pregnant women and social factors

PREGNANCY AND COMPLEX SOCIAL FACTORS

.

CATEGORIES OF PREGNANT WOMEN

Women who misuse substances

Women who are recent migrants, asylum seekers or refugee and who have difficulties reading or speaking English

Young women aged under 20

Women who experience domestic abuse

A F F E C T I N G C O M P L E X S O C I A L FA C T O R S

Some pregnant woman with complex social factors are discouraged from using antenatal care services.

Overwhelmed by the involvement of multiple agencies

Not familiar with antenatal care services

Practical problems that make it difficult for them to attend antenatal appointments

Finding hard to communicate with healthcare staff

Anxious about the attitudes of healthcare staff

METHO DS OF ADD RESS ING PRO BLEMS

Improve service organization

Provide training for healthcare staff

Enhance care delivery

IMPROVE SERVICE ORGANIZATION

Work with

Social care commissioners and providers

Service for migrants, refugees and asylum seekers

Substance misuse services

Domestic abuse support services

Housing services

Education authorities

Third-sector agencies

RECOMMENDATIONS

Tailor services to meet the needs of the local population• Maintain records for the no of woman presenting for

antenatal care with complex social factors• Maintain records for each complex social factor grouping• Maintain records for attendance of appointments by no of

woman in each complex social factor grouping

Involve woman in their antenatal care• Record, monitor and use as guide the women’s response on

satisfaction of services• Involve women and their families in determining local needs • Enable women to take a copy of their hand-held maternity

notes when moving from one area or hospital to another

PROVIDE TRAINING FOR HEALTHCARE STAFF

Work with

Social care professionals

RECOMMENDATION

Provide training on multi-agency needs assessment and information sharing

ENHANCE CARE DELIVERY

Work with:

Social care professionals

Substance misuse services

Midwives and doctors with specific expertise (e.g. in the care of women who misuse substances)

Domestic abuse support workers

Sexual health services

Interpreters

Link workers

GPs

RECOMMENDATIONS

Give information and offer referral at the first contact

Reinforce contact at the booking appointment

Coordinate care

Communicate sensitively

Keep the hand-held maternity notes up to date

RECOMMENDATIONS

Offer referral to a substance misuse program

Offer information and support

Work with social care professionals to provide supportive and coordinated care

P R E G N A N T W O M E N W H O A R E R E C E N T M I G R A N T S , A S Y LU M S E E K E R S O R R E F U G E E S O R

H A V E D I F F I C U LT Y I N R E A D I N G O R S P E A K I N G E N G L I S H

Issues:

May not make full use of antenatal care services

Unfamiliarity with the health service

Finding hard to communicate with healthcare staff

Resolution:

Use variety of means to communicate with women

Telling women about antenatal care services and how to use them

Undertaking training in the specific needs of women in these groups

RECOMMENDATION

Adapt antenatal services to meet local needs

Work with other agencies

Allow enough time for interpretation

Provide accessible information about pregnancy and how to find and use antenatal services in a variety of :

• Formats such as posters, notices, leaflets, photgraphs, drawings/diagrams, online video clips, audio clips and DVDs, interactive educational module

• Settings, including pharmacies, community centers, faith groups and centers, GP surgeries, family planning clinics, children’s centers, reception centers and hostels

• Languages

TRAINING FOR HEALTHCARE STAFF

Specific health needs of women such as needs arising from female genital mutilation or HIV

Specific social, religious and psychological needs of women in these groups

The most recent government policies on access and entitlement to care for recent migrants, asylum seekers and refugees

RECOMMENDATION

Offer information on access and entitlement to healthcare

Disscuss the importance of keeping her handheld maternity record with her at all times

Avoid making assumptions based on woman’s culture, ethnic origin or religious beliefs

Provide woman with interpreter who can communicate with her in her preferred language

Ask the woman about her understanding of what she has been told to ensure she has understood it correctly

REFERENCE

http://www.jhpiego.org/en/node/1191 (MCHIP)

http://www.guardian.co.uk/global-development/video/2012/dec/05/female-genital-mutilation-women-

video

Molly Melching, founder of NGO Toshan

http://www.guardian.co.uk/global-development/gallery/2013/feb/11/snapshots-suffering-survival-women-africa#/?picture=403732993&index=16

http://www.jhpiego.org/en/node/1191