Background. This pilot study explored health care providers’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement. 1. Introduction Somalis represent the largest influx of African refugees to the United States of America (USA) [1]. They began arriving in the early 1990s when their country became engulfed in armed conflicts and its citizens were forced to flee for survival [1–3]. Repeated humanitarian crises in Somalia contributed to the continual exodus of millions of Somalis throughout the years. The 2011 report from the US Department of Homeland Security [4] identifies Somalia as one of the leading African countries for refugee admissions in the USA. In Ohio, the Somali Community Association of Ohio (SCAO) estimated that more than 45,000 Somali refugees/immigrants had resettled in Columbus, Ohio, in 2010, with an estimated 200 arriving each month due to both direct resettlement and secondary migration [5, 6]. Columbus and Franklin county officials projected this number to be closer to 80,000, which would represent the second largest population of Somalis in the USA (behind Minnesota) and would account for 42% of all immigrants in Ohio [1, 7]. This increasing demographic diversity among Columbus residents has a profound impact on local population health profiles and health care needs. Somali immigrants form a very homogeneous population linguistically, religiously, and culturally. According to the Ohio Department of Public Safety [8], 99.9% of Somalis in Columbus are Sunni Muslims and share the same
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