title: Qualitative study of perinatal care experiences among Somali women and local health care professionals in Norway.
abstract: OBJECTIVE
  To explore how perinatal care practice may influence labor outcomes among circumcised women.
  
  
  METHODS
  In-depth interviews were conducted with 23 Somali immigrants and 36 Norwegian health care professionals about their experiences from antenatal care, delivery and the management of circumcision.
  
  
  RESULTS
  Circumcision was not recognized as an important delivery issue among Norwegian health care professionals and generally the topic was not addressed antenatally. The Somalis feared lack of experience and sub-optimal treatment at delivery. All of the women expressed a strong fear of cesarean section. Health care professionals were uncertain about delivery procedures for infibulated women and occasionally cesarean sections were performed in place of defibulation.
  
  
  CONCLUSIONS
  We hypothesize that neglect of circumcision may lead to adverse birth outcomes including unnecessary cesarean sections, prolonged second stage of labor and low Apgar scores. We suggest that infibulated women need a carefully planned delivery, correctly performed defibulation and adequate pain relief.
authors.affiliation: Department of Obstetrics and Gynecology, the National Hospital, and Divison of Epidemiology, Norweigian Institute of Public Health, Oslo, Norway. siri.vangen@fhi.no
authors.forename: Siri
authors.initials: S
authors.lastname: Vangen
authors.forename: R Elise B
authors.initials: RE
authors.lastname: Johansen
authors.forename: Johanne
authors.initials: J
authors.lastname: Sundby
authors.forename: Bente
authors.initials: B
authors.lastname: Traeen
authors.forename: Babill
authors.initials: B
authors.lastname: Stray-Pedersen
mesh_terms: D001291:Attitude of Health Personnel; D019093:Circumcision, Female / Q000208:ethnology* / Q000379:methods; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D036861:Delivery, Obstetric / Q000379:methods; D004641:Emigration and Immigration; D004989:Ethics; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D008427:Maternal Health Services; D009664:Norway / Q000453:epidemiology; D018743:Perinatal Care / Q000592:standards* / Q000639:trends; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D018570:Risk Assessment; D012998:Somalia / Q000208:ethnology; D011795:Surveys and Questionnaires