Exploring Somali-born women's experiences with contraceptive services in Sweden through a reproductive justice lens.

内容摘要

Timely and equitable access to contraceptive services is a key component of sexual and reproductive health and rights. Evidence shows that immigrant women in high-income countries often receive inadequate contraceptive counselling. There is also limited knowledge about how contraceptive services can best be organised within health systems to meet their needs. In Sweden, the Somali population is one of the country's largest immigrant groups facing a higher risk of adverse pregnancy and childbirth outcomes compared to Swedish-born women. This study aimed to gain a deeper understanding of Somali-born women's perceptions of and experiences with contraceptive services in Sweden. Eight focus group discussions were conducted, with a Somali-speaking moderator, and data were analysed using Braun and Clarke's reflexive thematic approach. All participants (N = 60) were Somali immigrants who had given birth in Sweden. Two main themes were constructed: (1) Factors shaping reproductive choices: community, household, and partner influences, and (2) women's perspectives on contraceptive services. The findings suggest opportunities to advance reproductive justice in contraceptive services in Sweden. Incorporating women's preferences and needs is essential to establishing person-centred contraceptive services, aligning with Sweden's health system priorities. Services must adapt to and reflect clients' experiences to avoid being shaped by preconceived notions and intersecting power dynamics. Our findings have implications for moving towards reproductive justice in the delivery of sexual and reproductive health services. Access to good-quality contraceptive services is an important part of sexual and reproductive health and rights. Research shows that immigrant women often do not get enough support or information about contraception. In Sweden, Somali-born women face more health risks during pregnancy and childbirth compared to Swedish-born women. This study looked at how Somali-born women in Sweden experience and think about contraceptive services. We conducted eight group discussions with 60 women, led by a Somali-speaking moderator. From the conversations, we found two main themes: 1) factors shaping reproductive choices and 2) Women’s perspectives on contraceptive services. The findings show that the health system needs to listen better to women’s needs and experiences to improve contraceptive services. To be fair and respectful, services should avoid stereotypes and take each woman’s situation into account. These findings can help improve sexual and reproductive healthcare for others in similar situations.