| 1. |
- Arousell, Jonna, 1985-, et al.
(författare)
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Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception? : A qualitative exploration and critique of a common argument in reproductive health research
- 2019
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 75, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Objective: 'Low socioeconomic status' and 'religiousness' appear to have gained status as nearly universal explanatory models for why women in minority groups are less likely to use contraception than other women in the Scandinavian countries. Through interviews with pious Muslim women with immigrant background, living in Denmark and Sweden, we wanted to gain empirical insights that could inform a discussion about what 'low socioeconomic status' and 'religiousness' might mean with regard to women's reproductive decisions. Design: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016. Findings: We found that a low level of education and a low income were not necessarily obstacles for women's use of contraception; rather, these were strong imperatives for women to wait to have children until their life circumstances become more stable. Arguments grounded in Islamic dictates on contraception became powerful tools for women to substantiate how it is religiously appropriate to postpone having children, particularly when their financial and emotional resources were not yet established. Conclusion: We have shown that the dominant theory that 'low socioeconomic status' and 'religiousness' are paramount barriers to women's use of contraception must be problematized. When formulating suggestions for how to provide contraceptive counseling to women in ethnic and religious minority groups in Denmark and Sweden, one must also take into account that factors such as low financial security as well as religious convictions can be strong imperatives for women to use contraception. Implications for practice: This study can help inform a critical discussion about the difficulties of using broad group-categorizations for understanding individuals' health-related behavior, as well as the validity of targeted interventions towards large heterogeneous minority groups in Scandinavian contraceptive counseling. (C) 2019 The Authors. Published by Elsevier Ltd.
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| 2. |
- Arousell, Jonna, 1985-, et al.
(författare)
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Culture and religious beliefs in relation to reproductive health
- 2016
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Ingår i: Baillière's Best Practice & Research. - : Elsevier. - 1521-6934 .- 1532-1932. ; :32, s. 77-87
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Tidskriftsartikel (refereegranskat)abstract
- Det är vanligt att betona betydelsen av att väga in kulturella och religiösa idéer i forskningen om sexuell och reproduktiv hälsa. I den här genomgången av litteratur på området visar författarna att beläggen för argumentet är svaga då det i hög utsträckning saknas kunskap kring hur muslimska patienter själva resonerar i de här frågorna. Vad som tycks vara betydelsefullt är att anpassa vården till religiös heterogenitet och variation och till de subjektiva och intersubjektiva religiösa förhandlingar som muslimska patienter själva är inblandade i.
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| 3. |
- Arousell, Jonna, 1985-, et al.
(författare)
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Does Religious Counselling on Abortion Comply with Sweden's 'Women-Friendly' Abortion Policies? : A Qualitative Exploration Among Religious Counsellors
- 2019
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Ingår i: Sexuality & Culture. - : Springer. - 1095-5143 .- 1936-4822. ; 23:4, s. 1230-1249
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Tidskriftsartikel (refereegranskat)abstract
- The abortion discourse in Sweden is marked by historically liberal ideals about women's inviolable right to make autonomous reproductive decisions. However, to respond to the increase in cultural and religious pluralism building up over several decades, religious organizations have been given opportunities to provide so-called spiritual care in affiliation with Swedish hospitals since the 1980s. In this study we asked: in what ways do religious counsellors, affiliated with Swedish hospitals, construct their ideas on abortion, and how well do their ideas comply with Sweden's 'women-friendly' abortion policies? Through interviews with Protestant, Catholic, Muslim, and Buddhist religious counsellors, we wanted to empirically test the presumption underlying the decisions to grant space to religious actors in Swedish healthcare, i.e., that religious counselling serves to complement existing services. We found that it cannot be expected that religious advice on abortion will always comply with Swedish abortion law and with the women-friendly abortion policy that the Swedish state seeks to impose. When policy-makers open up possibilities for diverse norms on abortion to manifest in close affiliation with healthcare institutions, they must be aware that some religious counsellors argue that only God-and not the woman herself-can decide whether a woman can terminate a pregnancy. We argue that the findings in this study speaks to what researchers have referred to as the "diversity-equality paradox", which highlights the tension between the promotion of religious ideas on abortion on the one hand and the promotion of liberal ideas about women's reproductive freedom on the other.
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| 4. |
- Arousell, Jonna, 1985-, et al.
(författare)
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Is multiculturalism bad for swedish abortion care? Exploring the diversity of religious counselling in public healthcare institutions
- 2018
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 28:Suppl 1, s. 122-122
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sweden has one of the most liberal abortion laws in the world, granting women extensive rights to make autonomous reproductive decisions. At the same time, Swedish policy-makers are keen to protect society’s religious diversity. This ambition is reflected in decisions to grant religious leaders the possibility to provide ‘spiritual care’ in public hospitals. Through interviews with religious representatives in public healthcare institutions, we asked: In what ways would they counsel a religious woman who is seeking their advice about abortion? And how does this advice correspond with Swedish policies on, and provision of, abortion care? Methods: Individual interviews were conducted with religious representatives of the Swedish Church, the Catholic Church, and the Buddhist and Muslim communities. Interviews took place in 2016 and 2017. Findings: We found that informants saw it as their obligation to provide religious people with abortion advice according to religious norms, giving them limited opportunities to harmonise the content of their counselling with Swedish healthcare laws or regulations. Most informants argued that it was their responsibility to inform women about the wrongdoing of terminating a pregnancy, and to provide suggestions about how women could mitigate the sin in order to gain God’s forgiveness. Conclusion: Informants appeared inclined to deliver religious recommendations on abortion that were more conservative than what is established in the Swedish Abortion Act. Main messages: ‘Spiritual care’ in the question of abortion favours the delivery of religious norms at the possible expense of women’s right to non-judgmental abortion counselling. ‘Spiritual care’ is now an integral part of Swedish healthcare institutions. A critical discussion is needed about the extent to which such services should be in compliance with Swedish laws and public health aims on abortion.
