Refugee and Migrant Women's Views of Antenatal Ultrasound on the Thai Burmese Border: A Mixed Methods Study

Antenatal ultrasound suits developing countries by virtue of its versatility, relatively low cost and safety, but little is known about women's or local provider's perspectives of this upcoming technology in such settings. This study was undertaken to better understand how routine obstetric ultrasound is experienced in a displaced Burmese population and identify barriers to its acceptance by local patients and providers.Qualitative (30 observations, 19 interviews, seven focus group discussions) and quantitative methods (questionnaire survey with 644 pregnant women) were used to provide a comprehensive understanding along four major themes: safety, emotions, information and communication, and unintended consequences of antenatal ultrasound in refugee and migrant clinics on the Thai Burmese border. One of the main concerns expressed by women was the danger of childbirth which they mainly attributed to fetal malposition. Both providers and patients recognized ultrasound as a technology improving the safety of pregnancy and delivery. A minority of patients experienced transitory shyness or anxiety before the ultrasound, but reported that these feelings could be ameliorated with improved patient information and staff communication. Unintended consequences of overuse and gender selective abortions in this population were not common.The results of this study are being used to improve local practice and allow development of explanatory materials for this population with low literacy. We strongly encourage facilities introducing new technology in resource poor settings to assess acceptability through similar inquiry

Demographics of 644 women participating in the questionnaire.

<p>Data are in median [range], or percentage (number).</p

Responses to open questions in a questionnaire among 644 pregnant women on the Thai Burmese border.

<p>This table refers to questions 6–8 of the questionnaire in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034018#pone.0034018.s001" target="_blank">file S1</a>.</p

Geographical setting of the antenatal clinics of the Shoklo Malaria Research Unit.

<p>Location of the Shoklo Malaria Research Unit antenatal clinics and Mae Sot, the main town in the Thai province of Tak, bordering Burma. The locations of the antenatal clinics are represented by squares.</p

Responses to “what would you do if?” questions in a questionnaire among 644 pregnant women on the Thai Burmese border.

<p>This table refers to questions 14–17 of the questionnaire in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034018#pone.0034018.s001" target="_blank">file S1</a>.</p