Double standards: dispersal and pregnant asylum seekers in Britain

The NHS prides itself on its high standard of maternity care, yet by transporting pregnant asylum seekers between cities, removing them from partners, support networks and trusted midwives, the UKBA is sending the message that these principles don’t apply to asylum seeking women

Anna Dixie
15 March 2013

Afya was three months pregnant when she arrived in the UK to claim asylum. She had spent months hidden in lorries on her journey to the UK. She arrived exhausted, undernourished, scared and having received no medical attention.

Rather than being able to rest and take care of herself during her pregnancy, the UK Border Agency (UKBA) proceeded to move Afya around the country six times before she gave birth, and once a week afterwards. She explains, ‘When I arrived I was put into prison for one day, and on the next day I was taken to Yarlswood Detention Centre in Bedford where I stayed for about two months. After that, they took me to a UKBA hostel and I stayed there for one month and two weeks. Then I was put in another accommodation for one night before being taken back to Yarlswood for a month. When I came out they took me to a hostel in Wales and I lived there for about a month, then they brought me to a shared house and then I went to hospital to give birth.’

These moves separated Afya from her partner at the time when she and her baby needed him most, and made it impossible for her to put down roots or to build a relationship with a midwife.

Afya was the first person I interviewed for a research study carried out by British Refugee Council and Maternity Action, which investigates the impact on pregnant women and new mothers of the UKBA’s policy of ‘dispersal’. This is a policy of accommodating asylum seekers on a ‘no-choice basis’ in areas of the country where there is ‘a ready supply’ of housing’. Afya was one of 20 asylum seekers and 17 midwives who took part in the research. Sadly, as I interviewed more women I discovered that her story was by no means exceptional.

'Dignity in pregnancy'. Photo by Simon Whitlock

'Dignity in pregnancy'. Photo by Simon Whitlock

Separating mothers from support networks

Clara had been living in London for over a year when she was moved to another town whilst eight months pregnant. She had built up a network of friends in London and was an active member of her local church and refugee agency. She was receiving counseling and had built up a strong relationship with her counselor, her midwife and the hospital consultant who had been very supportive during a previous operation and was planning to deliver her baby. Clara’s doctor wrote to the UKBA to tell them that she was not able to travel but this advice was ignored and she was moved anyway. Clara told me about the journey to her new home: ‘I was crying all the way in the car. I don’t even know why I was crying. I was thinking, “I’m going to a new place, I’m pregnant, I don’t know the hospital, I’ve left it behind”.’

Like many other pregnant asylum seeker women, Clara gave birth alone. Had she been in London she would have had friends who would have come with her to the hospital and the father of her child would have been her birth partner. As it was, he traveled down to see her as soon as she went into labour, but missed the birth because of the distance. Coping with a baby without friends and community support made the experience of being a new mother difficult and distressing for Clara: ‘Physically I was weak. Mentally I was worrying that I don’t have support at home and I have a little baby to look after and I have to look after myself....the night I was discharged I was in so much pain I had to call the emergency services.’

Putting women’s health at risk

Janet had been diagnosed with a low-lying placenta, which meant that she would have to have a cesarean section and needed to be monitored closely. She had a vital scan scheduled for her 37th week of pregnancy. However, the UKBA moved her to another city at 35 weeks. No arrangements were made to ensure continuity of care, and although the UKBA-contracted accommodation providers are required to assist asylum seekers in registering with health services, in Janet’s case, the ‘support’ she was given was inadequate. ‘The accommodation provider said to me there is a hospital there and waved her hand in the direction while we were driving through the town. But the next day when I went to look for it I couldn’t find it so I had to ask people in the streets but I still couldn’t find it. When I got there they said they couldn’t take me because before they could register me it would take three weeks. No-one helped me. I found a GP surgery where they asked me to fill a form and said they would call me after two weeks. But I couldn’t wait that long because I needed to do a scan at 37 weeks and it was really important. At that point I was already in the 37th week of my pregnancy.’ At this point Janet went to the Red Cross who contacted the surgery and forced them to register her immediately. Without their intervention she would have missed her scan, which could have had serious consequences for her baby’s health.

What alarmed me when speaking to Janet and the other women was the absence of almost any support for women who were often heavily pregnant, completely on their own in a new city, in urgent need of medical attention, didn’t know their way around and often couldn’t express their needs because they didn’t speak English.

Report launch in Parliament. Photography by Simon Whitlock

Report launch in Parliament. Photo by Simon Whitlock

Unsuitable accommodation

More than half of the mothers we interviewed for our research had spent time in a UKBA hostel whilst pregnant or with their new-born child. Most of them have bad memories of their stay, either because of poor standards of hygiene, fears about their personal safety when sharing facilities with men, sharing bedrooms, sleeping in bunkbeds or because they had difficulty accessing appropriate health care. Overwhelmingly, women felt that a hostel was not a safe place for their baby. Patience explains: ‘It was a bad experience because there was no bath for my baby. I had to put him in the sink to wash him. The bathroom was dirty. You have six or seven people using the same bathroom. There was no space for the baby to play. The top floor is for men, very huge men from prison. They always warn women that they should not go there.’

In their maternity care policies the National Institute for Health and Clinical Excellence (NICE) highlights asylum seekers as being a particularly vulnerable group because many suffer from underlying health problems, having survived violence, rape or torture in their home country. However, the UKBA still considers it acceptable to move pregnant asylum seeker women around the country in all but the most ‘exceptional circumstances’.

Putting an end to double standards

While I can understand the UKBA’s imperative to provide accommodation in cheaper areas of the country, this doesn’t explain why it is necessary to move women several times from one insecure, sub-standard temporary accommodation to another before allowing them to settle down. Nor does it justify the arrogant attitude of some UKBA officials who think that they know better than health professionals when it is safe for a woman to move. I was shocked to be told by one asylum support officer that she had disregarded a letter from a woman’s doctor which stated that she was not fit to travel at 37 weeks because it lacked a ‘detailed explanation’ of her condition. To me this seemed a clear tactic designed to pressurise this woman into accepting accommodation outside London, which eventually she did, telling me that she was ‘too tired to fight any more’.

The National Health Service (NHS) prides itself on its high standard of maternity care, where a strong relationship with a trusted midwife, extra attention for groups with complex social factors and continuity of care are central principles. Yet by removing asylum seeking women from already established antenatal services, and making no arrangements to transfer them to equivalent services in their new area, the UKBA is sending the message that these principles don’t apply to asylum seeking women. We need to speak up against this differential treatment and tell the UKBA that all women, including mothers like Afya, Clara and Janet, deserve dignity in pregnancy.

Refugee Council and Maternity Action’s final research report ‘When Maternity Doesn’t Matter’ was launched in parliament earlier this month, marking the start of an ongoing campaign to demand #dignityinpregnancy for asylum seekers in Britain.

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