Search Results (16)

Background: Maternity care for vulnerable pregnant women presents a particular challenge within midwifery practice. In Germany, maternity services lack standardized frameworks to adequately address the specific needs of individuals who have experienced, among other factors, sexualized violence, poverty, female genital mutilation/cutting (FGM/C), or discrimination. Limited access to healthcare among these populations contributes to increased maternal and neonatal morbidity and mortality. Emerging evidence indicates that comprehensive medical and psychosocial support provided by midwives can substantially improve obstetric outcomes for marginalized pregnant women. Methods: An elective course, Antenatal Care for Vulnerable Women, was offered in the sixth semester of the Bachelor’s program in Midwifery Science at the University of Tübingen in 2025. The course provided insights into the psychosocial challenges faced by vulnerable pregnant women and prepared students for these specific aspects of midwifery practice. The curriculum incorporated foundational lectures and innovative teaching formats aimed at cultivating constructivist approaches to problem-solving. All sixth-semester midwifery students were asked to assess their knowledge and skills across five vulnerability categories: asylum-seeking, FGM/C, intimate partner violence, trauma, and racism. A pilot pre–posttest analysis using a 6-point Likert scale (1 = very good, 6 = poor) was conducted as hypothesis-generating and curriculum-guiding. The pretest included 38 respondents. The posttest included 11 respondents who attended the course. Results: Students who attended the course demonstrated observable gains in knowledge and skills across all categories, with the greatest improvements in asylum-seeking, median of 5 (IQR 4–5) vs. 2 (2–3); FGM/C, 5 (4–5) vs. 2 (2–3); and racism, 5 (3–5) vs. 2 (2–3). Conclusions: Innovative teaching methods may contribute to preparing midwifery students for targeted care of vulnerable pregnant women. Findings from the pre- and posttests provide preliminary insight into the potential value of experiential learning and may inform the further development of practice-oriented teaching methods. Full article

Women seeking asylum experience markedly poorer health outcomes than refugees, other migrants, and host populations, with sexual and reproductive health (SRH) needs that are complex and multidimensional. This qualitative study explored the barriers to and enablers of accessing preventive SRH care among women seeking asylum in Australia. Between March 2022 and September 2023, semi-structured interviews were conducted with twelve women from eight countries. Using a socioecological framework, analysis revealed that access to preventive SRH care is shaped by intersecting factors at individual, interpersonal, community, and policy levels. Key barriers included limited knowledge of preventive care, psychosocial and financial constraints, fragmented health services, and restrictive immigration policies. Enabling factors included culturally concordant care, continuity with trusted general practitioners, and supportive community and social relationships. The findings underscore how structural and relational factors intersect to influence SRH access and highlight the need for coordinated, multi-level strategies to promote equitable SRH care for women seeking asylum in Australia. Full article

Introduction: Building a life in an asylum country poses specific challenges for women, who often face compounded barriers in healthcare, language acquisition, economic independence, childcare, education, cultural adaptation, and legal processes. This study examines the experiences of asylum-seeking women in Portugal, focusing on discrimination perpetrated by professionals within reception and integration institutions. Methods: Drawing on 24 semi-structured interviews with women from the Middle East (n = 14) and Africa (n = 10), this research adopts a criminological and gender lens and employs a narrative paradigm informed by constructivist Grounded Theory and an abductive approach. Results: The analysis reveals that institutional discrimination, manifested through neglect, hostility, and cultural insensitivity, reinforces feelings of abandonment and fear, obstructs integration, and perpetuates cycles of marginalization and vulnerability. These dynamics are intensified by gender-based and structural violence embedded in asylum procedures and professional practices. The findings highlight the emotional and relational dimensions of institutional encounters, showing how empathy, trust, and intercultural awareness among professionals are crucial for effective inclusion. Conclusions: This study concludes that addressing institutional discrimination requires systemic change, professional training in gender-sensitive and intercultural competencies, and the promotion of equitable, inclusive, and human rights-based reception practices in Portugal. Full article

The Nationality and Borders Act 2022 was enacted despite significant opposition from refugee charity and legal sectors. It is without question that the Act changes the domestic landscape of the refugee status determination system and has the potential to also negatively influence refugee status determinations in other jurisdictions. There are several sections of the Act that are particularly problematic for women’s claims of asylum. The Act reverses well-established international and regional human rights and refugee law principles and standards. The reversal, in some cases, of decades of jurisprudence on the interpretation of the Refugee Convention poses a concern for the integrity of the law and administrative justice. While the Act imposes barriers for all claimants, it disproportionately affects some of the most complex cases, including refugee women fleeing gender-based persecution. Of the various changes brought about by the Act, this article focuses on three that are particularly relevant to women asylum seekers: first, the regressive way in which membership of a particular social group has been framed; second, the heightened standard of proof now required; and third, the associated evidential burdens in relation to trauma and disclosure. Ultimately, these changes are likely to have a disproportionate and discriminatory impact on women seeking asylum, particularly those fleeing gender-based persecution. Full article

