Beginning to Optimize Peripartum Care for Somalia-Born Women by Evaluating Labor, Postpartum and Neonatal Outcomes in th
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ORIGINAL PAPER
Beginning to Optimize Peripartum Care for Somalia‑Born Women by Evaluating Labor, Postpartum and Neonatal Outcomes in the Somali Population Delivering at a Tertiary Care Center in Vermont Jenna Flanagan1 · Stephanie Mann2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Vermont has a large population of Somali immigrants and previous research has shown outcome disparities in this population. Labor curves, pregnancy and delivery outcomes information is required and critical to optimize current labor management in an institution that provides obstetrical care for this population. Data were collected for both Somalia-born and non Somaliaborn parturients in pre-pregnancy, pregnancy, delivery, neonatal and cervical change categories and were compared to non Somalia-born parturients to observe differences in demographic factors and outcomes as well as labor progress. Overall labor length trended differently between the two groups, the rate of preterm birth in the vaginal delivery group in the Somali population was much lower than the unmatched control group and overall more lacerations were noted. Findings are consistent with prior studies related to reduced preterm birth rate in Somalia-born women. Observation regarding refusal of care demonstrates need for targeted research related to concerns of Somali immigrants. Keywords Somalia · Labor · Birth · Outcomes
Introduction It is well known that social, demographic, medical and obstetrical risk factors affect pregnancy and neonatal outcomes. Many studies have shown primary cesarean delivery rates have been higher for black women when compared to white women since the 1990s which persists even in more recent literature, also demonstrating this trend to hold true with labor induction. Additionally, immigrant populations are less likely to seek prenatal care early or often [1], more likely to have hemorrhage, cesarean section delivery and small for gestational age infants [2]. Pregnancy outcomes analyzed by ethnically and culturally unique groups may highlight specific high risk populations and change labor and delivery management. * Jenna Flanagan [email protected] 1
Department of Obstetrics and Gynecology, University of Vermont Medical Center, Burlington, VT, USA
Department of Maternal Fetal Medicine, University of Vermont Medical Center, Burlington, VT, USA
2
The University of Vermont Medical Center (UVMMC) in Burlington, Vermont, serves a variety of immigrant and refugee populations. Somali immigrants have been immigrating to Vermont since the early 2000s and contribute to a large portion of deliveries from refugee mothers at the Medical Center; 9% of all refugees from 2008 to 2011 were from Somalia. Multiple studies have shown outcome disparities in Somali immigrants when compared to women native to the country or area. Specifically, investigation of pregnancy outcomes in Somalia-born women compared to women native to six other countries demonstrated Somalia-born women were less likely to deliver preter
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