Abstract
BackgroundIn Denmark, 13% of all children are born by non-Western immigrant women. The public antenatal care has not adapted to this increased diversity of women. Compared to women coming from Western countries, non-Western immigrant women have an increased prevalence of severe maternal morbidity and higher risks of maternal death, stillbirth and infant death. Suboptimal care is a contributing factor to these ethnic disparities, and thus the provision of appropriate antenatal care services is pivotal to reducing these disparities and challenges to public health. Yet, little is known about the targeted interventions which have been developed to reduce these inequities in reproductive health. The MAMAACT intervention, which included a training course for midwives, a leaflet and a mobile application, as well as additional visit time, was developed and tested at a maternity ward to increase responses to pregnancy warning signs among midwives and non-Western immigrant women. Aim: To explore the feasibility and acceptability of the MAMAACT intervention among midwives and identify factors affecting midwives’ delivery of the intervention.MethodsEight mini-group interviews with midwives (n = 18) were undertaken. Systematic text condensation was used to analyse data.ResultsThree main categories were identified, which were ‘Challenges of working with non-Western immigrant women’, ‘Attitudes towards and use of the leaflet and mobile application’, and ‘Organisational factors affecting the use of the MAMAACT intervention’.ConclusionsThe MAMAACT intervention was found to be feasible as well as acceptable among midwives. Women turning to relatives for pregnancy-related advice, time constraints during midwifery visits, incomplete clinical records and lack of professional interpreter assistance impacted midwives’ delivery of the MAMAACT intervention. Midwives displayed a readiness for the MAMAACT intervention; however, there is a need to further examine how contextual factors may impact the use of the intervention in antenatal care.Trial registrationClinicalTrials.gov, Retrospective Registration (07/2/2020), registration number NCT04261400.
Highlights
In Denmark, 13% of all children are born by non-Western immigrant women
Studies have shown that, during pregnancy, some groups of immigrant women have an elevated risk of severe maternal morbidity compared to women born in high-income countries [6,7,8]
Similar tendencies of suboptimal care have been found in Denmark, where non-Western immigrants were more likely to experience the death of a child during birth [15], which is a well-known indicator for the quality of care [16]
Summary
In Denmark, 13% of all children are born by non-Western immigrant women. The public antenatal care has not adapted to this increased diversity of women. Studies have shown that, during pregnancy, some groups of immigrant women have an elevated risk of severe maternal morbidity compared to women born in high-income countries [6,7,8]. Similar tendencies of suboptimal care have been found in Denmark, where non-Western immigrants were more likely to experience the death of a child during birth [15], which is a well-known indicator for the quality of care [16]. These findings highlight the need to improve the response to pregnancy complications among immigrant women in western countries
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