Skip to main content
Top
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

Contrasting “back home” and “here”: how Northeast African migrant women perceive and experience health during pregnancy and postpartum in Canada

Authors: Maira Quintanilha, Maria J. Mayan, Jessica Thompson, Rhonda C. Bell

Published in: International Journal for Equity in Health | Issue 1/2016

Login to get access

Abstract

Background

International migration and the number of migrant women who experience pregnancy and childbirth in receiving countries have significantly increased in the last two decades. Migrant women often have unmet social and economic needs during pregnancy, and are more likely to have problems unaddressed by health care systems. In this qualitative study, we explored migrant women’s perceptions and experiences of health during pregnancy and postpartum, while participating in a perinatal program offered through a community-based organization. Additionally, we examined sociocultural factors that might have shaped women’s health upon migration to the Canadian city of Edmonton, Alberta.

Methods

A community-based participatory research approach was used to engage migrant women connected to a community-based perinatal program in Edmonton. A focused ethnography was conducted with four Northeast African communities (Eritrean, Ethiopian, Oromo and Somali), and involved 10 focus groups with women (n = 8, per group) and direct observations of weekly perinatal program activities. Data generation and analysis occurred concurrently, and all generated data were analyzed using qualitative content analysis to inductively derive codes and categories.

Results

Women expressed their perceptions and experiences of health during pregnancy and postpartum by contrasting their countries of origin with Canada, respectively identified as “back home” and “here”. Differences in social support and the physical environment (both natural and built) between “back home” and “here” were commonly described as factors that shaped their opportunities to eat healthy, be physically active and emotionally well before and after having a baby “here”. Overall, women described that in Canada they lacked the social and environmental factors perceived as key enablers of healthy pregnancies and postpartum.

