Rag waa shaah, dumarna waa sheeko: Men are like tea, women are like conversation. Culturally Congruent Somali Perinatal Care in Seattle, WA - A Feasibility Study

Southeast Seattle has among the highest rates of preterm/low birth weight babies, cesarean births, women receiving inadequate perinatal and unmet maternal mental health needs in the state of Washington. Somali immigrant and refugee women in this area are medically underserved and face significant challenges accessing and utilizing perinatal care services. The Mama Amaan (safe motherhood, Somali) Perinatal Care Model was developed as an intervention to improve maternal perinatal (prenatal, birth, and post-natal) experiences and outcomes through the development of seamless, culturally congruent care for these vulnerable Somali refugee and immigrant households. Cultural congruence refers to increasing provider quality of services by situating patient needs within their broader, dynamic, and relevant cultural context. This thesis assesses the feasibility of Mama Amaan and evaluates the success of this culturally congruent model. We conducted focus groups, interviews, participant observations, and collected survey data. This thesis uncovered a paradigm shift in the culturally congruent model, which contributed to the feasibility of this project. A community congruence framework allowed us to employ a dialectical approach to change and illuminated how the lives of our participants are dynamic and necessary to take into account. As participants’ lives changed, their priorities changed. This shifted our priorities for the project. Adaptations to community realities through constant communication, the research team’s visibility in the community, trust-building, and forging connections determined the ultimate success of the project and are factors that mediate our conceptualization of feasibility. The Mama Amaan model of perinatal care depends on who is leading it, the active centering of maternal community-making, and the bundling of services. Ongoing capacity for transformations and modifications contributed to the success and feasibility of the project.