Childbirth in exile: asylum seeking women's experience of childbirth in Ireland.
OBJECTIVE
the purpose of this study was to gain insight into women's experiences of childbirth in Ireland while in the process of seeking asylum. This paper will focus on one of the primary findings of the study, how lack of connection, communication and cultural understanding impacted the health and well-being of the women who participated.


METHODS
researchers adopted a structural approach to narrative analysis using Burke's (1969) dramatistic pentad to analyse 22 women's narrative accounts of their childbirth experiences. Ethical approval was granted, and the study was funded by the Irish Health Research Board.


RESULTS
Burke's (1969) dramatistic pentad revealed numerous accounts of Scene/Agent and Act/Agency imbalance in the women's experiences, highlighting lack of communication, connection and culturally competent care evident in their experiences and how this impacted the care they received.


CONCLUSIONS
inadequate, poorly organised maternity services complicated by lack of training in cultural understanding and sporadic access to interpreter services had a detrimental impact on care provision. Providers appeared to have little insight into the specific needs of this vulnerable group already traumatised by pre and post migratory stressors. The resulting lack of effective connection and communication exacerbated women's experiences of alienation, loneliness, and isolation and were universal in the women's accounts. Implications for practice need to focus in Burkean terms on 'How' (Agency) providers can meet the maternity care needs of asylum seeking women. Dedicated community based services, mandatory training in cultural competence, 24 hour access to interpreters, information leaflets in several languages are essential measures. Further research looking specifically at the antenatal care and childbirth education needs of ethnic minority women is needed. Also, there is an urgent need for further exploration of the barriers to communication and the utilisation of trained interpreters in the provision of effective care to non-English speaking ethnic minority women.
Department of Nursing, College of Health and Human Services, University of New Hampshire, 4 Library Way, Durham, NH 03824, USA. Electronic address: carolyn.tobin@unh.edu.
Carolyn
C
Tobin
School of Nursing and Midwifery, 24, D'Olier Street, Trinity College, Dublin 2, Ireland. Electronic address: jlawless@tcd.ie.
Jo
J
Murphy-Lawless
University of Connecticut, School of Nursing, 231 Glenbrook Road, Storrs, CT 06269-2026, USA. Electronic address: cheryl.beck@uconn.edu.
Cheryl Tatano
CT
Beck
D000293:Adolescent; D000328:Adult; D065246:Culturally Competent Care; D005260:Female; D006801:Humans; D007494:Ireland; D008016:Life Change Events; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D012036:Refugees / Q000523:psychology*
Asylum seeker; Childbirth experiences; Ireland; Maternity care