Conclusion

A complex network of factors seem to influence Northeast African women’s health during pregnancy and postpartum upon migration to Canada. It is of the utmost importance to provide these women with the immediate sociocultural and environmental factors they need to successfully thrive during pregnancy and postpartum, especially while establishing social and support networks “here”.
Literature
1.
go back to reference Urquia ML, Gagnon AJ. Glossary: migration and health. J Epidemiol Community Health. 2011;65:467–72.CrossRefPubMed Urquia ML, Gagnon AJ. Glossary: migration and health. J Epidemiol Community Health. 2011;65:467–72.CrossRefPubMed
3.
go back to reference Urquia ML, Glazier RH, Blondel B, Zeitlin J, Gissler M, Macfarlane A, Ng E, Heaman M, Stray-Pedersen B, Gagnon AJ, collaboration R. International migration and adverse birth outcomes: role of ethnicity, region of origin and destination. J Epidemiol Community Health. 2010;64:243–51.CrossRefPubMedPubMedCentral Urquia ML, Glazier RH, Blondel B, Zeitlin J, Gissler M, Macfarlane A, Ng E, Heaman M, Stray-Pedersen B, Gagnon AJ, collaboration R. International migration and adverse birth outcomes: role of ethnicity, region of origin and destination. J Epidemiol Community Health. 2010;64:243–51.CrossRefPubMedPubMedCentral
4.
go back to reference Small R, Gagnon A, Gissler M, Zeitlin J, Bennis M, Glazier R, Haelterman E, Martens G, McDermott S, Urquia M, Vangen S. Somali women and their pregnancy outcomes postmigration: data from six receiving countries. BJOG. 2008;115:1630–40.CrossRefPubMedPubMedCentral Small R, Gagnon A, Gissler M, Zeitlin J, Bennis M, Glazier R, Haelterman E, Martens G, McDermott S, Urquia M, Vangen S. Somali women and their pregnancy outcomes postmigration: data from six receiving countries. BJOG. 2008;115:1630–40.CrossRefPubMedPubMedCentral
5.
go back to reference Gagnon AJ, Carnevale F, Mehta P, Rousseau H, Stewart DE. Developing population interventions with migrant women for maternal-child health: a focused ethnography. BMC Public Health. 2013;13:471.CrossRefPubMedPubMedCentral Gagnon AJ, Carnevale F, Mehta P, Rousseau H, Stewart DE. Developing population interventions with migrant women for maternal-child health: a focused ethnography. BMC Public Health. 2013;13:471.CrossRefPubMedPubMedCentral
7.
go back to reference Newbold KB. Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect. Soc Sci Med. 2005;60:1359–70.CrossRefPubMed Newbold KB. Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect. Soc Sci Med. 2005;60:1359–70.CrossRefPubMed
8.
go back to reference Gagnon AJ, Zimbeck M, Zeitlin J, Collaboration R, Alexander S, Blondel B, Buitendijk S, Desmeules M, Di Lallo D, Gagnon A, et al. Migration to western industrialised countries and perinatal health: a systematic review. Soc Sci Med. 2009;69:934–46.CrossRefPubMed Gagnon AJ, Zimbeck M, Zeitlin J, Collaboration R, Alexander S, Blondel B, Buitendijk S, Desmeules M, Di Lallo D, Gagnon A, et al. Migration to western industrialised countries and perinatal health: a systematic review. Soc Sci Med. 2009;69:934–46.CrossRefPubMed
9.
go back to reference Grewal SK, Bhagat R, Balneaves LG. Perinatal beliefs and practices of immigrant Punjabi women living in Canada. J Obstet Gynecol Neonatal Nurs. 2008;37:290–300.CrossRefPubMed Grewal SK, Bhagat R, Balneaves LG. Perinatal beliefs and practices of immigrant Punjabi women living in Canada. J Obstet Gynecol Neonatal Nurs. 2008;37:290–300.CrossRefPubMed
10.
go back to reference Mendez DD, Hogan VK, Culhane JF. Institutional racism, neighborhood factors, stress, and preterm birth. Ethn Health. 2014;19:479–99.CrossRefPubMed Mendez DD, Hogan VK, Culhane JF. Institutional racism, neighborhood factors, stress, and preterm birth. Ethn Health. 2014;19:479–99.CrossRefPubMed
11.
go back to reference Johnson EB, Reed SD, Hitti J, Batra M. Increased risk of adverse pregnancy outcome among Somali immigrants in Washington state. Am J Obstet Gynecol. 2005;193:475–82.CrossRefPubMed Johnson EB, Reed SD, Hitti J, Batra M. Increased risk of adverse pregnancy outcome among Somali immigrants in Washington state. Am J Obstet Gynecol. 2005;193:475–82.CrossRefPubMed
13.
