Babies born to women in Ter Apel asylum center 7 times more likely to die around birth

Women living in the asylum shelter in Ter Apel have a seven times higher chance of their child dying around birth than the average for Dutch women in that region, according to the Ph.D. research of doctor and researcher Anouk Verschuuren of UMC Groningen. She suspects the high mortality of babies in Ter Apel is due to poor living conditions, trauma, mental health problems, language barriers, and unfamiliarity with the Dutch healthcare system, Trouw reports.

Verschuuren has done eight studies in various asylum centers in recent years. She also surveyed 102 midwives throughout the Netherlands and analyzed the Central Agency for the Reception of Asylum Seekers’ (COA) data on all pregnant women.

Verschuuren compared the pregnancy outcomes of women from the Ter Apel asylum registration center with those of Dutch pregnant women in Noord-Oost Groningen. Of the 344 new mothers in Ter Apel, 11 lost their newborn child. Of the 2,323 Dutch mothers in the study, 14 lost their child during or shortly after birth, a proportion of 5.3 times less. After adjustment for other variables, like birth weight, the risk of birth mortality is 7.21 times greater for asylum seekers in Ter Apel than other women in the region.

“An important finding is that Dutch asylum policy also affects the health of people who have fled here,” Verschuuren told Trouw. “And, therefore, also for pregnant women.” Her study didn’t show conclusively that Dutch policy is the direct reason for babies dying more in Ter Apel, but there is a good chance that it plays a role, she said.

The living conditions in Dutch asylum centers, and in Ter Apel in particular, are not good. “For example, in some asylum centers, you cannot cook for yourself, people are forced to sleep in a large hall, and they share one toilet with many people. As a pregnant woman, you have a much greater risk of infections.”

The trauma these women experienced during their flight and the resulting mental health problems also play a role. “They carry all that with them. And people often don’t have friends and family around to talk about this, and little attention is paid to this in pregnancy care.” The culture shock, language barrier, and frequent moves in the asylum system come on top of that.

About 30 percent of asylum seekers who gave birth in the Netherlands between 2016 and 2020 moved two or more times. Some even had to relocate seven times. “Imagine. You are nine months pregnant, and you change your sleeping place and environment so often. It is then almost impossible for a midwife to provide good care to someone. There is no bond of trust. And information is often lost in all those transfers.”

Verschuuren suggests housing all pregnant asylum seekers at two or three locations in the Netherlands. Then, midwives can offer group care, treating several women at the same time. Verschuuren tested this method in Ter Apel, working with midwife practice New Life. “This way, people can share things with each other and pay closer attention to each other,” she said. “For example, if you ask whether women sometimes don’t feel their baby for a day, they can talk about it together and discuss how others experience that. It has been proven that this way of care reduces stress and makes women less lonely.”

She also urged obstetric care providers who treat asylum seekers to use interpreters more and improve their information sharing. These measures are reasonably easy to implement if the government makes the necessary resources available, Verschuuren said.

“But something structural has to change,” Verschuuren told the newspaper. “The Netherlands views asylum seekers very negatively. As a result, we are constantly in crisis mode instead of a long-term plan being made. That is needed because as long as there are people, there will be migration, no matter how much some would like to deny it.”