Let’s be honest, “Medical Anthropology” probably sounds like a quirky college major someone made up because they couldn’t get through medical school. The truth is it can save lives.
Pauline Binder is one such medical anthropologist who recently presented her doctoral thesis, “The Maternal Effect Migration: Exploring maternal healthcare in Diaspora using qualitative proxies for medical anthropology” at the Department of Women and Child Health in the Faculty of Medicine at Uppsala University, Sweden.
It should be required reading for Public Health officials all over the globe.
Binder brilliantly uses post childbirth interviews of immigrant African (mostly Somalian) women in the UK and Sweden to apply an anthropological approach to a clinical problem. Rates of maternal mortality and infant morbidity or severe illness from childbirth are low in modern western settings. Why then, do the rates remain high for African women who have migrated from a low-income, non-western setting to Europe? With new access to well-equipped health care facilities and life saving interventions, shouldn’t their odds of a successful health outcome increase? According to Binder, the problem lies in cultural awareness and language.
What she discovered is women remain influenced by childbearing experiences or stories of such from their country of origin. Binder called this the “maternal migration effect” and hypothesized pre-migration “knowledge” about childbirth directly affects their post-migration outcome. Understanding this as a healthcare provider is crucial to providing effective maternity care.
She also found delays or refusals of care, including life saving interventions like emergency caesarean sections, resulted from misunderstandings and broken trust during care delivery. Many assumed these women preferred to be cared for by female staff when they truly preferred competency over gender or ethnicity congruences. Language interpreters without any understanding of the women’s socio-cultural experiences also inhibited open dialog during the encounters.
“My studies show that Somali women have as a first priority a need for competent and safe care, just as the majority of all pregnant women. Optimal interpreter use is a key ingredient,” Binder says.
Simply moving a mother from a poor healthcare environment to a rich one does not ensure safety and life.
Her conclusion? Maternity care professionals need to incorporate socio-cultural evidence when providing care to immigrant populations. It would also benefit maternal health policy makers on the local and national level to seek advice from medical anthropologists and studies exploring socio-cultural factors. Maternity care guidelines should be developed based on evidence obtained from both immigrant and (currently underrepresented) non-immigrant groups and include appropriate guidelines for refusal of care by first-generation immigrants.