Contents
- Lifestyle related illnesses and hypertension
- Cancer
- Mental health
- Immunisation
- Maternity services
- Children and young people
- Rough sleepers and homeless community members
- Introduction to the Roma health guide
- Barriers to healthcare for the Roma community
- System barriers
- Language barriers and communication
- Cultural barriers - Common health problems and vulnerable groups:
- Lifestyle related illnesses and hypertension
- Cancer
- Mental health
- Immunisation
- Maternity services
- Children and young people
- Rough sleepers and homeless community members
Maternity services
Some barriers to maternity services are systemic, particularly for newly arrived migrant communities. There is no single source of information and explanations of the process, and many Roma expectant parents lack understanding of the maternity care pathway. There is also a move towards digital services which makes it difficult for people to access appointments and reliable information, and it is also not well advertised that patients can ask for interpreters at appointments.
Many of the other barriers to women receiving antenatal and postnatal care are grounded in Roma taboos and traditions around childbirth, which are associated with cultural conceptions of cleanliness and purity. Starting with antenatal care, in the Roma community healthcare is widely seen as curative and not preventative, and pregnancy is treated as a normal part of life and not a health issue. This leads to a lack of understanding of why attending checkups to get screening and blood tests are needed. There is also a linguistic taboo around using words like “breast” in breast feeding, showing pictures of genitals, or touching areas of the body seen as sexual. For materials on breastfeeding, see our page of Resources for the Roma Community. (Scroll down to the section on Children and Parenting).
A key barrier to postnatal care is that in traditional Roma culture a woman is considered “unclean” for a period of time after giving birth - usually one month, but in some very traditional communities up to three months, where she does not leave the house and is supported by female family members. The husband may move out of the home during this time. This custom is known as a purity period and will often mean missing routine appointments outside the home, such as the baby’s first immunisation or heel prick test.
Roma mothers are often not aware of what will happen on home visits and why – for example, that private conversation is needed or that instructions on breastfeeding may involve touching parts of the body seen as taboo. They may also be unaware of the option to seek help for postnatal depression, or afraid of getting help due to distrust of health professionals and the taboo around mental health problems described here.
Recommendations:
Many of the other barriers to women receiving antenatal and postnatal care are grounded in Roma taboos and traditions around childbirth, which are associated with cultural conceptions of cleanliness and purity. Starting with antenatal care, in the Roma community healthcare is widely seen as curative and not preventative, and pregnancy is treated as a normal part of life and not a health issue. This leads to a lack of understanding of why attending checkups to get screening and blood tests are needed. There is also a linguistic taboo around using words like “breast” in breast feeding, showing pictures of genitals, or touching areas of the body seen as sexual. For materials on breastfeeding, see our page of Resources for the Roma Community. (Scroll down to the section on Children and Parenting).
A key barrier to postnatal care is that in traditional Roma culture a woman is considered “unclean” for a period of time after giving birth - usually one month, but in some very traditional communities up to three months, where she does not leave the house and is supported by female family members. The husband may move out of the home during this time. This custom is known as a purity period and will often mean missing routine appointments outside the home, such as the baby’s first immunisation or heel prick test.
Roma mothers are often not aware of what will happen on home visits and why – for example, that private conversation is needed or that instructions on breastfeeding may involve touching parts of the body seen as taboo. They may also be unaware of the option to seek help for postnatal depression, or afraid of getting help due to distrust of health professionals and the taboo around mental health problems described here.
Recommendations:
- Offer training on cultural practices for GPs, midwives, maternity/perinatal health services and health visitors, including the postpartum "purity period" and good practice on home visits.
- Work with community organisations to hold Q&A sessions on maternity care for Roma women with female practitioner nurses in community venues.
- Produce information for distribution by GPs in community languages that explains the pregnancy care pathway, which professionals are involved and the reasons behind common practices.
- Rename sensitive terms in material and training, eg. “natural feeding” for breastfeeding.
- Provide women after the birth with information they can use during the postpartum “purity period”, eg. on preventing cot death, breast feeding, heel prick test and first bath for the baby.
- Explain to the family what will happen on health visits, and the need for private conversation / instructions that may involve touching.
- Ensure that maternity staff provide pre-natal and post-natal support for Roma women on public health messages, signposting to immunisation, sexual health and mental health.
- Avoid using children as interpreters, especially on gynaecological issues.
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The Roma Support Group is a registered Charity (No. 1103782)
and a Company Limited by Guarantee registered in England and Wales, (No. 0464598). Registered office address: 17 Old Ford Road, London, E2 9PJ |
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