As numbers of displaced people throughout the world steadily increase with the rise in global conflicts, many Western nations, including Australia, increasingly thwart asylum-seeking and place harsh restrictions on entry. Nonetheless, Afghanistan’s troubled political history over several decades has generated steady movement of refugees to Australia, and Australia has offered protection, although often conditional and limited. Little is known about the experiences of women who fled, giving up their homes, professions, education, extended family, and social lives that were rich in connection. Despite expanding research and literature, there are still gaps in what is known about what happens to refugee women who resettle in Australia. The research outlined in this article uncovers the stories of six Afghan women, highlighting their agency to counter stereotypes. The article focuses not only on losses experienced, but ways in which this group of Hazara women negotiated their way in their new home of Australia, with the support of STARTTS, a not-for-profit organisation. Some of the initial barriers to resettlement in Australia involved accessible and timely information, limited proficiency in English, and comprehending laws and norms. The ongoing effects of trauma along with these barriers often accelerated the ageing process for these women, limiting their ability as well as opportunity for employment. These barriers were exacerbated in the context of the yearnings for their homeland and loved ones who were still in Afghanistan. Women were torn between feelings of gratitude for their own security and of guilt and pain for those in Afghanistan. Through STARTTS-facilitated groups, women found opportunities to connect with one another. They also used these connections to gather information about support programs, for themselves or their families, crucial for them to reconstruct their lives in Australia. For refugees experiencing dislocation, the formation of social networks in the host country contributes to belonging and connectedness and facilitates rebuilding trusting relationships that have been intentionally destroyed, where they can share their experiences in a safe, trauma-informed environment. Full article

The Northern Triangle countries, including El Salvador, Guatemala, and Honduras, are sources of a significant number of asylum seekers in the United States today. This article examines the underlying societal dynamics in these countries and considers the typical profile of transgender immigrant women seeking asylum in the U.S. on the legal grounds of having faced gender-based violence in their countries of origin. It analyzes the relevant international conventions as well as the social determinants of the health and mental health of transgender asylum seekers. It draws from 35 cases of transgender immigrant women subjected to child sexual abuse; sexual assault, including assault by police; and forced sex work; it reviews examples from the academic and gray literature, including a precedent-setting case heard before the Inter-American Court on Human Rights. It discusses the implications for social science professionals, including the role of experts of country conditions. It provides guidance for immigrant service providers and advocates, particularly the importance of gender-affirming policies and healthcare to this population deserving of protection. Full article

Perinatal mental health is a growing public health concern. Refugee and asylum-seeking women are particularly susceptible to experiencing perinatal mental illness and may encounter a range of challenges in accessing healthcare. This scoping review sought to identify the enablers of and barriers to healthcare access and healthcare provision for refugee and asylum-seeking women experiencing perinatal mental illness in the WHO European Region. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was applied. Nine databases and six grey literature sources were initially searched in April 2022, and an updated search was completed in July 2023. The search identified 16,130 records, and after the removal of duplicates and the screening process, 18 sources of evidence were included in this review. A data extraction table was used to extract significant information from each individual source of evidence, which was then mapped to the seven dimensions of the candidacy framework. Empirical (n = 14; 77.8%) and non-empirical (n = 4; 22.2%) sources of evidence were included. The literature originated from seven countries within the WHO European Region, including the United Kingdom (n = 9; 50%), Germany (n = 3; 16.7%), Denmark (n = 2; 11.2%), Norway (n = 1; 5.6%), Greece (n = 1; 5.6%), Sweden (n = 1; 5.6%), and Switzerland (n = 1; 5.6%). The results indicate that, although enablers and barriers were apparent throughout the seven dimensions of candidacy, barriers and impeding factors were more frequently reported. There was also a notable overall lack of reported enablers at the system level. Unaddressed language barriers and lack of attention to the diversity in culturally informed perceptions of perinatal mental illness were the main barriers at the individual level (micro-level) to identifying candidacy, navigating healthcare systems, and asserting the need for care. The lack of culturally appropriate alignment of healthcare services was the key organizational (meso-level) barrier identified. The wider structural and political contexts (macro-level factors), such as lack of funding for consultation time, focus on Western diagnostic and management criteria, and lack of services that adequately respond to the needs of refugee and asylum-seeking women, negatively influenced the operating conditions and wider production of candidacy. It can be concluded that there are multilevel and interconnected complexities influencing access to and provision of perinatal mental healthcare for refugee and asylum-seeking women. Full article

