Krevende kommunikasjon om svangerskap og fødsel - Om veiledning av innvandrerkvinner på en norsk helsestasjon
SammendragEngelsk sammendrag
Health policy documents highlight cultural knowledge as a means to achieve health care adapted to the needs of immigrants in Norway. In this article, I argue that other social factors may be as crucial for achieving this goal. Non-western immigrant women who give birth in Norwegian hospitals have a greater risk of complications than others giving birth in the same hospitals. By exploring the guidance offered to immigrant women in a Norwegian health centre I seek to cast light on this inequality. The article explores principles and guidelines for antenatal care and looks at ideals and identity of midwifery as a profession. It examines the antenatal checkups as situations of interaction between parties with unequal status and argues that midwives interacting with immigrant women often hold a double expert status. I underpin this argument through empirical examples of how absence of the pregnant woman’s mother or other female family members in Norway and lack of contacts with relevant knowledge about the Norwegian society may limit the sources of information available to immigrant women and subsequently their ability to evaluate the advice they receive from the midwives. Increased awareness about this could facilitate a more equitable and adapted antenatal health care service.
Keywords: Health, Medical anthropology, Migration, Pregnancy, Childbirth
Sammendrag
I styrende helsepolitiske dokument vektlegges kunnskap om kultur som et virkemiddel for å oppnå et tilpasset og likeverdig helsetilbud til innvandrere i Norge. I denne artikkelen argumenterer jeg for at andre sosiale faktorer kan være avgjørende for en god og likeverdig oppfølging av gravide innvandrerkvinner. Ikke-vestlige innvandrerkvinner som føder på norske sykehus, har større risiko for fødselskomplikasjoner enn andre kvinner som føder på samme sykehus. Ved å ta for meg den fødselsforberedende veiledningen for innvandrerkvinner på en norsk helsestasjon, ønsker jeg å kaste lys over denne alvorlige ulikheten i det norske helsevesenet. Jeg tar for meg prinsipper og retningslinjer for svangerskapsomsorgen og ser på jordmødres profesjonsidentitet og idealer. Videre ser jeg på svangerskapskonsultasjonen som en samhandlingssituasjon mellom parter med ulik status og argumenterer for at jordmødre i møte med innvandrerkvinner ofte innehar en dobbel ekspertstatus. Jeg bygger opp under dette argumentet ved å vise til hvordan fravær av egen mor eller andre kvinnelige familiemedlemmer, samt få kontakter med relevant kunnskap om det norske samfunnet, kan begrense innvandrerkvinners kilder til informasjon og dermed deres mulighet til å vurdere de rådene de mottar fra jordmødrene. Bevissthet rundt dette vil kunne være med å legge til rette for en tilpasset og likeverdig svangerskapsomsorg.English abstract
Communicating pregnancy and childbirth. On guidance of pregnant immigrant women in a Norwegian health centreHealth policy documents highlight cultural knowledge as a means to achieve health care adapted to the needs of immigrants in Norway. In this article, I argue that other social factors may be as crucial for achieving this goal. Non-western immigrant women who give birth in Norwegian hospitals have a greater risk of complications than others giving birth in the same hospitals. By exploring the guidance offered to immigrant women in a Norwegian health centre I seek to cast light on this inequality. The article explores principles and guidelines for antenatal care and looks at ideals and identity of midwifery as a profession. It examines the antenatal checkups as situations of interaction between parties with unequal status and argues that midwives interacting with immigrant women often hold a double expert status. I underpin this argument through empirical examples of how absence of the pregnant woman’s mother or other female family members in Norway and lack of contacts with relevant knowledge about the Norwegian society may limit the sources of information available to immigrant women and subsequently their ability to evaluate the advice they receive from the midwives. Increased awareness about this could facilitate a more equitable and adapted antenatal health care service.
Keywords: Health, Medical anthropology, Migration, Pregnancy, Childbirth
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