Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109483

Julka Almquist, MPH, Division of Epidemiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, 507-538-0225, almquist.julka@mayo.edu and Priscilla Flynn, MPH, CHES, Office of Women's Heatlh, Mayo Clinic, 200 First Street SW, Ei 7 -239, Rochester, MN 55905.

The number of Somali refugees settling in Minnesota has increased over 620% between 1990 – 2000. During this time, it has become clear that there are substantial differences in pregnancy-related health care expectations and practices between Somali women and obstetric practitioners. Somali women perceive pregnancy as a “normal state” in which ongoing care is unnecessary. Additionally, Somali women frequently resist or refuse labor induction and Cesarean sections (C-sections). In some cases, this has resulted in substantial patient-provider conflict and even court ordered C-sections. The purpose of this study was to obtain an initial understanding of why many women in the Somali community oppose C-sections or labor induction and to move toward resolution of the conflict between these two groups. Three focus groups were held in Rochester, Minnesota with a total of 29 Somali women. Two overarching themes emerged from the interviews. First, there was a misperception of risks related to pregnancy and delivery largely due to two factors: the belief that the outcome of the pregnancy was based on “destiny” or the “will of God” and a lack of health information resulting in a misunderstanding of pregnancy related complications. Second, pregnancy holds a sacred role in Somali culture. While it is acceptable to receive medical intervention for other health problems, the women expressed strongly that they were less accepting of an intervention during the delivery of their baby. Results are being used to provide culturally competent education for both clinical practitioners and Somali women.

Learning Objectives: "At the conclusion of this session the participant will be able to

• Recognize why there is misunderstanding between Somali Women and obstetric practitioners."
• Identify Somali women’s health care beliefs surrounding pregnancy and labor."
• Discuss why Somali women prefer natural childbirth versus induced labor and/or Cesarean section."

Keywords: Maternal and Child Health, Cultural Competency

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.