Women's Health

CONTRACEPTION

Using a culturally sensitive approach, all refugee women of reproductive age should be asked about their contraception history and desire for a contraception method. This should preferably be discussed with the patient alone in the room.

While all the usual contraception methods are valid options, we usually prefer intra-uterine devices and medroxyprogesterone acetate injections. This is because these methods present less risk of non-adherence (compared to oral combined contraceptive pill for example), which is a common issue in refugee patients. However, we have found that some refugee women prefer to continue having their monthly period. Patients should thus be counselled about this before being prescribed a birth control method.

 

CERVICAL CANCER SCREENING

Most of our newly arrived female refugee patients have never been screened for cervical cancer. It is thus important to ask about previous Pap tests and discuss the importance of this screening program. Screening recommendations for refugee women are the same as for the rest of the population (every 3 years between ages 25-69).

While we rarely perform a Pap test on the first visit (remember that this is an invasive procedure), we recommend discussing it as soon as possible. If a patient is not comfortable having a Pap test done by a male physician, she should be offered a referral to a female practitioner.

 

FEMALE GENITAL CUTTING

Screening for female genital cutting should be considered in women from countries where this practice is prevalent (see Map). See Female Genital Cutting for our recommended screening criteria.