This article aims to illuminate the little-studied phenomenon of asylum-seeking child-bearing women in the UK, survivors of violence and human trafficking. This is a significant issue in terms of the proportion of women affected and the paucity of care and support currently available to them as mother survivors. This study looked to examine the frontline support services of one project to survivor mothers through two collaborating organisations, Happy Baby Community and Hestia, and how their services support mothers’ experiences of perinatal mental health, infant feeding, and the general experiences of migrant women and trafficking survivors in maternity care in the UK. Using evidence collected from semi-structured service-users’ interviews and focus groups, and an anonymous online staff survey, this article shows the types of care and support that are required to address not only the challenges faced by any new mother, but also the additional challenges experienced with trafficking and seeking asylum such as mental health, housing, and legal and access to other support. This article illustrates the many complex and inter-related challenges these women face, and the way the project meets practical, informational, emotional, appraisal, and social needs. It concludes by identifying several implications of the support provided and/or needed, which could be considered by other services or policymakers looking to meet the fundamental needs and rights of this cohort. Full article

Asylum-seeking migrants represent a vulnerable segment of the population, and among them, women constitute an even more vulnerable group. Most of these women and girls have been exposed to threats, coercion, and violence of many kinds, including rape, forced prostitution, harassment, sexual slavery, forced marriage and pregnancy, female genital mutilation/excision, and/or other violations of their rights (e.g., deprivation of education, prohibition to work, etc.). The perpetrators of the violence from which they flee are often their own families, partners, and even institutional figures who should be in charge of their protection (such as police officers). In the process for the acceptance/rejection of an asylum application, the forensic and psychological certification can make the difference between successful and unsuccessful applications, as it can support the credibility of the asylum seeker through an assessment of the degree of compatibility between the story told and the diagnostic and forensic evidence. This is why constant and renewed reflection on the ethical, forensic, and methodological issues surrounding medico-legal and psychological certification is essential. This article aims to propose some reflections on these issues, starting from the experience of the inward healthcare service dedicated to Migrant Victims of Maltreatment, Torture, and Female Genital Mutilation operating since 2018 at the Institute of Forensic Medicine of the University Hospital of Palermo. Full article

Within the ancient corpus we find depictions of people seeking refuge and protection: in works of fiction, drama and poetry; on wall paintings and vases, they cluster at protective altars and cling to statues of gods who seemingly look on. Yet the ancient evidence does not lend itself easily to exploring attitudes to refugees or asylum seekers. Hence, the question that begins this investigation is, representation of whom? Through a focus on the Greco-Roman material of the Mediterranean region, drawing on select representations, such as the tragedies Medea and Suppliant Women, the historical failed plea of the Plataeans and pictorial imagery of supplication, the goal of the exploration below is not to shape into existence an ancient refugee or asylum seeker experience. Rather, it is to highlight the multiplicity of experiences within narratives of victimhood and the confines of such labels as refugee and asylum seeker. The absence of ancient representations of a generic figure or group of the ‘displaced’, broadly defined, precludes any exceptionalising or homogenising of people in such contexts. Remaining depictions are of named, recognisable protagonists, whose stories are known. There is no ‘mass’ of refuge seekers, to whom a single set of rules could apply across time and space. Given these diverse stories of negotiation for refuge, another aim is to illustrate the ways such experience does not come to define the entirety of who a person is or encompass the complete life and its many layers. This paper addresses the challenges of representation that are exposed by, among others, thinkers such as Hannah Arendt, Liisa Malkki and Gerawork Gizaw. Full article

In recent years, European countries have made their asylum systems increasingly stricter. Norway has been no exception, taking additional measures to tighten its asylum system to make it less attractive to seek asylum. How does the asylum procedure and living in asylum centres influence psychosocial well-being and, in turn, the prospects of incorporation into a new society? This article identifies the main challenges that a group of women face while seeking asylum and living in asylum centres in Norway, and it explores the influence that these challenges have on their mental health and well-being. To do this, it draws on ethnographic fieldwork conducted during approximately one year (2017–2018) with nine women—of different nationalities, ages and backgrounds—living in asylum centres in Norway. The analysis shows five main elements of the Norwegian asylum and reception system that result in the main challenges that the women deal with during their wait in the asylum centres. These elements are the wait and uncertainty around their asylum application coupled with the inability to influence their circumstances, the limitations to engage in meaningful activities as well as the financial and mobility limitations imposed by the Norwegian authorities. The interconnections of these five elements make the women often feel powerless, unable to influence their circumstances and feel stuck in the present, unable to plan their future, thus, experiencing high levels of uncertainty and existential immobility (Hage 2009). This, in turn, leads to frustration, apathy and even depression in the women, which can have a negative effect on their future incorporation into the Norwegian society. Full article

