Quality of maternal and newborn care around the time of childbirth for migrant versus nonmigrant women during the COVID‐19 pandemic: Results of the IMAgiNE EURO study in 11 countries of the WHO European region

Abstract

Objective: To describe the perception of quality of maternal and newborn care (QMNC) around the time of childbirth among migrant and nonmigrant women in Europe. Methods: Women who gave birth at a health facility in 11 countries of the WHO European Region from March 2020 to July 2021 were invited to answer an online questionnaire including demographics and childbirth experience. Data were analyzed and compared for 1781 migrant and 20 653 nonmigrant women.Results: Migrant women who experienced labor perceived slightly more difficulties in attending routine antenatal visits (41.2% vs 39.4%; P = 0.001), more barriers in accessing facilities (32.9% vs 29.9%; P = 0.001), lack of timely care (14.7% vs 13.0%; P = 0.025), inadequate room comfort and equipment (9.2% vs 8.5%; P = 0.004), inadequate number of women per room (9.4% vs 8.6%; P = 0.039), being prevented from staying with their baby as they wished (7.8% vs 6.9%; P = 0.011), or suffering abuse (14.5% vs 12.7%; P = 0.022) compared with nonmigrant women. For women who had a prelabor cesarean, migrant women were more likely not to receive pain relief after birth (16.8% vs.13.5%; P = 0.039) and less likely to provide informal payment (1.8% vs 4.4%; P = 0.005) compared with nonmigrant women. Overall, the QMNC index was not significantly different for migrant compared with nonmigrant women.

Perspectives of professionals and human rights associations on the IMAgiNE EURO study

“…The IMAgiNE EURO surveys show high levels of medicalization throughout Europe, especially cesarean, instrumental births, and application of fundal pressure 1–10 . This is also coupled with lack of informed consent, lack of support for initiation and continuation of breastfeeding, and lack of respect and dignity for birthing women.…”

“…This is also coupled with lack of informed consent, lack of support for initiation and continuation of breastfeeding, and lack of respect and dignity for birthing women. The results were even worse for women who were not from the majority population—young, immigrant, or from linguistic minorities 9,10 . With the increase in medicalization, including cesarean and instrumental vaginal birth (IVB), women reported feeling that they were treated with less dignity and respect 1 .…”

“…However, no country, no health system, nor the World Health Organization, to say nothing of our hospitals, was prepared for what 2020–2022 brought us. The articles in this Supplement 1–10 . chronicle the risk of pregnancy during COVID‐19, particularly the vulnerability of women giving birth during a pandemic.…”

Immigrant women’s and families’ views and experiences of routine postnatal care: findings from a qualitative evidence synthesis

“…Another recent review of immigrant women’s experiences with maternity care in Europe highlighted the challenges around navigating new health systems, language barriers, and quality of care 13. Further, a multi-country survey from 11 countries also in Europe found that immigrant women reported more barriers in accessing facilities, less timely care, less comfortable care, and more negative experiences, including more separation from infants, fewer offers for pain relief, and more requests for informal payments, than non-immigrant women 14…”

“… 13 Further, a multi-country survey from 11 countries also in Europe found that immigrant women reported more barriers in accessing facilities, less timely care, less comfortable care, and more negative experiences, including more separation from infants, fewer offers for pain relief, and more requests for informal payments, than non-immigrant women. 14 …”