Beyond the social determinants common to immigrants and refugees in general, a number of barriers affect women's access to care and assistance with postpartum depression and sexual violence. Most refugee survivors of sexual violence do not receive the help they need (Yohani & Hagen, 2010). Psychological trauma, combined with sociocultural factors, limited awareness of available services and language challenges create barriers to seeking help.

Common barriers include:

• Recognition

  A major barrier for pregnant immigrant and refugee women is recognizing symptoms of depression and seeking help.
  
  Many immigrant and refugee women report not knowing or recognizing the symptoms of postpartum or prenatal depression (O'Mahony et al., 2012; Wittkowksi et al., 2017). Also, health service providers may not recognize depressive symptoms or may minimize the concerns that immigrant and refugee women face. The result is that clients may not seek or receive care (O'Mahony et al., 2012).

• Cultural norms

  Cultural norms influence how survivors and their communities perceive and respond to sexual violence. In many societies including within a North American context, women who have been sexually assaulted are often stigmatized by their community and considered unsuitable for marriage or motherhood (Ahmad et al., 2009; Yohani & Hagen, 2010). In some cases, they may even be rejected by family members or perceived to bring suffering and a loss of respect to their family. Similarly, in cultures where sexuality is not openly discussed, disclosing sexual violence breaks social taboos. Survivors are therefore often reluctant to reveal sexual violence for fear of experiencing rejection, isolation or humiliation.

• Gender norms

  Immigrant women, as compared to non-immigrant women in Canada, are more likely to support patriarchal gender norms and agree that their husband has power and rights that supersede their own. As a result, they may be less likely to report victimization or seek help or problems (Alvi et al., 2012). Thus, silence becomes a habit many develop for self-protection—one they find difficult to break even to get help. Importantly, many Canadian women who are victims of domestic violence also live in silence, which leaves them with physical and psychological scars.

• Language

  Language can be a significant barrier to accessing services, as discussed in Module 1. Programs that help women overcome language barriers have a significant impact on their ability to access health and social services, realize their rights and leave abusive relationships.

Featured resource

The Department of Justice of Canada developed the booklet Abuse is Wrong in any Language for immigrant and refugee families experiencing any type of family violence.

To learn more about the impact of violence against immigrant and refugee women and how to help, see these self-directed online courses offered by the Ontario Council of Agencies Serving Immigrants (OCASI).