Communication barriers in maternity care - a questionnaire study among migrants to Norway

Abstract

Abstract Background Sub-optimal maternity care among migrants has been reported in a number of European countries. Explanations are multifactorial; however, communication barriers have been suggested as a major factor. Our aim was to explore recent migrant women's reported need for interpreter, actual interpreter use and the understanding of information provided during maternity care in Norway. Methods As part of the multidisciplinary, mixed method MiPreg-project, we applied a quantitative questionnaire, using a modified version of Migrant Friendly Maternity Care Questionnaire. We included recently (≤ 5 years) migrated women born in low or middle-income countries giving birth in urban Oslo, Norway, during 2019. Face-to-face interviews in women's own language of choice were conducted postpartum. Results We included 401 women from 65 countries. The five most frequent languages spoken at home were English, Polish, Arabic, Urdu and Tigrinya. The Norwegian proficiency was low; 23% not at all, 39% with difficulty, 39% good. Two thirds of women would have understood the information during maternity care better in another language. Two out of five felt a need for interpreting services and of these 44% and 81% were not offered interpreter during pregnancy and birth, respectively. The woman's partner or other adult family member interpreted most frequently, followed by professional interpreter and healthcare professionals. The women themselves often felt they understood the information provided; 78% always, 20% sometimes and 2% rarely/never. Increased length of residency and higher education was associated with better understanding, also after adjusting for maternal age and immigrant status. Discussions Several communication barriers exist for recent migrant women, with possible consequences for quality of maternity care. Recommended standards for interpretation services were not followed. To address barriers, increased use of interpreter and multilingual antenatal courses could be effective. Key messages Low language proficiency and use of interpreter may contribute to disparities in maternity care for migrants. The unmet needs for interpretation services must be addressed with appropriate actions.