Migrant women's experiences of pregnancy, childbirth and motherhood - an interpretative phenomenological study in Tunis, Tunisia

Abstract: Bearing a child and giving birth are often considered as a life-changing event in the life of a woman and her family, a source of joy and fulfillment. But in spite of the progress achieved in the last century, every two minutes one woman still dies from pregnancy or childbirth related causes (WHO 2018). All too often, becoming a mother can be associated with pain, suffering and even distress, disability or death. Recent research has shown that women in situation of migration count among the most vulnerable - notably facing consequent barriers to health services including maternal care - and are exposed to health risks that in most cases can be prevented. This study addresses the perceptions of migrant women living in Tunisia on their experiences of pregnancy, childbirth and postpartum care. Via a qualitative, interpretative phenomenological study design, a sample of 13 pregnant women or women who recently gave birth, has been interviewed in Tunis in parallel with 10 health professionals. The aim was to explore their perceptions of maternal health as well as to collect some insights on their patient care experiences in order to ensure the quality and continuity of care for all and to prevent any woman from experiencing giving birth abroad as one more trauma. The results indicate that according to migrant women and health professionals; migrant women’s experiences of pregnancy, childbirth, motherhood and care are affected by many struggles – cultural, displacement and human rights related – at the individual, social environment, living and working as well as at the socio-cultural and health system levels. Understanding these difficulties constitutive of migrant women vulnerabilities and implementing appropriate relational and operational changes could improve maternal health experiences for both the women and the health care providers. Further research on maternal health in Tunisia is needed to gain a broader understanding of migrant women’s experiences at the national level as well as in other MENA countries, to improve the maternal health experiences of this particularly vulnerable population.