Pregnancy health status of sub-Saharan refugee women who have resettled in developed countries: a review of the literature.
OBJECTIVE
to present the literature relating to health status and pregnancy complications among sub-Saharan African women.


BACKGROUND
sub-Saharan refugee women constitute a new and growing group of maternity service users in developed countries today. These women are perceived to be at high risk of pregnancy complication, based on concurrent disease and unusual medical conditions. As a result of these concerns, midwives may feel ill equipped to provide their pregnancy care.


METHODS
searches were conducted of CINAHL, Maternity and Infant Care, MEDLINE and PsychINFO databases using the search terms 'migrants', 'Africa', 'sub-Saharan', 'pregnancy', 'refugees' and 'women'. Additional articles were located by pursuing references identified in key papers.


RESULTS
pregnant sub-Saharan women present as an at-risk population related to poor prior health, co-existing disease and cultural practices such as female genital mutilation. Nonetheless, principal pregnancy complications for this population include anaemia and high parity, rather than exotic disease. Higher rates of infant mortality and morbidity appear to persist following resettlement, and are not explained by maternal risk factors alone. Limited access to care is of concern.


CONCLUSIONS
further research is warranted into the impediments to care uptake among sub-Saharan African women. It is hoped that such research will inform the development of culturally appropriate and acceptable services for African refugees.


CONCLUSIONS
it is important that midwives are aware of common health problems among sub-Saharan women. Midwives also need to act to promote access to health services among this group. Social disadvantage and late access to care may impact on neonatal outcomes and thus warrant investigation.
Carolan
Mary
M
School of Nursing and Midwifery, Victoria University, Melbourne, Vic 8001, Australia. mary.carolan@vu.edu.au
D017954:Africa South of the Sahara / Q000453:epidemiology; D003466:Cultural Characteristics; D019049:Developed Countries; D019317:Evidence-Based Medicine; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006304:Health Status; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration; D008880:Midwifery / Q000379:methods; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology; D012036:Refugees / Q000706:statistics & numerical data*; D016387:Women's Health / Q000208:ethnology