Doctor of Philosophy

dissertationResearch indicates that culturally determined beliefs and values play a significant role in influencing perinatal healthcare access and utilization among Somali refugee women resettled in the U.S. The purpose of this qualitative descriptive study was to explore the practices of resettled Somali refugee women around pregnancy, to explore the cultural gaps between the women and healthcare providers, and to identify their perception of barriers in accessing and utilizing perinatal services in Salt Lake City, Utah. This study utilized a qualitative descriptive (interpretive description) method of inquiry to analytically inquire about the cultural descriptions and experiences of Somali refugee women as narrated by themselves. Data collection methods used in this study included interviews, field notes and observation. Recruitment of study participants began September 2016 concluding in April 2017. Leininger's Theory of Culture, Care Diversity and Universality and Ramsden's Cultural Safety theory both served as theoretical frameworks that helped shape the conception of culture and interpretation of data that emerged from interviews. Fifteen individual interviews were recorded independently and transcribed. The data were coded and labeled according to content and concepts. The emergent codes were organized based on similarity, salience or relevance leading to emergent concepts, subthemes and themes. Results describe the symbolism of Somali refugee women living in two separate worlds and their resulting state of in-betweenness. The cultural context in which Somali iv refugee women approached, managed, and conceptualized pregnancy and childbirth is also described. The results also captured significant external influences that affected the women's perinatal healthcare decisions as well as their own descriptions of their experiences and perceptions with Western perinatal healthcare. Recommendations from the women on how to bridge the cultural gaps as well as implications of this work are identified. These include better perinatal healthcare practices by Western healthcare providers, increased cultural competence and provision of culturally safe care. When Western healthcare providers ignore or are unfamiliar with the cultural beliefs of refugee women patients, it can lead to inadvertent consequences such as medication errors, breakdown in care, noncompliance with care plans, lack of or reduced utilization of care, and overall patient dissatisfaction