{"id":1833,"date":"2020-01-05T13:25:45","date_gmt":"2020-01-05T13:25:45","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=1833"},"modified":"2020-01-05T13:25:45","modified_gmt":"2020-01-05T13:25:45","slug":"human-trafficking-an-emerging-and-critical-challenge-for-maternity-and-health-care","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2020\/01\/05\/human-trafficking-an-emerging-and-critical-challenge-for-maternity-and-health-care\/","title":{"rendered":"Human Trafficking: An emerging and critical challenge for maternity and health care"},"content":{"rendered":"

\"\"<\/a>This week’s EBN Blog is written by Sam Nightingale (@mwsamnight), a clinical academic midwife from UHCW NHS Trust (Coventry). Sam’s research interests lie in vulnerable women in pregnancy and she has recently completed and NIHR MRes on the topic of human trafficking and pregnancy. Sam will be leading the @EBNursingBMJ Twitter chat on Weds 8th Jan (8pm UK time) along with @liz8ailey. To join in add #ebnjc to your tweets; to follow the discussion during the chat search for #ebnjc (latest).<\/p>\n

Human trafficking, a form of modern-day slavery, is a brutal abuse which denies people their dignity and safety1 <\/sup>and is linked to poor mental and physical health outcomes 2<\/sup>. Human trafficking is a growing problem, but due to its illegal nature it is difficult to know the exact figures3<\/sup>. However, statistics for the National Referral Mechanism (NRM)4<\/sup> report that in the third-year quarter of 2019, 2808 potential victims of modern slavery were referred to the NRM; a 21% increase from the previous quarter and a 61% increase from the same quarter in 2018. The statistics around known human trafficking victims have been described as the \u201ctip of the iceberg\u201d5<\/sup>.<\/p>\n

The ILO1<\/sup> points out that trafficking affects every country of the world, and estimates that, in 2016, 40.3 million people were victims of trafficking. Women and girls were disproportionately affected by forced labour and made up 99% of victims in the commercial sex industry, 58% of victims in other sectors, and 71% being of childbearing age6 <\/sup>.One in four women become pregnant while trafficked7<\/sup>, and maternity services being able to appropriately identify and respond to victims of human trafficking and offer appropriate referral and care is of high imprtance2,7<\/sup>.<\/p>\n

Given that sexual abuse and physical violence are associated with human trafficking8<\/sup> these are also potential risks associated with maternal and neonatal morbidity and mortality for women within a trafficking context. 9,10<\/sup>.<\/p>\n

Emerging research links human trafficking to poor physical and mental health outcomes2-8-11<\/sup>. These studies show that mental health is especially poor, with suicidality and post-traumatic stress disorder (PTSD) the most common mental health issues. Stanley et al.2 <\/sup>discuss that chronic illnesses and symptoms from physical injuries are also a major issue.<\/p>\n

Barriers to accessing health care for victims of trafficking include restrictions to liberty, language difficulties, fear for own safety, and navigating the perceived complex \u201cgatekeeping\u201d barriers such as accessing a GP without identification and address2<\/sup>.<\/p>\n

Midwives and nurses need to be aware of signs that their patient may be a victim of trafficking:<\/p>\n