45 Birth companions as maternal health interventions for asylum seekers and refugees in the UK

Abstract OP 30: Refugees and Asylum Seekers 5, B308 (FCSH), September 4, 2025, 16:00 - 17:12 Background In the UK, much attention has been paid to the maternal mortality rate of black and Asian women who have almost a four-fold and two-fold difference (respectively) compared to white women. The release of MBRRACE-UK drew national attention to the clear racial variations in maternal deaths. Working alongside nurses and midwives, birth companions or doulas have increased across the UK in attempt to improve perinatal experiences of pregnant patients and clients partially in response to these rates. Typically located in and provided by charities in the voluntary, community and social enterprise (VCSE) sector, these birth companion organisations face tremendous strain supporting families who face micro and macro aggressive racism and discrimination. Birth companions who support asylum seekers and refugees are increasingly supporting the birth journeys and often navigate and advocate in these often hostile environments. Method Undertaking qualitative, semi-structured interviews, this project explores the ways that UK birth companions who work primarily with asylum seeker and refugee families to support a positive birth experience despite the experiences of racism. Interviews were analyzed using thematic analysis generating themes using Nowell et al’s (2017) five phases. Results This project identified several key themes including (a) how birth companions selected to support clients, (b) how the birth companions work with nurses and midwives to support clients during racist and discriminatory encounters and process these experiences, (c) the ways in which birth companions and nurses and midwives navigate these encounters and interactions with one another. Conclusions Supporting asylum seeker and refugee families during pregnancy, birth and post-partum requires cultural competency and cultural safety. Doulas are often well equipped to support racialized families and navigate tense situations when they have specialized training around anti-racism.