The Perinatal Journey of a Refugee Woman in Greece: A Qualitative Study in the Context of the ORAMMA Project to Elucidate Current Challenges and Future Perspectives

Abstract

Migrant and refugee women face specific health risks and challenges during the perinatal period, presenting with complex physical, psychological, and mental health issues. Compassionate antenatal and postnatal care is urgently required across Europe given how outcomes during this period determine the health wellbeing throughout a person’s life. The current study aimed to describe the perinatal health care provided to refugee and migrant women in Greece, as well as to identify the barriers to delivering quality health care to these population groups. Data were gathered via qualitative research, and via document analysis, including grey literature research. Two focus groups were convened; one with five midwives in Athens (representing NGOs in refugee camps and public maternity hospitals) and another in Crete with twenty-six representatives of key stakeholder groups involved in the perinatal care of refugees and migrant women. Desk research was conducted with in a stepwise manner comprising two steps: (a) a mapping exercise to identify organizations/institutes of relevance across Greece, i.e., entities involved in perinatal healthcare provision for refugees and migrants; (b) an electronic search across institutional websites and the World Wide Web, for key documents on the perinatal care of refugee and migrant women that were published during the 10-year period prior to the research being conducted and referring to Greece. Analysis of the desk research followed the principles of content analysis, and the analysis of the focus group data followed the principles of an inductive thematic analysis utilizing the actual data to drive the structure analysis. Key findings of the current study indicate that the socioeconomic status, living and working conditions, the legal status in the host country, as well as providers’ cultural competence, attitudes and beliefs and communication challenges, all currently represent major barriers to the efficient and culturally appropriate provision of perinatal care. The low capacity of the healthcare system to meet the needs of women in these population groups in the context of maternal care in a country that has suffered years of austerity has been amply recorded and adds further contextual constraints. Policy reform is urgently required to achieve cultural competence, to improve transcultural care provision across maternity care settings, and to ensure improved maternal and children’s outcomes.