Migrant women suffer more foetal losses and face lack of cultural understanding

Thuraya still recalls the day when she was at Mater Dei Hospital about to give birth in 2016.

“A lot of the doctors were nice, but then there were some nurses who told me to stop praying, while I was going into labour. I said I’m praying because I’m in pain, but they didn’t understand,” Thuraya, a Libyan national told Times of Malta.

A new clinic opened this week in an effort to improve the pregnancy success rate among immigrants.

According to hospital CEO, Ivan Falzon, migrant women suffer more foetal losses than Maltese women do, which can be attributed to missed antenatal visits.

However, whether or not this warrants separating migrant and local women is a matter of contention.

Culturally-sensitive healthcare

Thuraya told Times of Malta that a migrant maternity clinic with understanding and culturally sensitive staff would be extremely welcome.

While Thuraya can communicate in Maltese, she still wishes that she was given the choice of having a cultural mediator present when she gave birth to her son in 2016.

I said I’m praying because I’m in pain, but they didn’t understand

While Libyan, Eritrean and Somali cultural mediators are currently present on certain days at Mater Dei, they are not on call for emergencies.

The most important thing about this maternity clinic, according to Thuriya, is that women are met with people who understand their culture.

“There are a lot of things that are different about the way we do things. In Libya, women are seen to by only female doctors. Here, sometimes it is not always possible to do that.”

Jamila from Somalia, who gave birth to her son prematurely a year ago, feels it would not help to have a separate migrant maternity clinic.

“I believe it is important to feel we are part of the community. I got a great deal of attention and was very well looked after.”

While she had no need for an interpreter since her husband speaks English well, she did run into a few difficulties based on cultural differences.

“One of the problems was giving the baby a family name. The staff at Mater Dei said it was a law to give the baby your family name, but we don’t do that in Somalia,” she explained.

In the eyes of the Maltese public, it could come across as migrants getting ‘extra rights

These difficulties were minor however, and she and her husband managed to overcome them.

They were especially grateful for the kindness that the staff at Mater Dei showed to them during such a challenging time.

Migrant maternal health lacking

Diana Tudorancea, a counsellor and academic who has been treating mental health issues in open centres, agrees with Mr Falzon that maternal health among asylum seekers is lacking.

The journey asylum seekers are forced to embark on and acts of sexual and gender based violence they may endure can cause significant health issues among expecting mothers.

In addition to this, a lack of experience with antenatal care in the country of origin, communication difficulties and overall mistrust in the system all put a dent in women’s antenatal care, said Ms Tudorancea.

Asked whether she viewed the migrant maternity clinic as a positive development, she said it depended on what services would be offered by the clinic.

“If it means allocating certain hours to trained specialists, and developing outreach programmes with paid interpreters, then that’s a brilliant idea,” she said.

Specialised physicians, trained interpreters and good outreach programmes are definitely needed

However, pushing the idea of separation too extremely would also have “a very segregationist ring to it that cannot be good”, she countered.

In addition to that, she said, in the eyes of the Maltese public, it could come across as migrants getting “extra rights” which fuels an ultra-right rhetoric.

In Ms Tudorancea’s view, services can be a platform for inclusion and integration.

“Specialised physicians, trained interpreters and good outreach programmes are definitely needed, to provide multi language, culturally competent care.”

Otherwise, however, while it may make sense logistically to people in separate rooms and may and can come from a good place, it can be very counterproductive, she explained.

Questions on the type of services the new migrant maternity clinic will offer its clients went unanswered by the Health Ministry.

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