go back to reference Torres S, Spitzer DL, Labonte R, Amaratunga C, Andrew C. Community health workers in Canada: innovative approaches to health promotion outreach and community development among immigrant and refugee populations. J Ambul Care Manage. 2013;36:305–18.CrossRefPubMed Torres S, Spitzer DL, Labonte R, Amaratunga C, Andrew C. Community health workers in Canada: innovative approaches to health promotion outreach and community development among immigrant and refugee populations. J Ambul Care Manage. 2013;36:305–18.CrossRefPubMed
14.
go back to reference Israel BA, Coombe CM, Cheezum RR, Schulz AJ, McGranaghan RJ, Lichtenstein R, Reyes AG, Clement J, Burris A. Community-based participatory research: a capacity-building approach for policy advocacy aimed at eliminating health disparities. Am J Public Health. 2010;100:2094–102.CrossRefPubMedPubMedCentral Israel BA, Coombe CM, Cheezum RR, Schulz AJ, McGranaghan RJ, Lichtenstein R, Reyes AG, Clement J, Burris A. Community-based participatory research: a capacity-building approach for policy advocacy aimed at eliminating health disparities. Am J Public Health. 2010;100:2094–102.CrossRefPubMedPubMedCentral
15.
go back to reference Minkler M, Wallerstein N. Community-based participatory research for health: from process to outcomes. 2nd ed. San Francisco: Jossey-Bass; 2008. Minkler M, Wallerstein N. Community-based participatory research for health: from process to outcomes. 2nd ed. San Francisco: Jossey-Bass; 2008.
17.
go back to reference Higginbottom GMA, Pillay JJ, Boadu NY. Guidance on performing focused ethnographies with an emphasis on healthcare research. Qual Rep. 2013;18:1–16. Higginbottom GMA, Pillay JJ, Boadu NY. Guidance on performing focused ethnographies with an emphasis on healthcare research. Qual Rep. 2013;18:1–16.
18.
go back to reference Graham JE, Mayan M, McCargar LJ, Bell RC, Sweet Moms T. Making compromises: a qualitative study of sugar consumption behaviors during pregnancy. J Nutr Educ Behav. 2013;45:578–85.CrossRefPubMed Graham JE, Mayan M, McCargar LJ, Bell RC, Sweet Moms T. Making compromises: a qualitative study of sugar consumption behaviors during pregnancy. J Nutr Educ Behav. 2013;45:578–85.CrossRefPubMed
19.
go back to reference Agar M. The professional stranger: An informal introduction to ethnography. 2nd ed. San Diego: Academic; 1996. Agar M. The professional stranger: An informal introduction to ethnography. 2nd ed. San Diego: Academic; 1996.
20.
go back to reference Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.CrossRefPubMed Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.CrossRefPubMed
21.
go back to reference Quintanilha M, Mayan MJ, Thompson J, Bell RC, The ENRICH Study Team: Different Approaches to Cross-Lingual Focus Groups: Lessons from a Cross-Cultural Community-Based Participatory Research Project in the ENRICH Study. International Journal of Qualitative Methods 2015;14:1–10. Quintanilha M, Mayan MJ, Thompson J, Bell RC, The ENRICH Study Team: Different Approaches to Cross-Lingual Focus Groups: Lessons from a Cross-Cultural Community-Based Participatory Research Project in the ENRICH Study. International Journal of Qualitative Methods 2015;14:1–10.
22.
go back to reference Barbour R. Doing focus groups. London: Sage; 2013. Barbour R. Doing focus groups. London: Sage; 2013.
23.
go back to reference Mayan MJ. Essentials of qualitative inquiry. Walnut Creek: Left Coast Press; 2009. Mayan MJ. Essentials of qualitative inquiry. Walnut Creek: Left Coast Press; 2009.
24.
go back to reference Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. 2007;62:107–15.CrossRef Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. 2007;62:107–15.CrossRef
25.
go back to reference Hsiu-Fang H, Shannon SE. Three approached to qualitative content analysis. Qual Health Res. 2005;15:1277–88.CrossRef Hsiu-Fang H, Shannon SE. Three approached to qualitative content analysis. Qual Health Res. 2005;15:1277–88.CrossRef
26.
go back to reference Orr ST. Social support and pregnancy outcome: a review of the literature. Clin Obstet Gynecol. 2004;47:842–55.CrossRefPubMed Orr ST. Social support and pregnancy outcome: a review of the literature. Clin Obstet Gynecol. 2004;47:842–55.CrossRefPubMed
27.
