Immigrant women’s experiences with Norwegian maternal health services: implications for policy and practice

Mehrara, Lydia; Gjernes, Trude; Young, Susan

doi:10.1080/17482631.2022.2066256

Cited by 10 publications

(3 citation statements)

References 37 publications

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“…Women’s previous experiences from, and familiarity with, other health care system, socio-cultural values and practices, as well as health literacy more broadly influence the use of antenatal care [ 45 , 58 ]. However, structural vulnerabilities, such as restricted access, low or no income, degrees of dependency on others, and psychosocial hardship, might have a stronger influence on their ability to access adequate antenatal care.…”

Section: Discussionmentioning

confidence: 99%

Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway

Eick

Vallersnes

Fjeld

et al. 2022

BMC Pregnancy Childbirth

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Background In 2011 Norway granted undocumented women the right to antenatal care and to give birth at a hospital but did not include them in the general practitioner and reimbursement schemes. As a response to limited access to health care, Non-Governmental Organizations (NGO) have been running health clinics for undocumented migrants in Norway’s two largest cities. To further facilitate universal health coverage, there is a need to investigate how pregnant undocumented women use NGO clinics and how this affects their maternal health. We therefore investigated the care received, occurrence of pregnancy-related complications and pregnancy outcomes in women receiving antenatal care at these clinics. Methods In this historic cohort study we included pregnant women aged 18–49 attending urban NGO clinics from 2009 to 2020 and retrieved their medical records from referral hospitals. We compared women based on region of origin using log-binominal regression to estimate relative risk of adverse pregnancy outcomes. Results We identified 582 pregnancies in 500 women during the study period. About half (46.5%) the women sought antenatal care after gestational week 12, and 25.7% after week 22. The women had median 1 (IQR 1–3) antenatal visit at the NGO clinics, which referred 77.7% of the women to public health care. A total of 28.4% of women were referred for induced abortion. In 205 retrieved deliveries in medical records, there was a 45.9% risk for any adverse pregnancy outcome. The risk of stillbirth was 1.0%, preterm birth 10.3%, and emergency caesarean section 19.3%. Conclusion Pregnant undocumented women who use NGO clinics receive substandard antenatal care and have a high risk of adverse pregnancy outcomes despite low occurrence of comorbidities. To achieve universal health coverage, increased attention should be given to the structural vulnerabilities of undocumented women and to ensure that adequate antenatal care is accessible for them.

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Section: Discussionmentioning

confidence: 99%

Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway

Eick

Vallersnes

Fjeld

et al. 2022

BMC Pregnancy Childbirth

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“…As the findings above suggest, trust is not static. Migrant women's expectations and their unfulfilled expectations of the care system (in Norway) can lead to distrust at the meso-level, which means distrust in the care system (Mehrara et al, 2022). Distrust can be reversed by the gradual building of individual trust between a woman and a particular health professional.…”

Section: Importance Of Trust In Maternity Carementioning

confidence: 99%

Trust in maternity care: challenges for healthcare professionals and migrant women

Pařízková,

Glajchová

2024

Kontakt

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Migrant women have a greater potential to experience limits when using maternity care than non-migrant women; therefore, they have a greater risk of vulnerability. Vulnerability and barriers to maternity care have the potential to erode trust, which is an important aspect of maternity care in general. In this exploratory qualitative study, we analyzed factors influencing trust in interactions between migrant women and healthcare professionals in maternity care. In total, 71 in-depth interviews were conducted with migrant women and healthcare professionals in the Czech Republic. Migrant women generally trust medical care, and healthcare professionals trust the capacity of women's bodies and their expertise. Unfortunately, in relation to women giving birth, healthcare professionals do not see the importance of building or strengthening trust but appreciate obedience, no matter what it is based on. In this context, healthcare professionals are limited by the routinization of care and a lack of time. Consequently, migrant women have a higher probability of being excluded from maternal care as active agents, which increases their vulnerable position.

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“…Ng and Newbold (2011) found that 'often, differences in cultural expectations or knowledge of different cultural groups resulted in less than optimal consultations' (p. 566), one of the reasons being that immigrant women 'may feel that they are not receiving appropriate care when their cultural needs are not being met' (p. 566). Lastly, Mehrara et al (2022) presented that some immigrant women found Norway's approach to maternity care to be less medicalized in comparison to that of their home countries, which consequently hindered their trust in it. This speaks directly to the encountered differences between cultural health models that extend beyond a concern for immigrants' knowledge or language barriers.…”

Section: More Than Health Carementioning

confidence: 99%

More than health care

Mehrara¹

2022

JCSW

Self Cite

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The Norwegian community health centres are one of the main providers of maternal and child health care services. They are often the primary, as well as a regular point of contact, for women during pregnancy and after childbirth. As such, they are a place where encounters between primary health care providers like public health nurses, midwives and immigrant women, are frequent. Midwives and public health nurses play an important role as state employees in the distribution of universal health provisions at the local level. This is especially important in meeting the diverse needs of service users in a universal health care system. This study investigates the implications of cultural diversity for health care practice in a universal system. It employs a qualitative approach, using data from nine semi-structured interviews with midwives and public health nurses across three Norwegian municipalities. It analyses their experiences in working with immigrant women during pregnancy, and after childbirth, through thematic analysis. The findings illustrate the practitioners’ different approaches to meeting with culturally diverse patients, the challenges they face in their work, and how they overcome them. The discussions address the practice of cross-cultural health care in the absence of national guidelines or formal training using street-level bureaucracy as an analytical concept. This article contributes to knowledge on the practice of cross-cultural health care at Norwegian community health centres in the absence of a culturally cognizant health policy. On a broader scale, this study illustrates the implications of diversity for policy and practice in a universal welfare state.

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Immigrant women’s experiences with Norwegian maternal health services: implications for policy and practice

Cited by 10 publications

References 37 publications

Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway

Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway

Trust in maternity care: challenges for healthcare professionals and migrant women

More than health care

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