PROREF (PH-LENS sub-project)

Pregnancy and Obstetric Care of Refugees

Project duration: 01/11/2019 - 31/10/2022

Principal investigator: Prof. Dr. Theda Borde, Prof. Dr. Matthias David (Charité – Universitätsmedizin Berlin)

Project staff: Martha Engelhardt (ASH), Louise Teschemacher (Charité)


PROREF is a cooperation project between ASH Berlin and Charité Berlin. The project is part of the research group ‘Refugee migration to Germany: a magnifying glass for broader public health challenges (PH-LENS)’ funded by the German Research Foundation (DFG).
Perinatal health of mothers and newborns is an important quality of care indicator. In Germany little is known about antenatal obstetric care, the outcomes for refugees and how pregnancy and obstetric care services respond to diversity. PROREF will employ a mixed-methods design to understand how and to what extent contextual factors (geographical region, living conditions in shared accommodations) influence pregnancy, obstetric care and perinatal health outcomes.

For this purpose qualitative data will be collected in three regions: Brandenburg, Berlin and North Rhine-Westphalia. Refugee mothers (up to 3 months after childbirth) will be interviewed individually and in focus group discussions in order to analyse experiences, pathways, resources and obstacles in pregnancy and maternity care (related to e.g. the region of residence, the accommodation type, private social networks, institutions and other factors contributing to their agency). In addition to the perspective of refugee mothers, problem-centered interviews with health care professionals will be conducted to identify their perception and attitudes of providing pregnancy and maternity care to refugees and to analyse the role of contextual conditions in their care units.

Quantitative data will be collected over a period of 24 months in three obstetric wards in Berlin. Perinatal process and outcome data routinely collected in the framework of quality assurance in obstetric wards will be compared for women with refugee status, immigrants and patients born in Germany. Standardised interviews with women in the same maternity wards will be conducted regarding sociodemographic aspects, experiences and challenges during pregnancy and birth and the perceived  adequacy of care.

The results of PROREF will define what is needed to increase health system resilience facing diversity in pregnancy and obstetric care in Germany.

Funding: Deutsche Forschungsgemeinschaft (DFG)

Keywords: Female Refugees, Pregnancy, Obstetric Care, PROREF