Experiences of pregnancy and maternity care in women exposed to human trafficking
: a qualitative evidence synthesis

  • Samantha Nightingale

    Student thesis: Master's ThesisMaster of Science by Research


    Emerging research has linked human trafficking and sexual exploitation to poor
    health outcomes. Of women who die in pregnancy, or up to a year postnatally (in
    the UK), two-thirds had pre-existing physical or mental health problems.
    Experiences of intimate partner violence and sexual violence are associated with
    poor maternal outcomes, and these risk factors share characteristics with human
    trafficking and sexual exploitation. However, studies on human trafficking/sexual exploitation are relatively sparse, and to date, there is no synthesis that draws together the existing evidence.

    A systematic review was undertaken to critically evaluate studies that had examined women’s experiences of pregnancy, and maternity services. Eight electronic databases were searched using predefined search terms. Studies were included where participants were female and had experienced trafficking or sexual exploitation and pregnancy, if they reported primary qualitative data, and were reported in English in peer-reviewed journals. The analysis used ‘Thematic
    Synthesis’ which promotes synthesis of findings from multiple qualitative studies.

    Thirteen studies were included in the final analysis. Eight descriptive themes
    emerged; barriers to healthcare (generally); late access to maternity care; thwarted continuity of care; communication difficulties; stigma; co-morbidities: women’s experiences of multiple, complex health issues; polyvictimisation; issues regarding health and care of babies. These themes developed into three analytical themes; Access, Person-centred, Poor health, with an underpinning theme of Safeguarding.

    Human trafficking victims face many barriers and abuses which cause them
    extreme and often multiple physical, mental, sexual health and social problems.
    Further research into pregnancy and neonatal outcomes of women victims and
    survivors of human trafficking is needed, specifically examining the quantitative data linking causal factors with maternity/neonatal outcomes, and interventions to support staff to recognise and respond human trafficking/sexual exploitation.
    However, the findings provide essential knowledge for healthcare providers, with
    the new “POPPY” approach offering guidance around provision of care based on
    the analytic themes - Poor health, Person centred, People who need us to say Yes to access, with an underpinning theme of safeguarding the family, mother and baby together as a family unit.
    Date of AwardOct 2019
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorLorna O'Doherty (Supervisor) & Diane Phimister (Supervisor)

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