Striving for excellence in maternity care: The Maternity Stream of the City of Sanctuary
Asylum-seeking and refugee (AS&R) women living in the UK often have complex health and social care needs, with poor underlying mental and physical health and an increased risk of negative pregnancy outcomes. Despite this, AS&R women are less likely to attend for timely maternity care and when they do, care may be poor, with staff not understanding their specific needs and displaying poor attitudes. This article discusses the Maternity Stream of the City of Sanctuary and how this charity aims to work with statutory and voluntary sector maternity-related services and groups to develop services that are inclusive for AS&R women and meet their specific needs. Volunteer AS&R women are central to the activities of the Maternity Stream and this article discusses how they engage with midwives and other maternity workers to facilitate the development of services that may ultimately improve pregnancy outcomes for AS&R women.
Asylum seekers are people who have fled their home country due to a fear of being persecuted, and are awaiting a decision as to whether their asylum claim is accepted by the government of the country they have fled to. Refugees have had their claim accepted and are allowed to remain in the country, either temporarily or permanently (UN High Commissioner for Refugees (UNHCR), 2015). Asylum seekers and refugees (AS&R) living in the UK often have complex health and social care needs (Burnett and Fassil, 2004). On arrival in the UK, they may have poor underlying physical and mental health, which can deteriorate further due to living in poverty and experiencing social isolation (Aspinall and Watters, 2010). This can be exacerbated in pregnant women, who may experience pregnancy complications in addition to their existing poor health. Although there is a dearth of data specifically on AS&R women, migrant women are at a disproportionately increased risk of a negative pregnancy outcomes including low birth weight, preterm birth, and perinatal and maternal mortality (Lewis, 2007; Bollini et al, 2009; National Institute for Health and Care Excellence (NICE), 2010; Centre for Maternal and Child Enquiries (CMACE), 2011). Black women in the UK, including AS&R women, are four times more likely to die in childbirth than White women (CMACE, 2011; Lewis, 2007).
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