The recent arrival of refugees from Ukraine has thrown into sharp focus the racialised colonial underpinnings of the French asylum and refugee system, as the open-door welcome afforded to Ukrainians, supposedly “closer” to the French population, highlights the rejection and marginalisation of “others” who seek refuge in the country. The current situation lays bare not only the “double standards” applied to refugees depending on their country of origin and race, but also the colonial foundations of the French asylum system as a whole. This might be seen as particularly significant in a country where even within academic research on asylum and refugees the racial and colonial foundations of the current system are rarely mentioned, and where the principle of Republican universalism has been consistently used to both hide and justify racialised and gendered forms of inequality and discrimination. In this contribution we wish to explore the ways in which the coloniality of the French asylum system works to deny exiled women access to welfare and social services, creating systems of racialised and gendered violence against them. We highlight the ways in which the State not only neglects these women, but actively contributes to violence through its racialised neo-liberal policies. The withdrawal of access to welfare and social services, including housing, welfare payments or health services, all form a part of this system of structural violence which leads to increasing levels of harm. Based on ethnographic research carried out in the Paris region, our article aims to emphasise that the structural production of gendered violence, particularly sexual violence against racialised exiled women, illustrates the coloniality of the asylum system and more broadly of the migration regime, which manifests itself in policies of exclusion, neglect and endangerment—including death. Full article

How is the concept of “vulnerability” employed in Canadian immigration law? This article presents findings from research conducted as part of the VULNER project (2019–23). We analyze how vulnerability is operationalized in Canada’s inland refugee (or asylum) determination procedures compared to its overseas resettlement program by first discussing some general principles, followed by an examination of the treatment of women and LGBTQI+ individuals seeking protection. We show that legal-bureaucratic logics have constructed two very heterogeneous worlds of vulnerability that may reproduce and exacerbate vulnerabilities rather than create a more inclusive, equitable protection regime in law, policy, and practice. Full article

There is a need to understand the specific perinatal mental health care needs of migrant subgroups who often have differing health care needs and specific barriers to accessing and engaging with health care services. It is important to have evidence about the WHO European context given the rising numbers of refugees and asylum seekers in the region. The aim of this scoping review is to map the factors that enable and prevent access and engagement of refugee and asylum-seeking women with perinatal mental health care services in the WHO European Region, from the perspectives of service providers and service users. The database search will include PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL complete, Scopus, Academic Search Complete, and Maternity and Infant Care (OVID). Search results will be exported to an online tool that provides a platform to help manage the review process, including title, abstract, and full-text screening and voting by reviewers independently. Data concerning access and engagement with health care services will be mapped on to the candidacy framework. Systematically searching evidence within the WHO European region and examining this evidence through the candidacy lens will help develop a more comprehensive and a deeper conceptual understanding of the barriers and levers of access and engagement with perinatal mental health care services, whilst identifying gaps in existing evidence. Exploring factors that influence access and engagement for refugee and asylum-seeking women from the perspective of key stakeholders in the service provision and/or service utilisation of perinatal mental health care services will add a more comprehensive understanding of the recursive relationship between service provision and use. Full article

This five-year cross-sectional study mapped the prevalence of several known risk factors for adverse perinatal outcomes in asylum-seeking women in The Netherlands. Characteristics of 2831 registered childbirths among residents of asylum seekers centers (ASCs) in The Netherlands from 2016 to 2020 were included. Results showed a high general and teenage birthrate (2.15 and 6.77 times higher compared to the Dutch, respectively). Most mothers were pregnant upon arrival, and the number of births was highest in the second month of stay in ASCs. Another peak in births between 9 and 12 months after arrival suggested that many women became pregnant shortly after arrival in The Netherlands. Furthermore, 69.5 percent of all asylum-seeking women were relocated between ASCs at least once during pregnancy, which compromises continuity of care. The high prevalence of these risk factors in our study population might explain the increased rate of adverse pregnancy outcomes in asylum seekers compared to native women found in earlier studies. Incorporating migration-related indicators in perinatal health registration is key to support future interventions, policies, and research. Ultimately, our findings call for tailored and timely reproductive and perinatal healthcare for refugee women who simultaneously face the challenges of resettlement and pregnancy. Full article