Migrant and native women’s perceptions of prenatal care communication quality: the role of host-country language proficiency

Abstract

Background Despite the potentially significant impact of women-prenatal care provider communication quality (WPCQ) on women’s perinatal health, evidence on the determinants of those perceptions is still lacking, particularly among migrant women. Methods We aimed to examine the effect of women’s host-country language proficiency on their perceived WPCQ. We analyzed the data of 1210 migrant and 1400 native women who gave birth at Portuguese public hospitals between 2017 and 2019 and participated in the baMBINO cohort study. Migrants’ language proficiency was self-rated. Perceived WPCQ was measured as a composite score of 9 different aspects of self-reported communication quality and ranged from 0 (optimal) to 27. Results A high percentage of women (29%) rated communication quality as “optimal”. Zero-inflated regression models were fitted to estimate the association between language proficiency and perceived WPCQ. Women with full (aIRR 1.35; 95% CI 1.22,1.50), intermediate (aIRR 1.41; 95% CI 1.23,1.61), and limited (aIRR 1.72; 95% CI 1.45,2.05) language proficiencies were increasingly more likely to have lower WPCQ when compared to natives. Conclusions Facilitating communication with migrant women experiencing language barriers in prenatal care could provide an important contribution to improving prenatal care quality and addressing potential subsequent disparities in perinatal health outcomes.

Obstetric Interventions Among Native and Migrant Women: The (Over)use of Episiotomy in Portugal

“…We did not have appropriate data on the healthcare professionals attending childbirth to test this hypothesis. Second, migrant status may affect how healthcare providers perceive patients’ ability to communicate and understand medical information [ 17 , 55 ]. Migrant women might also have low health literacy and/or limited host-country language skills resulting in poorer empowerment and capacity to participate in medical decisions [ 58 ].…”

“…Migrant women might also have low health literacy and/or limited host-country language skills resulting in poorer empowerment and capacity to participate in medical decisions [ 58 ]. Communication difficulties prevent adequate information and consent [ 17 , 18 ] and could lead to more obstetric interventions, particularly during instrumental delivery, which is a potentially stressful and painful emergency situation. Finally, healthcare professionals’ practices can be influenced by implicit biases, which refer to unconscious negative feelings or stereotypes against a social group or a person on the basis of irrelevant characteristics such as ethnicity or gender.…”

“…Improving migrant maternal health has emerged as a top priority for many stakeholders in highincome countries, due to the large influx of migrant women of reproductive age (in Europe, 21% of babies are born to foreignborn women [4,5]), the importance of adequate maternal care in the health of pregnant women and their offspring, and previously observed migrant-native disparities in perinatal health [1,[6][7][8][9]. Migrant women may have better perinatal health than native women, explained by the healthy migrant effect, or conversely be more vulnerable to maternal and child health problems, due to socioeconomic circumstances, health background and the existence of health inequalities or language barriers [10][11][12][13][14][15][16][17]. Studies comparing migrants with natives often focus on assessing health outcomes.…”

Associations of language barriers with behavioural and socio-emotional problems among 5-year-old children born very preterm across Europe

“…Proficiency in a country's majority language correlates with migrant women's prenatal care utilisation (Eslier et al, 2023;Hamwi et al, 9900;Hamwi et al, 2022), self-perceived prenatal care communication quality (Hamwi et al, 2023), overall health (Dewalt et al, 2004). Higher levels of behavioural and socio-emotional problems among VP children growing up with language barriers are likely an indirect consequence of their mothers' and fathers' lived experiences in navigating the host society and its social systems.…”

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings

“…Health communication and counselling for pregnant women are paramount to prevent poor pregnancy outcomes and ensure a positive pregnancy experience (12). Language barriers (13) and lack of good interpretation services (14), lower health literacy levels (15), and prejudicial attitudes and discrimination from healthcare providers (1) are potential barriers to equitable communication and care. A recent Norwegian study found that more than one-third of women with immigrant backgrounds did not understand the information provided during maternity care and 50% were unaware of whom to contact in case of pregnancy-related complications (16).…”