Challenges in migrant women’s maternity care in a high‐income country: A population‐based cohort study of maternal and perinatal outcomes

Guðmundsdóttir, Embla Ýr; Gottfreðsdóttir, Helga; Hálfdánsdóttir, Berglind; Nieuwenhuijze, Marianne; Gissler, Mika; Einarsdóttir, Kristjana

doi:10.1111/aogs.14186

Cited by 9 publications

(16 citation statements)

References 18 publications

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“…Furthermore, in a number of studies on immigrant women of sub-Saharan origin in a range of countries such as Norway [ 27 ] and Australia [ 28 ], such sub-Saharan women were seen to present episiotomies and tears (concurrently), to a greater degree. These data are in line with the Gudmundsdottir [ 18 ] study conducted in a migrant population from low-income countries, and with the study by Lorthe [ 29 ], who also found unjustifiable differences in obstetric outcomes in the native and migrant population. According to Wuest [ 30 ], intrapartum third degree tears affecting even the anal passage are common in women subjected to FGM.…”

Section: Discussionsupporting

confidence: 91%

“…Those showing a higher risk were primiparous or multiparous African immigrant women, or from Southern Asia [ 17 ]. Along the same lines, a study conducted in Iceland in 2021 also established worse obstetric outcomes in migrant women from countries with a development index below 0.900 compared to women in the country [ 18 ]. In the bibliography addressing obstetric complications with female genital mutilation [ 4 ], it was shown that women with FGM types II and III were at a greater risk of undergoing caesarean than those not mutilated.…”

Section: Discussionmentioning

confidence: 99%

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Obstetric Complications in Women from Sub-Saharan Africa—A Cross-Sectional Study

Gombau-Giménez

Martínez

Suárez-Cortés

et al. 2022

IJERPH

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Aim: The aim of this study was to identify and compare birthing complications in women originating from countries where they are at risk (may become victims) of FGM with those of Spanish women, all having given birth from 2012 to 2015 at the “Virgen de la Arrixaca” University Clinical Hospital in Murcia, Spain. Methods: A transversal, observational, quantitative study was carried out, retrospectively, comparing 245 sub-Saharan women originating from countries where FGM is practiced with 490 Spanish women, in terms of obstetric complications. Data collection was performed via electronic clinical records. Results: The sub-Saharan women presented higher rates of intrapartum and emergency caesareans, intense postpartum haemorrhages, concurrent episiotomies and tears (2nd and 3rd degree), failed inductions, and non-progressive labours, and a more severe risk of foetal distress when compared with Spanish women. Conclusions: The fact that the sub-Saharan women originating from countries where FGM is practiced presented a greater number of birthing complications than the Spanish women proves the need for Spanish healthcare professionals to receive training towards cultural competency acquisition, in order to provide a multidisciplinary approach, with standardized action protocols focused fundamentally on prevention.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Obstetric Complications in Women from Sub-Saharan Africa—A Cross-Sectional Study

Gombau-Giménez

Martínez

Suárez-Cortés

et al. 2022

IJERPH

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“…The polytomous categorical variable was based on the Human Development Index (HDI), described in more details in previous research. 1 HDI scores were categorized by IMBR in 12 groups with increments of 0.050. Because of the small number of migrants in Iceland coming from countries with low HDI, we combined the groups in the lower levels based on the number of migrants in each of the twelve categories.…”

Section: Exposure Variablementioning

confidence: 99%

“…The results suggest that factors such as access interfere with quality of midwifery care and might exacerbate inequity in health care. 1 Intrapartum midwifery care is one of the key factors that contributes to quality of care and a woman's positive childbirth experience. 3 Promoting comfort is an integral part of the "art" of midwifery care.…”

Section: Introductionmentioning

confidence: 99%

Use of pain management in childbirth among migrant women in Iceland: A population‐based cohort study

