Care and support during maternity for mothers affected by modern slavery
A scoping review
Funders: Rights Lab (University of Nottingham)
The project:• The project aim was to map the available evidence and resources on maternity care provision and non-statutory support to pregnant women and mothers affected by modern slavery.
Three key themes were identified:
a) women's perspectives on barriers to access and engagement with maternity services;
b) challenges and needs identified by healthcare professionals; and
c) the impact of human trafficking on maternal and neonatal outcomes.
Maternity was being experienced by survivor mothers with the following: unfamiliarity with and lack of access to systems and information across all sectors, barriers to care and entitlements, contemporary threats of violence from partners/traffickers, restricted ability to move freely, issues related to traumatisation, dispersal policies, and dealing with multiple new systems.
Healthcare professionals and midwives did not feel adequately prepared to respond to the needs of this vulnerable population due to several factors, including the following: lack of training in how to assist trafficked women, individualized tools, or maternity-specific guidelines or intervention protocols; insufficient knowledge on the human trafficking topic; difficulty in recognising signs of trafficking; absence of a clear plan of action to follow, and confusion of roles amongst different healthcare professionals.
Women who have been trafficked are at risk of physical and emotional health issues that may affect maternal and foetal outcomes, including prematurity, low birth weight, increased perinatal mortality, developmental delays and behavioural and mental health issues, compromised mother-baby bonding, infections, foetal death, and miscarriage. Late access to maternity care is an additional risk factor for maternal and foetal/neonatal morbidity and mortality.
The aims of maternity care and non-statutory support should be to achieve optimal health and well-being for each woman and her baby, avoid further traumatisation, facilitate recovery, promote reintegration, and prevent re-exploitation. Although several sources indicate principles that should be adopted, the detail of how optimal care and support during maternity should be provided by healthcare professionals and non-statutory service staff is lacking. Further research is required, from which recommendations for good maternity practice and the effective intersection between statutory and non-statutory services can be derived and subsequently mobilised across different systems and settings. We are currently seeking funding to conduct additional research in this area and address the gaps identified.
For more information contact: sara.borrelli@nottingham.ac.uk
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