Abstract
In western countries, immigrant women have an increased risk of negative birth outcomes. Immigrant women’s and maternity care system’s delayed response to pregnancy complications contribute to ethnic inequities in reproductive health. The MAMAACT intervention was developed to improve midwives’ and women’s response to pregnancy complications in Denmark. The study examines the context of the implementation of the MAMAACT intervention and investigates how the intended intervention mechanisms regarding response to pregnancy complications were affected by barriers in non-Western immigrant women’s everyday life situations. Twenty-one interviews with non-Western immigrant women were undertaken. Systematic text condensation and the situational-adaptation framework by Alonzo were used to analyze data. Four main categories were identified: ‘Sources of knowledge during pregnancy’, ‘Containment of pregnancy warning signs’, ‘Barriers during the onset of acute illness’ and ‘Previous situations with maternity care providers’. Attention to potential pregnancy complications may conflict with immigrant women’s everyday life situations and result in the containment of symptoms as well as causing delays in seeking medical assistance. It is probable that barriers in women’s everyday life will impact the intended intervention mechanisms and thus the full potential of the intervention may not be reached.
Highlights
Immigrants contribute to a growing part of childbirths in Denmark
This study reports on findings part of a qualitative process evaluation [18] of the MAMAACT intervention [19]
Findings in this study suggested that some women would explain signs and symptoms of potential pregnancy complications as everyday illness situations or that they would contain them to meet obligations
Summary
Immigrants contribute to a growing part of childbirths in Denmark. Of children are born by immigrant mothers [1]. A number of individual and organizational barriers to maternity care utilization affect immigrant women’s health [2]. A major individual barrier is a low proficiency level of the native language [2,3,4]. This barrier may be accentuated by the insufficient use of professionally trained interpreters during emergency service contacts to hospitals [5,6,7]. Challenges related to navigation within maternity care systems constitute additional barriers for non-Western migrant women [2,5]
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