Exclusion and Othering in maternity care for forced migrant women: a qualitative study with forced migrant mothers and health care professionals in Germany

This article investigates the political, legal, institutional, and interpersonal experiences of exclusion and Othering that forced migrant mothers encountered during pregnancy, birth and up to one year postpartum. Problem-centred qualitative interviews were conducted with 33 forced migrant mothers and 80 maternity health care professionals (HCPs) in Berlin, Brandenburg and NRW, Germany. All mothers had recently given birth to a child in a hospital. Mothers were between 24 and 39 years old and were living in Germany for an average of three years. The sample represented a broad heterogeneity in country of origin, family constellation, level of education and housing conditions. Based on the framework method (Gale et al., 2013), three interrelated dimensions of exclusion in maternity care were identified: (1) Political and legal exclusion (e.g., housing restrictions, lack of legal documents, insecure residency); (2) Institutional exclusion (e.g., absence of interpreters, staff shortage, non-recognition of qualifications); and (3) Interpersonal exclusion (e.g., racism, stereotyping, social isolation). These dimensions of exclusion are further illuminated through the concept of Othering, understood as a symbolic process that legitimises and reinforces social inequality. In the context of forced migration, maternity care is shaped to a considerable extent by exclusionary state practices and systemic barriers. Our findings underscore the need for structural change to reduce barriers, strengthen equity, and protect reproductive autonomy. This is the first qualitative study in Germany to explore these issues from both the perspective of forced migrant mothers and HCPs across regions.