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| 5. |
- Arousell, J., 1985-, et al.
(författare)
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Unintended consequences of gender equality promotion in Swedish contraceptive counselling
- 2018
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 28:Suppl 1, s. 105-105
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sweden stands out as an interesting example of potential cross-cultural tensions in reproductive healthcare. On the one hand, most people agree that gender equality between men and women should apply to everyone. On the other hand, people in Sweden report a high level of respect for cultural diversity, emphasising people’s ‘right to be different’. The aim of this study was to explore how midwives communicate gender equality perspectives in encounters with non-Western patients, many of whom have migrated from countries expressing less support for gender equality. Methods: Semi-structured individual interviews as well as focus group interviews were conducted in Denmark and Sweden between 2013 and 2016. Carol Bacchi’s ‘What’s the Problem Represented to be’ approach guided the analysis. Findings: We found that it is difficult for health care providers who are ideologically motivated to promote gender equality in clinical encounters, to simultaneously value and tolerate traditions that are considered to uphold gender-unequal structures. The gender equality standard is thus one example of a liberal, egalitarian value that health care providers appeared to give priority to at the expense of others. Conclusions: That the gender equality ideology is given priority is not necessarily undesirable but nevertheless appears to generate unintended consequences. We argue that a high level of ideological persuasion upon female patients may negatively influence their experience of the encounter, and negatively influence women’s possibilities to obtain adequate support in relation to their individual needs. Main messages: Healthcare providers are also part of cultural systems of norms — such as pertinence to gender equality — although these are seldom problematized ‘Reflexivity’ as a working tool can assist healthcare providers to reflect upon how gender equality norms influence clinical encounters.
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| 6. |
- Arousell, Jonna, 1985-, et al.
(författare)
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Unintended consequences of gender equality promotion in Swedish multicultural contraceptive counseling : a discourse analysis
- 2017
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 27:10, s. 1518-1528
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we explore how reproductive health care providers in Sweden, a country often described as one of the most gender-equal countries in the world, incorporate gender equality ideals in multicultural contraceptive counseling. In the tension between gender equality promotion on one hand and respect for cultural diversity and individualized care on the other, we will demonstrate that values of gender equality were often given priority. This is not necessarily undesirable. Nevertheless, our proposal is that the gender equality ideology may inhibit providers’ ability to think differently about issues at stake in contraceptive counseling, which may negatively influence women’s possibilities to obtain adequate support. At the end of the article, we suggest how health care providers’ reflexivity might be used as a working tool for increased awareness about the taken-for-granted cultural norms that exist in their clinical milieu.
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| 7. |
- Johnsdotter, Sara, et al.
(författare)
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"Never my daughters" : a qualitative study regarding attitude change toward female genital cutting among Ethiopian and Eritrean families in Sweden
- 2009
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Ingår i: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 30:1-2, s. 114-133
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Tidskriftsartikel (refereegranskat)abstract
- To explore attitudes toward female genital cutting (FGC) in a migration perspective, qualitative interviews were conducted with men and women from Ethiopia and Eritrea in Sweden. We found firm rejection of all forms of FGC and absence of a guiding motive. Informants failed to see any meaning in upholding the custom. We conclude that children of Ethiopian or Eritrean parents resident in Sweden run little risk of being subjected to FGC. A societal structure prepared to deal with suspected cases of FGC with a high level of alertness should be combined with a healthy sceptical attitude toward exaggerations of risk estimates.
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| 8. |
- Mohammadi, Soheila, et al.
(författare)
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Experiences of inequitable care among Afghan mothers surviving near-miss morbidity in Tehran, Iran : a qualitative interview study
- 2017
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Ingår i: International Journal for Equity in Health. - : BioMed Central. - 1475-9276. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Providing equitable maternal care to migrants is a seriously challenging task for hosting countries. Iran, the second-most accessed country for refugees from Afghanistan, has achieved maternal health improvement. However, Afghan women with near-miss morbidity faced pre-hospital delays and disparity in maternal care at hospitals. This study explores experiences of maternal care among Afghan women surviving near-miss morbidity to increase insight into healthcare improvements for migrants. Methods: A qualitative study was conducted at university hospitals in Tehran, from April 2013 to May 2014. A total of 11 Afghan women and 4 husbands were interviewed when women recovered from near-miss morbidity that occurred around the childbirth period. Mothers were identified prospectively using the WHO maternal near-miss approach. Thematic analysis was used along with a data-driven approach to organize data guided by the 'three delays model' theoretical framework. Results: Mistreatment in the form of discrimination and insufficient medical attention were key experiences. Participants commonly perceived poor women-professional communication and delays in recognizing obstetric complications despite repeated care-seeking. Financial constraints, costly care, lack of health insurance, and low literacy were experienced barriers to accessing care to a lesser extent. Non-somatic consequences of near-miss morbidity affected mothers and families for extended periods. Conclusions: Near-miss survivors' experiences provided remarkable insights into maternal care of Afghans in Iran. The challenge for the health system and professionals is to provide equitable care with dignity and improve communication skills with caring attitudes toward ethnic minorities. Antenatal visits provide the best and most appropriate opportunities to tackle health illiteracy in Afghan women.
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