title: Somali immigrant women's perceptions of cesarean delivery and patient-provider communication surrounding female circumcision and childbirth in the USA.
abstract: OBJECTIVE
  To explore perceptions of cesarean delivery and patient-provider communication surrounding female circumcision and childbirth through interviews with Somali women residing in the USA.
  
  
  METHODS
  Semistructured in-depth interviews were conducted with 23 Somali immigrant women living in Boston who had given birth in the USA and Africa. Interviews asked about birth experiences in the USA and Africa, as well as norms and attitudes surrounding childbirth practices. Interview transcripts were coded and themes identified through an iterative process.
  
  
  RESULTS
  Participants were aged 25-52 years and had been living in the USA for an average of 7 years. All women had experienced circumcision. Five women had undergone a cesarean delivery. Women feared having a cesarean because of their perception that it could result in death or disability. Women also highlighted that providers in the USA rarely discussed female circumcision or how it could affect childbirth experiences.
  
  
  CONCLUSIONS
  Previous experiences and cultural beliefs can affect how Somali immigrant women understand labor and delivery practices in the USA and can explain why some women are wary of cesarean delivery. Educating providers and encouraging patient-provider communication about cesarean delivery and female circumcision can ease fears, increase trust, and improve birth experiences for Somali immigrant women in the USA.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA. maithri@post.harvard.edu
authors.forename: Maithri
authors.initials: M
authors.lastname: Ameresekere
authors.forename: Ryan
authors.initials: R
authors.lastname: Borg
authors.forename: Jamie
authors.initials: J
authors.lastname: Frederick
authors.forename: Olivera
authors.initials: O
authors.lastname: Vragovic
authors.forename: Kelley
authors.initials: K
authors.lastname: Saia
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
mesh_terms: D000328:Adult; D001294:Attitude to Health / Q000208:ethnology*; D001900:Boston; D002585:Cesarean Section / Q000523:psychology*; D019093:Circumcision, Female / Q000523:psychology*; D003142:Communication; D054242:Emigrants and Immigrants / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D012998:Somalia / Q000208:ethnology; D014481:United States