“I have to do what I believe” : Sudanese women’s beliefs and resistance to hegemonic practices at home and during experiences of maternity care in Canada

摘要

Background: Evidence suggests that immigrant women having different ethnocultural backgrounds than thosedominant in the host country have difficulty during their access to and reception of maternity care services, butlittle knowledge exists on how factors such as ethnic group and cultural beliefs intersect and influence health careaccess and outcomes. Amongst immigrant populations in Canada, refugee women are one of the most vulnerablegroups and pregnant women with immediate needs for health care services may be at higher risk of healthproblems. This paper describes findings from the qualitative dimension of a mixed-methodological study. Methods: A focused ethnographic approach was conducted in 2010 with Sudanese women living in an urban Canadian city. Focus group interviews were conducted to map out the experiences of these women in maternitycare, particularly with respect to the challenges faced when attempting to use health care services. Results: Twelve women (mean age 36.6 yrs) having experience using maternity services in Canada within the past two years participated. The findings revealed that there are many beliefs that impact upon behaviours andperceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe couldharm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without needfor special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family bymales and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment forwomen, and the women tend to exert control in ways that may or may not be respected by their husbands.Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength. Conclusion: In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm,through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.