Background: Illegal migration is an increasing problem worldwide and the so-called undocumented migrants encounter major problems in access to prevention and health care. The objective of the study was to compare the use of preventive measures and pregnancy care of undocumented pregnant migrants with those of women from the general population of Geneva, Switzerland.
The objective of this work was to review published articles on the impact of perinatal stress on mothers' medium- or long-term psychological health and the efficacy of coping strategies, to determine if social support plays a role in the interaction between birth events and mothers' psychological experiences, and to identify the tools used for these measurements. MEDLINE, PsycINFO, and CINAHL databases were searched for English and French language articles from 2000 through 2010 inclusive. Thirty-seven articles fulfilled the selection criteria. The results of this review highlight an association between perceived stress and postpartum depressive symptoms. However, because perceived stress has been evaluated in a general manner, it was not possible to identify events having more or less relation to postpartum depressive symptoms in mothers. Social support also appeared to be related to mothers' psychological health. Coping strategies were difficult to analyze because of the lack of homogeneity in their definition across studies. The comparison among studies of social support and coping strategies was also difficult due to the diversity of tools used and their lack of specificity. New tools should be specifically developed for the perinatal period, and further research should be performed to understand better the events and adequacy of social support.
Background
Migrant mothers in high-income countries often encounter more complications during pregnancy, delivery, and the postpartum period. To enlighten health care providers concerning potential barriers, the objective of this study was to explore positive and negative experiences with maternal health services in the University Hospitals of Geneva and Zurich and to describe barriers to maternity services from a qualitative perspective.
Methods
In this qualitative study, six focus groups (FGs) were conducted involving 33 women aged 21 to 40 years. All FG discussions were audio-recorded and later transcribed. Data were analysed using a thematic analysis approach assisted by the Atlas.ti qualitative data management software.
Results
Positive experiences included not only the availability of maternity services, especially during emergency situations and the postpartum period, but also the availability of specific maternity services for undocumented migrants in Geneva.
Negative experiences were classified into either personal or structural barriers. On the personal level, the main barriers were a lack of social support and a lack of health literacy, whereas the main themes on the structural level were language barriers and a lack of information.
Conclusion
Structural adaptation is necessary to meet the needs of the extremely diverse population. The needs include (1) the provision of specific information for migrant women in multiple languages, (2) the availability of trained interpreters who are easily accessible to health care providers, (3) specifically trained nurses or social assistance providers to guide migrants through the health system, and (4) a cultural competence-training programme for health care providers.
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