go back to reference Thornton PL, Kieffer EC, Salabarria-Pena Y, Odoms-Young A, Willis SK, Kim H, Salinas MA. Weight, diet, and physical activity-related beliefs and practices among pregnant and postpartum Latino women: the role of social support. Matern Child Health J. 2006;10:95–104.CrossRefPubMed Thornton PL, Kieffer EC, Salabarria-Pena Y, Odoms-Young A, Willis SK, Kim H, Salinas MA. Weight, diet, and physical activity-related beliefs and practices among pregnant and postpartum Latino women: the role of social support. Matern Child Health J. 2006;10:95–104.CrossRefPubMed
28.
go back to reference Qureshi R, Pacquiao DF. Ethnographic study of experiences of Pakistani women immigrants with pregnancy, birthing, and postpartum care in the United States and Pakistan. J Transcult Nurs. 2013;24:355–62.CrossRefPubMed Qureshi R, Pacquiao DF. Ethnographic study of experiences of Pakistani women immigrants with pregnancy, birthing, and postpartum care in the United States and Pakistan. J Transcult Nurs. 2013;24:355–62.CrossRefPubMed
30.
go back to reference Choudhry UK, Jandu S, Mahal J, Singh R, Sohi-Pabla H, Mutta B. Health promotion and participatory action research with South Asian women. J Nurs Scholarsh. 2002;34:75–81.CrossRefPubMed Choudhry UK, Jandu S, Mahal J, Singh R, Sohi-Pabla H, Mutta B. Health promotion and participatory action research with South Asian women. J Nurs Scholarsh. 2002;34:75–81.CrossRefPubMed
31.
go back to reference Merry LA, Gagnon AJ, Kalim N, Bouris SS. Refugee claimant women and barriers to health and social services post-birth. Can J Public Health. 2011;102:286–90.PubMed Merry LA, Gagnon AJ, Kalim N, Bouris SS. Refugee claimant women and barriers to health and social services post-birth. Can J Public Health. 2011;102:286–90.PubMed
32.
go back to reference Laraia BA, Siega-Riz AM, Gundersen C. Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. J Am Diet Assoc. 2010;110:692–701.CrossRefPubMedPubMedCentral Laraia BA, Siega-Riz AM, Gundersen C. Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. J Am Diet Assoc. 2010;110:692–701.CrossRefPubMedPubMedCentral
33.
go back to reference Legault A, Marquis M. Nutrition information-seeking behaviour of low-income pregnant Maghrebian women. Can J Diet Pract Res. 2014;75:22–8.CrossRefPubMed Legault A, Marquis M. Nutrition information-seeking behaviour of low-income pregnant Maghrebian women. Can J Diet Pract Res. 2014;75:22–8.CrossRefPubMed
34.
35.
go back to reference Paul KH, Graham ML, Olson CM. The web of risk factors for excessive gestational weight gain in low income women. Matern Child Health J. 2013;17:344–51.CrossRefPubMedPubMedCentral Paul KH, Graham ML, Olson CM. The web of risk factors for excessive gestational weight gain in low income women. Matern Child Health J. 2013;17:344–51.CrossRefPubMedPubMedCentral
36.
go back to reference Middleton G, Henderson H, Evans D. Implementing a community-based obesity prevention programme: experiences of stakeholders in the north east of England. Health Promot Int. 2014;29:201–11.CrossRefPubMed Middleton G, Henderson H, Evans D. Implementing a community-based obesity prevention programme: experiences of stakeholders in the north east of England. Health Promot Int. 2014;29:201–11.CrossRefPubMed
37.
go back to reference Berggren V, Bergstrom S, Edberg AK. Being different and vulnerable: experiences of immigrant African women who have been circumcised and sought maternity care in Sweden. J Transcult Nurs. 2006;17:50–7.CrossRefPubMed Berggren V, Bergstrom S, Edberg AK. Being different and vulnerable: experiences of immigrant African women who have been circumcised and sought maternity care in Sweden. J Transcult Nurs. 2006;17:50–7.CrossRefPubMed
38.
go back to reference Bollini P, Pampallona S, Wanner P, Kupelnick B. Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med. 2009;68:452–61.CrossRefPubMed Bollini P, Pampallona S, Wanner P, Kupelnick B. Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med. 2009;68:452–61.CrossRefPubMed
Metadata
Title
Contrasting “back home” and “here”: how Northeast African migrant women perceive and experience health during pregnancy and postpartum in Canada
Authors
Maira Quintanilha
Maria J. Mayan
Jessica Thompson
Rhonda C. Bell
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0369-x

Other articles of this Issue 1/2016

International Journal for Equity in Health 1/2016 Go to the issue