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Open Access Research article

“I have to do what I believe”: Sudanese women’s beliefs and resistance to hegemonic practices at home and during experiences of maternity care in Canada

Gina MA Higginbottom1*, Jalal Safipour1, Zubia Mumtaz2, Yvonne Chiu3, Patricia Paton4 and Jennifer Pillay1

Author affiliations

1 Faculty of Nursing, University of Alberta, Edmonton, Canada

2 School of Public Health, University of Alberta, Edmonton, Canada

3 Multicultural Health Brokers Co-operative, Edmonton, AB, Canada

4 Women’s Health, Alberta Health Services, Edmonton, AB, Canada

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Citation and License

BMC Pregnancy and Childbirth 2013, 13:51  doi:10.1186/1471-2393-13-51

Published: 25 February 2013

Abstract

Background

Evidence suggests that immigrant women having different ethnocultural backgrounds than those dominant in the host country have difficulty during their access to and reception of maternity care services, but little knowledge exists on how factors such as ethnic group and cultural beliefs intersect and influence health care access and outcomes. Amongst immigrant populations in Canada, refugee women are one of the most vulnerable groups and pregnant women with immediate needs for health care services may be at higher risk of health problems. This paper describes findings from the qualitative dimension of a mixed-methodological study.

Methods

A focused ethnographic approach was conducted in 2010 with Sudanese women living in an urban Canadian city. Focus group interviews were conducted to map out the experiences of these women in maternity care, particularly with respect to the challenges faced when attempting to use health care services.

Results

Twelve women (mean age 36.6 yrs) having experience using maternity services in Canada within the past two years participated. The findings revealed that there are many beliefs that impact upon behaviours and perceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe could harm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without need for special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family by males and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment for women, and the women tend to exert control in ways that may or may not be respected by their husbands. Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength.

Conclusion

In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm, through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.

Keywords:
Canada; Sudanese; Beliefs; Culture; Focused ethnography; Maternity; Refugee; Pregnancy