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An anthropological analysis of the perspectives of Somali women in the West and their obstetric care providers on caesarean birth.

Essén B, Binder P, Johnsdotter S - J Psychosom Obstet Gynaecol (2011)

Bottom Line: For women, avoiding or refusing caesarean was based on a rational choice to avoid death and coping with adverse outcome relied on fatalistic attitudes.Motivation for the development of preventive actions among both groups was not described, which lends weight to the vast distinction and lack of correspondence in identified perspectives between Somali women and UK obstetric providers.Early booking and identification of women likely to avoid caesarean is proposed, as is the development of preventive strategies to address CS avoidance.

View Article: PubMed Central - PubMed

Affiliation: Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden.

ABSTRACT
We explored the perceptions of 39 Somali women and 62 obstetric care providers in London in relation to caesarean birth, as borne out of a paradox we recognised from evidence-based information about the Somali group. Socio-cultural factors potentially leading to adverse obstetric outcome were identified using in-depth and focus group interviews with semi-structured, open-ended questions. A cultural anthropology model, the emic/etic model, was used for analysis. Somali women expressed fear and anxiety throughout the pregnancy and identified strategies to avoid caesarean section (CS). There was widespread, yet anecdotal, awareness among obstetric care providers about negative Somali attitudes. Caesarean avoidance and refusal were expressed as being highly stressful among providers, but also as being the responsibility of the women and families. For women, avoiding or refusing caesarean was based on a rational choice to avoid death and coping with adverse outcome relied on fatalistic attitudes. Motivation for the development of preventive actions among both groups was not described, which lends weight to the vast distinction and lack of correspondence in identified perspectives between Somali women and UK obstetric providers. Early booking and identification of women likely to avoid caesarean is proposed, as is the development of preventive strategies to address CS avoidance.

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The emic perspectives of Somali women and their obstetric providers, as identified from the etic position of the researchers, show potential for conceptual misunderstanding in maternal care in relation to CS.
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fig1: The emic perspectives of Somali women and their obstetric providers, as identified from the etic position of the researchers, show potential for conceptual misunderstanding in maternal care in relation to CS.

Mentions: With respect to CS, Somali women's emic definition of required care and treatment do not correspond to the provider's emic biomedical expectations. Figure 1 summarises the opposing attitudes, beliefs and perceptions about prior knowledge of both women and providers and highlights key areas that are discordant and potentially likely to inhibit open interaction between the groups.


An anthropological analysis of the perspectives of Somali women in the West and their obstetric care providers on caesarean birth.

Essén B, Binder P, Johnsdotter S - J Psychosom Obstet Gynaecol (2011)

The emic perspectives of Somali women and their obstetric providers, as identified from the etic position of the researchers, show potential for conceptual misunderstanding in maternal care in relation to CS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3055712&req=5

fig1: The emic perspectives of Somali women and their obstetric providers, as identified from the etic position of the researchers, show potential for conceptual misunderstanding in maternal care in relation to CS.
Mentions: With respect to CS, Somali women's emic definition of required care and treatment do not correspond to the provider's emic biomedical expectations. Figure 1 summarises the opposing attitudes, beliefs and perceptions about prior knowledge of both women and providers and highlights key areas that are discordant and potentially likely to inhibit open interaction between the groups.

Bottom Line: For women, avoiding or refusing caesarean was based on a rational choice to avoid death and coping with adverse outcome relied on fatalistic attitudes.Motivation for the development of preventive actions among both groups was not described, which lends weight to the vast distinction and lack of correspondence in identified perspectives between Somali women and UK obstetric providers.Early booking and identification of women likely to avoid caesarean is proposed, as is the development of preventive strategies to address CS avoidance.

View Article: PubMed Central - PubMed

Affiliation: Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden.

ABSTRACT
We explored the perceptions of 39 Somali women and 62 obstetric care providers in London in relation to caesarean birth, as borne out of a paradox we recognised from evidence-based information about the Somali group. Socio-cultural factors potentially leading to adverse obstetric outcome were identified using in-depth and focus group interviews with semi-structured, open-ended questions. A cultural anthropology model, the emic/etic model, was used for analysis. Somali women expressed fear and anxiety throughout the pregnancy and identified strategies to avoid caesarean section (CS). There was widespread, yet anecdotal, awareness among obstetric care providers about negative Somali attitudes. Caesarean avoidance and refusal were expressed as being highly stressful among providers, but also as being the responsibility of the women and families. For women, avoiding or refusing caesarean was based on a rational choice to avoid death and coping with adverse outcome relied on fatalistic attitudes. Motivation for the development of preventive actions among both groups was not described, which lends weight to the vast distinction and lack of correspondence in identified perspectives between Somali women and UK obstetric providers. Early booking and identification of women likely to avoid caesarean is proposed, as is the development of preventive strategies to address CS avoidance.

Show MeSH
Related in: MedlinePlus