Nav: Home

Refugee women have healthier pregnancies than US women -- why? An unhealthy US culture

March 18, 2019

BUFFALO, N.Y. -- African refugee women experience healthier pregnancies than women born in the United States, despite receiving less prenatal care, found a recent University at Buffalo study.

Compared to U.S.-born black and white women, African refugee women had fewer pre-pregnancy health risks, fewer preterm births and higher rates of vaginal deliveries. Surprisingly, the refugee women were more likely to delay beginning prenatal care until the second trimester.

The disparity, says the researchers, may be tied to various unhealthy behaviors and practices present within U.S. culture. For African refugee women, acculturation may negatively impact health.

"It is often thought that refugees immigrating to the United States from war-torn nations will experience a better quality of life once here," says Kafuli Agbemenu, PhD, assistant professor in the UB School of Nursing and lead investigator on the study, published in February in the Journal of Women's Health.

"However, some of the elements of U.S. life such as eating processed food, an increased reliance on cars or buses for transportation, extended inclement weather, a more individualistic society, and drug and alcohol use may, in fact, contribute to African refugee women having poorer reproductive health outcomes."

Reproductive health disparities between U.S.-born white and black women are well documented, says Agbemenu. However, few comparisons have been made between African refugee women and U.S.-born women.

African refugee women are susceptible to numerous health disparities as a result factors such as socioeconomic status, gender, ethnicity, low-levels of education and language. Another risk-factor specific to their population is the high prevalence of past traumatic experiences.

These risks led researchers to believe African refugee women would have poorer reproductive health outcomes than women born in the U.S. The unexpected results reveal that the healthy immigrant effect -- a phenomenon where immigrants experience healthier outcomes than native populations -- extends to reproductive health.

The researchers examined electronic birth certificate data from hospitals within Erie County, an area of Western New York that resettles a large number of refugees. The data contained clinical, psychosocial, socioeconomic and demographic information, as well as the mother's country of birth.

Women born in Burundi, Democratic Republic of Congo, Eritrea, Rwanda and Somalia were considered of refugee status for the study, due to the large refugee populations in Western New York resettled from these nations.

The data contained information on nearly 60,000 white, almost 17,500 black and close to 800 African refugee women who gave birth from 2007-16. The information was limited to mothers who used Medicaid to cover medical expenses to control for socioeconomic status.

Researchers discovered that African refugee women had significantly less maternal medical risk factors, such as pre-pregnancy hypertension or diabetes, compared to U.S.-born women. Refugee women experienced more vaginal births, and were less likely to undergo cesarean sections or to be medically induced into labor.

Less than 1 percent of refugee women smoked or took illegal drugs during pregnancy, compared to white women (12 percent smoked, 4.5 percent took illegal drugs) and black women (15 percent smoked, 18 percent took illegal drugs).

Refugee women also had the fewest preterm birth (6 percent) compared with white women (9 percent) and black women (13 percent).

While most of the women from all groups began prenatal within the first trimester, African refugee women were more likely to delay prenatal care until the second trimester. Refugee women also received higher amounts of inadequate prenatal care (27 percent) compared to white women (12 percent) and black women (24 percent).

These favorable health outcomes for African refugee women also occurred in spite of the group experiencing higher rates of meconium staining, the earliest stool of an infant that when passed in the womb is a sign of fetal distress.

The high rate of inadequate prenatal care for African refugee women is troubling, says Agbemenu, and indicative of the disconnect between refugee populations and the health care community.

"These women have reported feeling ostracized and marginalized by the medical community," says Agbemenu. "They are at times hesitant to seek care, and when they do, it is typically at a time when the problem has escalated."

The development of culturally-targeted reproductive health education is urgently needed, she says. Health care professionals also need to understand that refugee women are likely to have histories of trauma and, therefore, need care delivered from a trauma-informed perspective.
-end-
Additional investigators on the study include Nadine Shaanta Murshid, PhD, assistant professor in the UB School of Social Work; James Shelton, clinical assistant professor of obstetrics and gynecology in the Jacobs School of Medicine and Biomedical Sciences at UB; UB nursing doctoral student Samantha Auerbach; and Ndidiamaka Amutah-Onukagha, PhD, assistant professor of public health and community medicine at Tufts University School of Medicine.

University at Buffalo

Related Reproductive Health Articles:

One-third of reproductive age women have health conditions that may complicate pregnancy
One in three women of reproductive age have at least one chronic condition that could compromise their health or lead to adverse outcomes during pregnancy, according to University of Utah Health scientists.
The reproductive function of the clitoris
A recent review published in Clinical Anatomy highlights evidence that the female clitoris is important for reproduction.
Leading experts in high-risk pregnancies issue report on reproductive health services
The Society for Maternal-Fetal Medicine (SMFM), hosted a two-day workshop entitled 'Reproductive Services for Women at High Risk for Maternal Mortality.' The workshop was held in conjunction with SMFM's 39th Annual Pregnancy Meeting in February 2019 and was co-sponsored by the American College of Obstetricians and Gynecologists, Fellowship in Family Planning, and Society of Family Planning.
ENDO 2019 news conferences to feature breakthroughs in diabetes, reproductive health, aging
Researchers will explore the link between unhealthy snack intake and screen time, long-term opioid use and its impact on men's testosterone levels, and other emerging science during news conferences at ENDO 2019, the Endocrine Society's annual meeting taking place March 23-26 in New Orleans, La.
New robotic sensor technology can diagnose reproductive health problems in real-time
Researchers have developed new robotic sensor technology that has the capability to diagnose women's reproductive health problems in real-time.
One in 4 women at sexual health clinics reports coercion over their reproductive lives
As many as one in four women attending sexual and reproductive healthcare services say they are not allowed to take control of their own reproductive lives, reveals a review of the available evidence, published today in BMJ Sexual & Reproductive Health.
Information on reproductive health outcomes lacking in Catholic hospitals
As Catholic health care systems expand nationwide, little is known about the reproductive outcomes of their patients compared to patients in other settings, according to researchers at the University of Colorado Anschutz Medical Campus.
Reproductive cycle may foreshadow Alzheimer's disease
Female mice destined to develop Alzheimer's-like pathology and related cognitive impairments display a unique pattern of fluctuation in sex hormones during the ovarian cycle, finds new research published in eNeuro.
Do sexual minority women receive appropriate sexual and reproductive health counseling?
According to a new study that used data from the National Survey of Family Growth 2006-2015, lesbian women were less likely to report receiving a birth control prescription or birth control counseling compared with heterosexual women.
New tool for female reproductive genetics
The fruit fly Drosophila is powerful for studying development and disease and there are many tools to genetically modify its cells.
More Reproductive Health News and Reproductive Health Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.