The obstetric care of asylum seekers and refugee women in the UK

Key content Asylum seekers and refugees are a vulnerable group with regards to pregnancy outcomes and accessing maternity care. Asylum seekers and refugees who are pregnant and living in the UK face medical, sexual and psychosocial challenges, including dispersal late in pregnancy. The health needs of asylum seekers and refugees are complex but similar to other deprived and ethnic minority communities in the UK. Asylum-seeking women are three times more likely to die in childbirth and up to four times more likely to experience postnatal depression than the general population because of a complex combination of physical, psychological, educational, monetary and language problems. Healthcare professionals may not be aware of the legal issues surrounding asylum seekers, and therefore may not provide adequate help and support. Learning objectives To gain knowledge of how to provide good antenatal care for this group of vulnerable women. To be able to describe the medical, sexual and psychosocial issues that face pregnant asylum seekers and refugee women in the UK. To gain awareness of the legal aspects of seeking asylum in the UK and its impact on accessing health care, especially in pregnancy. Ethical issues Should the NHS provide free health care to failed asylum seekers? Is it justified to disperse pregnant women late in the third trimester (up to 36 weeks of gestation) to prevent destitution with consequent fragmentation of care and isolation of the women?