Family Planning Knowledge, Attitudes, and Practices Among Somali and Congolese Refugee Women After Resettlement to the United States

Abstract

It is crucial for refugee service providers to understand the family planning knowledge, attitudes, and practices of refugee women following third country resettlement. Using an ethnographic approach rooted in Reproductive Justice, we conducted six focus groups that included 66 resettled Somali and Congolese women in a western United States (US) metropolitan area. We analyzed data using modified grounded theory. Three themes emerged within the family planning domain: (a) concepts of family, (b) fertility management, and (c) unintended pregnancy. We contextualized these themes within existing frameworks for refugee cultural transition under the analytic paradigms of “pronatalism and stable versus evolving family structure” and “active versus passive engagement with family planning.” Provision of just and equitable family planning care to resettled refugee women requires understanding cultural relativism, social determinants of health, and how lived experiences influence family planning conceptualization. We suggest a counseling approach and provider practice recommendations based on our study findings.

Traditional Medicine and Help-Seeking Behaviors for Health Problems Among Somali Bantu Refugees Resettled in the United States

“…This study sheds light on the major role that religion and culture played in their understanding of health problems, and when certain rituals to address jinn possessions were employed. Researchers working with diverse populations of immigrants and refugees have observed across cultures the role that religion and faith play in health behavior, health understanding, and health care seeking, and the need for culturally compatible care (Herbstsomer & Stahl, 2020; Royer et al, 2020). Understanding the relevance of jinn possession to health and the complex implications on help-seeking behaviors is important to guide formal health care providers in the United States who are treating Somali Bantu patients.…”

“…Evidence suggests that after resettlement, the health needs of refugees are often unmet due in part to inadequate training of health care providers (Adams et al, 2004). Health care providers in host countries do not always feel prepared to provide health care to resettled refugee patients (Royer et al, 2020). It is imperative that practitioners provide culturally sensitive care to prevent or ameliorate health disparities based on immigration status (Brach & Fraserirector, 2000; Derose et al, 2007; Reed & Barbosa, 2016; Singh et al, 2013).…”

Evidence from a Longitudinal Photovoice and Interview Assessment with Congolese Refugee Women in the Midwestern United States

“… 7–14 However, the body of research focusing specifically on Congolese refugee women in settings in the United States is limited, with a notable gap in longitudinal evidence beyond the initial resettlement process. 6 , 11 , 15–20 …”

Exploring Black Women’s Pathways to Motherhood Within a Reproductive Justice Framework

“…Their framework includes three main tenets: (1) the right to have a child under the conditions of one’s choosing; (2) the right not to have a child by using birth control, abortion, or abstinence; and (3) the right to parent children in safe and healthy environments free from violence by individuals or the state (Ross, 2017, p. 290). This conceptualization rests on the premise that systemic inequality has shaped Black women’s decision-making around childbearing and parenting, and highlights how other identity-based and contextual factors (e.g., ability status, sexual orientation, age, carceral status, and employment status) affect women’s reproductive and family planning options (Logan et al, 2021; Royer et al, 2020). In line with the first tenet, we complicate clear-cut narratives in family planning literature that categorize pregnancies as intentional, unintentional, or mistimed by highlighting the multiplicative factors and conditions shaping Black women’s pathways to motherhood.…”