Maternal care in special situations

Maternal mortality in Europe is less of an issue than in the developing countries. But even in Europe, too many women die during pregnancy and/or childbirth, and there are significant differences in mortality rates between countries. Currently, a very large number of people are seeking refuge and/or asylum, including an increasing proportion of pregnant women and infants in need of health services, and it is important that we ensure they receive the appropriate care.

Refugee and migrant groups

A recent report by the United Nations Refugee Agency, United Nations Population Fund and Women’s Refugee Commission confirm that women and girl refugees and migrants in Europe face serious protection risks and that the response by government agencies, humanitarian actors and civil society organisations are inadequate.

Many pregnant women have suffered severe physical and psychological stress, and are at higher risk of complications, preterm delivery or even death. Even when medical services are available, pregnant and breastfeeding women are reluctant to access health services, as they do not wish to delay their journey and that of their families.

Accessing appropriate care among refugees and migrants can be challenging for the following reasons:

1. Language barriers and cultural differences
2. A lack of legal status can impact the mental and physical health of undocumented migrants. Increased stress and isolation can be detrimental to their wellbeing
3. Non-status migrant women often face additional barriers in seeking access to the limited healthcare available to non-status people
4. Women who experienced violence are less likely to come forward to report instances of abuse or seek treatment for the resulting injuries
5. Non-status women facing domestic violence are less likely to seek medical care following abuse due to fear of disclosing status and deportation
6. Many abused pregnant women without status do not seek out prenatal care and only go to the hospital for emergency situations or to deliver
7. There is little access to medication or continuing medical services for non-status women and their children
8. For women who are raped and experienced forced pregnancies, there are few (if any) options to access abortions
9. Survivors of gender based violence, such as women who have experienced torture, human trafficking, or female genital mutilation, often go without the required specialized services and care due to their lack of status
10. Women who have gone through traumatic experiences require specialized and culturally sensitive services, which may not be readily available

Getting support if you are a refugee or migrant

Sources: https://www.unhcr.org/protection/operations/569f8f419/initial-assessment-report-protection-risks-women-girls-european-refugee.html
https://www.europeristat.com/
https://www.wma.net/en/30publications/10policies/30council/cr_32/index.html
https://migrantmothersprojectsymposium.weebly.com/access-to-health-care.html

Pregnancy and disabilities

Women and parents with disabilities face particular challenges during pregnancy. Parents express frustration at a lack of information, lack of continuity of care and not feeling that their individual needs are fully understood and addressed by healthcare providers.

Charities such as Disability, Pregnancy and Parenthood international (DPPi) can be a good source for information and support during the pregnancy experience. The DPPi website provides extensive information by stage of parenthood, specific challenges addressed and by type of disability. The website also provides a section specifically providing help for professionals. Parents can also ask questions to the community, and browse existing answers.

Sources: https://www.theguardian.com/society/2010/nov/23/challenges-disability-pregnancy
https://disabledparent.org.uk/