Immigrant Women and Health Services in Pregnancy

Blog by Catalina C.

“Before coming to this country, I tried to get pregnant many times, but it just didn´t happened. After a year in Finland, I became pregnant, and I was the happiest I have ever been. Because we are not Finnish and we don´t have close Finnish friends, we didn’t know what to do or where to go, so I went to my health station and asked there. The person in the reception did not speak English very well, so she had to ask a nurse to come and help.”

“She told me to go in an app and make an appointment, so a doctor could order the tests and send me to the clinic if it was needed. The first time I went to the doctor he didn´t asked much information, I had many questions and fears because of my previous experiences, and I tried to ask, but he only ask standard questions and told me I needed to go and do some test. I asked for directions and more information about what came after the test and he said, we will see later, and he said goodbye.”

“After the test results, I had another appointment with a different doctor. During the appointment, she told me the result came back positive and I was pregnant, so I started to cry, it was a happy moment for me. She looked at me and didn´t even asked why I was crying, she just continued to look at the computer writing something down there. I tried to compose myself and started to tell her my story and why I was crying, but she stopped me and asked me questions related to my health and my partner’s health.

“After some minutes of questions, she told me I was going to be sent to a special unit where they have specialized care for pregnant people, I thought to myself, finally I will have my own OBGYN. When attending the new clinic, I had four different doctors during my whole pregnancy, and during the delivery process I had one doctor that I had never seen before who did not even ask my husband for his name.”

“Throughout the different appointments I thought my mental health was rarely considered, and I didn´t have the chance to see a psychologist or anything like it, they did offer a support group for immigrant women who were pregnant or had just had their babies. I felt on many occasions the fact that we are not Finnish people, even when feeling I really needed the support, especially because we are alone in this country.”

”When talking with professionals some weird questions came along, like if I had any rituals that I expected to do during labor, so I asked, like what? They responded that they did not know, but many of the things that you do in your country you will not be able to do here, we have very strict protocols for your safety and the safety of your child. I didn’t replay to this, I did not know how, because I really didn´t understand what this person meant by that question, so I just stayed quiet and ashamed, but I still don’t know why I felt shame.”

This story is based on the experiences of four different women with different immigrant background, skin color and mother tongue, and even though they haven’t met each other, there are several similarities in their stories. 

The Universal Declaration of Human Rights recognizes that every person has the right to health and wellbeing, specially to medical assistance and specifies that motherhood is among the moments of life that requires special care and assistance (United Nations 2023).

Thus, the international declarations and conventions recognize that when pregnant, people are at such stage in their lives that is particularly sensitive and requires specialized care.

Furthermore, the World Health Organization (2023) states that the principle of Acceptability, meaning that health facilities, goods and services should be medically and ethically respectful and culturally appropriate, and sensitive to the needs of each sex and life cycle stage, should be present in any policy or strategy that aims to develop a health approach based on human rights. 

There is a specific kind of phenomenon that has been studied that occurs when medical practitioners who provide care for pregnant people don´t provide services guided by the human rights principle. 

Obstetric violence refers to the practices and conducts of professionals of the field of health that by omission, or active actions are violent or can be perceived as violent, by the people who are in their care (pregnant, in labor our in post-partum) (Rodriguez & Martinez 2022). This practice can also include impropriated acts and nonconsensual acts and physiological violence (Rodriguez & Martinez 2022). 

According to this categorization, one could say that even without being aware, the professionals that have cared for the people in the above-mentioned story have engaged in conducts that could be labeled in the spectrum of obstetric violence. 

When these experiences are also analyzed through the lens of migration, these actions can feel even more disruptive, as the people who have been affected by them are in a more vulnerable position, and the ramifications can have even deeper consequences. 

Having experiences like the ones described above remind of the importance of trainings like the one offered by The Finnish Institute for Health and Welfare, namely “Anti-racism for professionals”. 

Such education is relevant when trying to eradicate racism and discrimination against immigrants. It allows the professionals to become more aware of the struggles of migrants but also reflects on their own actions and the services they provide.

Sources:

Rodríguez, J., & Martínez, A. 2022. La violencia obstétrica: una práctica invisibilizada en la atención médica en España. Gaceta sanitaria, 35, 211-212. https://scielo.isciii.es/pdf/gs/v35n3/0213-9111-gs-35-03-211.pdf

United Nations, Universal Declaration of Human Rights. https://www.un.org/es/about-us/universal-declaration-of-human-rights

World Health organization. https://www.who.int/es/newsroom/fact-sheets/detail/human-rights-and-health

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