Migration and maternal health: experiences of brazilian women in Portugal

Abstract

OBJECTIVES: to characterize maternal and neonatal healthcare provided to Brazilian population, assessing key factors: access, use and quality of care received during this period. The goal was to assess possible differences regarding women's perceptions regarding the quality and appropriateness of care received, providing qualitative information, as part of a holistic perspective. METHODS: the present study adopted a qualitative methodology (semi-structured interviews) for collecting and analyzing data. Possible differences in women's perceptions regarding the quality and appropriateness of care received were assessed, providing qualitative information, as part of a holistic perspective. The present study was based on privileged information obtained from Brazilian women, residing in the metropolitan area of Porto, regardless of their legal status. RESULTS: a certain dissatisfaction emerged among Brazilian women regarding the quality of information provided by health professionals, the communications skills of these professionals, in addition to a perception of reduced access to medical specialties, especially in primary care. Misinformation about legal rights and inappropriate clarification during medical appointments were frequently reported and interacted with social determinants to result in poorer medical care. CONCLUSIONS: special attention should be given to the specific needs and understanding of immigrants during pregnancy and motherhood in order to improve healthcare. New challenges tend to lie not only in ensuring access, but mostly in promoting equity, as away of providing high-quality care for all.

Migrant women’s experiences of pregnancy, childbirth and maternity care in European countries: A systematic review

“…Of the 47 included studies, 43 exclusively used qualitative methodology and four adopted a mixed methods approach and reported relevant qualitative data [34][35][36][37]. Individual interviews were exclusively undertaken in 27 of the studies [8, and focus groups in five studies [64][65][66][67][68]. Multiple methods of data collection were…”

“…Unmet information needs. Women identified a lack of information around pregnancy, childbirth or the postpartum period, and a lack of information that was available in an accessible language or format [8,35,37,[46][47][48][49][50]52,58,64,66,[70][71][72][75][76][77][78][79][81][82][83]. Professional advice often conflicted with cultural and family advice [41,46,49,54,63,[77][78][79] and this left women feeling insecure about which actions to take [46, 63,77].…”

“…So in labour I don't speak, so that I don't upset them." (Tobin et al 2014, pp.836) [60] Procedures which were familiar to practitioners were not always familiar to women coming from other care systems [8,70], and this caused women to feel fearful [60,82] and to lack trust in the information provided by HCPs [39].…”

“…(Tobin et al 2014, pp.836) [60] Women's cultural backgrounds influenced some of their preferences [39, 56,60,71] and beliefs about procedures [49,55,67,70,71,81] and the way they wanted to discuss these [56,74]. Experiences in their country of origin influenced their expectation of the need for medical surveillance and interventions during pregnancy and childbirth [8,42,43,63,80,81].…”

“…Pregnancy is a period of increased vulnerability for migrant women [6,7]. There is a consistent trend for poorer pregnancy outcomes amongst migrant women [2] who are at greater risk of maternal and neonatal morbidity and mortality when compared to native born women [2,[8][9][10][11][12][13][14][15][16][17]. This is a result of the complex interplay of multiple factors including substandard healthcare in the country of origin [2] and issues around accessing care and the quality of care in the new country [2,14,18].…”