Transnationalism and caring for vulnerable-status, migrant women and their families during pregnancy and early-childhood

Migrants commonly maintain transnational ties with their home country including identities, attachments, and social, cultural, economic and service/care interactions. Significant gaps remain regarding care-providers’ perspectives on migrants’ transnational ties and whether and how these ties are addressed in the context of care. La Maison Bleue (LMB) is a community-based social perinatal care service with four sites in Montreal, Canada, providing health and social care to families in vulnerable contexts from pregnancy up until age five. We conducted a small, qualitative descriptive study and interviewed 7 care-providers (nursing, social work, family medicine, psycho-education) and 3 administrators/support personnel from LMB to gather data on their experiences and perspectives on “transnationalism” in care with vulnerable-status migrant women and their families. Transnational identity (language, culture, attachment to the home country), and ongoing connections with back home, including communication with children and extended family, remittent sending, and the receipt of child-rearing and health advice, commonly arise within care interactions. Fostering transnational relationships and cultural identity are strategies used by LMB care-providers to strengthen migrant families’ sense of belonging and to help them cope with losses, while addressing transnational tensions and stresses are used to promote families’ well-being and integration. This involves a combination of listening, humility, remaining open, providing information and delivering care that is respectful of culture and sensitive to families’ situations. Cultural negotiation, directly with migrant families or via local peers, is sometimes used to overcome transnational cultural barriers related to health decisions and child-rearing. At times, care-providers also engage directly with family back home to mediate cross-border stresses and cultural tensions and/or to draw on them as a source of information and support. Care-providers view transnational cultural ties and relationships as both positive and negative for the well-being of families and with respect to its impact on interventions with families. Although not always feasible, care-providers believe it's important to know about families’ transnational contexts, in order to provide responsive, supportive care.