Guðmundsdóttir

Nieuwenhuijze

Einarsdóttir

et al. 2022

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Background Immigration is rapidly increasing in Iceland with 13.6% of the population holding foreign citizenship in 2020. Earlier findings identified inequities in childbirth care for some women in Iceland. To gain insight into the quality of intrapartum midwifery care, migrant women's use of pain management methods during birth in Iceland was explored. Methods A population‐based cohort study including all women with a singleton birth in Iceland between 2007 and 2018, in total 48 173 births. Logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs) were used to investigate the relationship between migrant backgrounds defined as holding foreign citizenship and the use of pain management during birth. The main outcome measures were use of nonpharmacological and pharmacological pain management methods. Results Data from 6097 migrant women were included. Migrant women had higher adjusted OR (aORs) for no use of pain management (aOR = 1.23 95% CI [1.12, 1.34]), when compared to Icelandic women. Migrant women also had lower aORs for the use of acupuncture (0.73 [0.64, 0.83]), transcutaneous electrical nerve stimulation (TENS) (0.92 [0.01, 0.67]), shower/bath (0.73 [0.66, 0.82]), aromatherapy (0.59 [0.44, 0.78]), and nitrous oxide inhalation (0.89 [0.83, 0.96]). Human Development Index (HDI) scores of countries of citizenship <0.900 were associated with lower aORs for the use of various pain management methods. Conclusions Our results suggest that being a migrant in Iceland is an important factor that limits the use of nonpharmacological pain management, especially for migrant women with citizenship from countries with HDI score <0.900.

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“…Guðmundsdóttir et al's large study conducted in Iceland between 1997 and 2018 revealed increased odds of several maternal and perinatal complications in refugee women compared with Icelandic women. 13 Although perinatal healthcare is advanced and Open access its services are free in those countries, the authors argued that a large proportion of the refugee women still did not have access to these healthcare services. A recent review by Sturrock et al concluded that despite better healthcare services in high-income countries, refugee mothers still had worse outcomes that may be explained by their late or lack of attendance to antenatal care.…”

Section: Open Accessmentioning

confidence: 99%

Neonatal morbidity among African refugee women in Israel: a case–control study

et al. 2021

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ObjectivesReports on neonatal morbidity (NM) among refugees in developed countries remain inconsistent. We aimed to compare NM among infants of African refugees in Israel to the native population based on a large population sample.DesignA case–control study.SettingA tertiary hospital in Israel.ParticipantsData on hospital-based live births of refugee women and their newborns who were born in 2014 and 2017 were retrieved from medical records. Perinatal and neonatal data were compared between the refugee group and the native residents matched for gestational age and year of birth as well as within the refugee group.Primary outcomePrevalence of NM among African refugees in Israel.ResultsNewborns delivered by 357 refugee women (mean age 30.2 years) and 357 controls (mean age 32.2 years) were analysed. Both groups were similar for the newborns’ weight and gestational age. There were no significant differences in NM between the groups. A within-refugee comparison conducted between 2014 and 2017 yielded significant differences in birth weight (3051.4 vs 3373.6 gr, p<0.001, 95% CI (198.3 to 446.2), d=0.56), the number of twin deliveries (10 vs 4, p=0.002, Φ=0.173), the number of neonates evaluated as small for gestational age (15 vs 10, p=0.003, Φ=0.167) and the use of human milk (71% vs 93%, p<0.001, Φ=−0.298).ConclusionsWe conclude that NM among neonates born to refugee mothers was not higher than that of neonates born to native Israeli mothers. We suggest that successful implementation of health policies for refugees has improved their accessibility to mother–child health services.

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Challenges in migrant women’s maternity care in a high‐income country: A population‐based cohort study of maternal and perinatal outcomes

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 9 publications

References 18 publications

Obstetric Complications in Women from Sub-Saharan Africa—A Cross-Sectional Study

Obstetric Complications in Women from Sub-Saharan Africa—A Cross-Sectional Study

Use of pain management in childbirth among migrant women in Iceland: A population‐based cohort study

Neonatal morbidity among African refugee women in Israel: a case–control study

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