A Qualitative Exploration of Somali Refugee Women’s Experiences with Family Planning in the U.S.


The purpose of our study was to explore the knowledge, attitudes, and experiences of Somali refugee women with family planning in the U.S. We conducted focus groups of Somali refugee women and used grounded theory methodology to identify emergent themes. Fifty-three women, aged 18–49 years, participated. Somali refugee women’s cultural and religious beliefs and social identities strongly influence their conceptualization of family planning. Participants agreed that a woman’s fertility is ultimately decided by Allah and identified environmental changes after immigration and the desire to optimize maternal health as facilitators to modern contraceptive use. Misconceptions about and fear of side effects of modern contraceptive methods, including a fear of infertility, were identified as barriers to use. To deliver patient-centered family planning counseling to Somali refugee women, it is essential that healthcare providers approach these discussions with cultural humility and consider employing community partners or cultural brokers to help provide family planning education.

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This study was funded in part by a Research Stimulation Grant (G1502RS) from the American Academy of Family Physicians Foundation and the Society of Family Planning Research Fund (SFPRF9-MC1). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official position of AAFP Foundation nor the Society of Family Planning Research Fund. We thank Ladna Farah, the Somali Health Board of King County, WA and the University of Washington Family Planning Division for their help with this study.

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Correspondence to Ying Zhang.

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Appendix 1

Appendix 1

See Table 2.

Table 2 Focus group guide & questions

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Zhang, Y., McCoy, E.E., Scego, R. et al. A Qualitative Exploration of Somali Refugee Women’s Experiences with Family Planning in the U.S.. J Immigrant Minority Health 22, 66–73 (2020).

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  • Family planning
  • Somali refugees
  • Contraception
  • Birth spacing
  • Qualitative