Somali Women's Experiences with Obstetrician Care Providers During Childbirth in Canada

Introduction: In the context of international migration, an increasing number of women from countries that traditionally practice FGC have immigrated to Canada (Perron et al., 2013). Given these demographic shifts, it is necessary to provide appropriate reproductive care to newcomer women who have undergone FGC, and to do this it is important to understand women’s perceived childbirth experiences Methods: The purpose of this study was to explore how Somali women who have undergone FGC perceive their experiences with childbirth and their interaction with obstetrician care providers in British Columbia. The study used qualitative method of focus group interviews. Results: Thematic analysis was conducted and 5 main themes were identified, including: preference for a natural birth; health care provider interaction; clinical care for FGC including vaginal examinations, de-infibulation, re-infibulation; desire for greater decision making capacity and differences in biomedical and Somali cultural practices. Discussion: The results show that there still remain largely unmet needs regarding appropriate clinical care for FGC and provider-patient interaction. In particular, there is tension between Somali women’s preference for a natural birth and perceived extra interventions by obstetricians. Furthermore, the Somali women reported dissatisfaction with aspects of the clinical management of FGC during delivery, particularly the timing of de-infibulation. Improving patient-provider communication and addressing issues of power-asymmetry could mitigate tensions, improve trust and reduce dissatisfaction experienced by Somali women during the childbirth experience.