Somali immigrant women's knowledge of and experiences with folic acid supplement use before and during pregnancy: A qualitative study from Norway.

INTRODUCTION: Health authorities in many countries recommend that women should take folic acid supplements before and during pregnancy to prevent having babies with neural tube defects. Somali immigrant women in Norway use less folic acid supplements than the recommended amount and subsequently, less than Norwegian-born women. OBJECTIVES: To explore Somali immigrant women's knowledge of and experiences with using folic acid supplements before and during pregnancy. METHODS: Data were collected through semi-structured individual interviews with ten Somali immigrant women in Norway. The participants were recruited and interviewed between September and November 2019. Graneheim and Lundmans qualitative content analysis was used for data analysis. RESULTS: Two main themes were developed through the process of analysing the data: 1) Attitudes to life and pregnancy affect how health care advice is met; 2) Understanding the benefits of folic acid is crucial. CONCLUSIONS: The women in this study had varied knowledge about, and experiences with the use of folic acid supplements before and during pregnancy. The findings suggest that the healthcare system needs to adapt the information it provides on folic acid supplementation to target the needs of Somali immigrant women. In line with suggestions from the study participants, information needs to be given in a timely manner, by someone they trust, in their first language, include visual aids, and be offered to all women of childbearing age before their first pregnancy.

Immigrant women's experiences with Norwegian maternal health services: implications for policy and practice.

PURPOSE: Navigating a health system which differs considerably from one's own can be a challenging process. Navigating this in seeking maternal health care can be additionally daunting. This article explores how immigrant women from diverse countries and ethnic backgrounds experienced and navigated the Norwegian maternal health service during pregnancy and childbirth. METHOD: Eleven semi-structured interviews collected between 2019 to 2020 and analysed thematically informed this analysis. FINDINGS: Principles of universalism underpinning all social and health policy in Norway, expect equality of service provision and access. These principles result in less individual choice. The women in this study found these contrary to their expectations of care but responded differently, with some experiencing the health provision as liberating while others distrusted that they were receiving the best care. A focus of concern was the expectation of more medicalized services. While some of these women used their own resources to circumvent the Norwegian health provisions, the implications for the health system extend beyond these women's experiences. CONCLUSIONS: The analysis suggests a need to encourage those whose expectations of care differ to build trust in institutions providing care. This article contributes to knowledge on the implications of diversity on Norway's universal health system.