Antenatal care and women from refugee backgrounds

Women from refugee backgrounds may have many potentially complex medical needs. Routine antenatal screening tests should include: FBC, blood group and antibodies, ferritin, hepatitis B, TPHA, rubella, and HIV with pre-test discussion, and MSU. Offer maternal screening for chromosomal abnormalities at the correct stages of pregnancy. Many women from refugee backgrounds (McLeod & Reeve, 2005):

• Will have had little or no previous health screening, particularly cervical and breast screening.
• Will have had limited access to and knowledge of family planning services.
• Will have had limited access to sexual or reproductive health screening services.
• Will have had minimal exposure to formal antenatal care.
• May have psychosexual and psychological health issues following trauma, rape and abuse during refugee flight, and subsequently a lack of adequate follow-up care and treatment in New Zealand.
• May have difficulty accessing health care services in New Zealand due to language barriers, cultural barriers, cost and difficulties with transport.
• May experience difficulties associated with FGM and in accessing services providing appropriate rehabilitative, gynaecological and obstetric care.
• May become increasingly socially isolated due to language barriers as their families become more proficient in English.
• May have health problems due to untreated gynaecological and obstetric conditions after years in refugee camps or homelands where medical facilities were lacking.

Caring for pregnant women from refugee backgrounds

• Women may feel more comfortable with a female doctor.
• A female interpreter would be most appropriate.
• Families may face financial hardship.
• Women may have low levels of literacy (in any language).
• Women may have low health literacy.