psychological health, maternal deaths, preterm delivery, and congenital anomalies are often more severe among migrant mothers [29,30]…”

“…Not understanding the native dialect and being inexperienced with the local way of life and health practices might cause additional burdens and hazards for mental and physical health. According to systematic reviews, perinatal consequences such as psychological health, maternal deaths, preterm delivery, and congenital anomalies are often more severe among migrant mothers [29,30]. According to the findings of a research conducted in Germany, 87.4% of the pre-and postpartum migrants experienced medical difficulties or high-risk conceptions [31][32][33].…”

The impact of the war in Ukraine on the perinatal period: Perinatal mental health for refugee women (pmh-rw) protocol

“…Systematic reviews report that perinatal outcomes such as mental health, maternal mortality, preterm birth and congenital anomalies are predominantly more severe among migrant women ( Falah-Hassani et al, 2015 : Heslehurst et al, 2018 ). In a German study, 87.4% of the pre-and postpartum migrants were affected by medical complications or high-risk pregnancies ( Kaufmann et al, 2022 ). However, these studies often do not distinguish among the different statuses of migrant (refugee vs. immigrant) populations, and host countries that may significantly differ regarding the organization of access to support and health care services.…”

Maternal multimorbidity - experiences of women seeking asylum during pregnancy and after childbirth: a qualitative study

“…In addition to increased rates of maternal mortality, rates of multimorbidity, especially psychological ill-health, are high for women seeking asylum during pregnancy and after childbirth because of limited healthcare provision in their home country and/or during the migration journey [ 14 ]. An estimated 40% of refugees are affected by post-traumatic stress (PTSD), depression- and anxiety disorders and women seeking asylum during pregnancy and after childbirth are at greatest risk [ 15 ]. Furthermore, women seeking asylum have a higher risk of Caesarean birth and adverse perinatal outcomes, including pre-term delivery, low birth weight, congenital malformations and newborn morbidity and mortality [ 16 – 19 ].…”