Betty Goguikian Ratcliff

Factors associated with antenatal depression and obstetric complications in immigrant women in Geneva

OBJECTIVE immigrant women are at increased risk for health problems during pregnancy, and for antenatal and postnatal depression. This study aimed to identify sociodemographic and specific psychosocial risk factors of antenatal depression and obstetric complications in an economically and culturally heterogeneous sample. DESIGN prospective cross-sectional design. SETTING the study was conducted in a midwifery office. PARTICIPANTS the community sample included 228 immigrant pregnant women with low French proficiency referred to birth preparation classes between 2006 and 2014 in Geneva, Switzerland. MEASUREMENT depressive symptoms were measured during the third trimester of pregnancy using the Edinburgh Postnatal Depression Scale. A cut-off score ≥12 was considered to be indicative of antenatal depression. FINDINGS more than half of the participants had been living in Switzerland for less than five years and had a short-term residence permit. Thirty-seven per cent of women scored above the clinical cut-off score. Women with several risk factors, such as a precarious legal status, lack of marital support, difficult living conditions and being a newcomer to Switzerland, were at higher risk of depression. Women who encountered difficult living conditions were at higher risk of obstetric complications. IMPLICATIONS FOR PRACTICE these results confirm the findings of previous research, and highlight the need for early detection. Public health prevention policies should consist of multidimensional programmes to address simultaneously psychosocial, cultural and obstetric issues in pregnant immigrant women.

Psychosocial and Sociocultural Factors Influencing Antenatal Anxiety and Depression in Non-precarious Migrant Women

The aims of this paper are (1) to assess the role of sociodemographic and psychosocial risk factors on antenatal anxiety (AA) and antenatal depression (AD) in first-generation migrant women in Geneva, as compared to a control group of native Swiss women, and (2) to examine the role of acculturation and other sociocultural factors in the development of antenatal distress in migrant women. A sample of 43 migrant and 41 Swiss pregnant women were recruited during the third trimester of pregnancy. AA was assessed by using the State Trait Anxiety Inventory, and AD by using the Edinburgh Postnatal Depression Scale. Acculturation was assessed as a bidimensional process comprising attachment to the heritage culture and adaptation to the local Swiss culture, using the Vancouver Index of Acculturation. AA in migrant women was mainly predicted by psychosocial factors, namely socioeconomic status, marital support, family presence in Geneva and parity, while AD was predicted by one dimension of acculturation, i.e., attachment to the heritage culture. Our study can inform perinatal health care professionals about some specific risk factors for antenatal distress in migrant women in order to increase systematic screening procedures.

Antenatal Depression in Immigrant Women: a Culturally Sensitive Prevention Program in Geneva (Switzerland)

Introduction: Immigrant women in developed countries experience worse pregnancy outcomes than native women and are at high risk for antenatal depression and anxiety. Stresses related to the immigration and lack of cultural support affect emotional well-being, a situation calling for a response from primary caregivers and healthcare policies.

Traumatisme psychique chez des femmes en exil : un dispositif de soin groupal

Dans la prise en charge therapeutique de victimes de violences collectives, l’approche analytique groupale constitue un dispositif privilegie car elle permet de consolider une identite et une memoire collectives mises a mal, et d’elaborer par la meme, une identite individuelle en mutation. La presente recherche analyse le processus therapeutique dans un groupe de femmes albanaises requerantes d’asile a Geneve, en elaborant une grille d’analyse du discours originale. Les resultats montrent que le groupe aborde les thematiques relatives a l’identite et aux appartenances collectives, mais les echanges portent aussi sur le changement du systeme de valeurs, sur les dimensions du choix et de la maitrise de son destin. L’effet structurant du dispositif groupal est mis en evidence. Le travail psychotherapeutique est axe a la fois sur l’elaboration de l’experience traumatique et de l’experience migratoire, toutes deux impliquant une rupture et une discontinuite.