Experiences and preferences of care among Swedish immigrants following a prenatal diagnosis of congenital heart defect in the fetus: a qualitative interview study.

Tommy Carlsson,Elisabet Mattsson,Ulla Melander Marttala,Anders Ringnér

doi:10.1186/s12884-016-0912-1

Abstract

BackgroundImmigrants experience significant challenges when in contact with healthcare and report less satisfaction with maternity care compared to native Swedes. Research that gives voice to pregnant immigrant women and their partners following a prenatal diagnosis of a fetal anomaly is scarce. Thus, the aim of this study was to explore experiences and preferences of care following a prenatal diagnosis of congenital heart defect among Swedish immigrants.MethodsPregnant immigrants and their partners were consecutively recruited following a prenatal diagnosis of a congenital heart defect in the fetus. Nine respondents were interviewed in five interviews, four with the aid of a professional interpreter. The material was analyzed using manifest qualitative content analysis.ResultsThe analysis resulted in five categories: 1) “Trustworthy information”, 2) “Language barriers”, 3) “Psychosocial situation”, 4) “Peer support”, and 5) “Religious positions”.ConclusionThe potential need for interpreter services, visual information, psychosocial support, coordination with welfare officers, and respect for religious positions about termination of pregnancy are all important aspects for health professionals to consider when consulting immigrants faced with a prenatal diagnosis of fetal anomaly in the fetus. Peer support within this context needs to be further explored in future studies.

Highlights

Immigrants experience significant challenges when in contact with healthcare and report less satisfaction with maternity care compared to native Swedes
Previous studies have observed that religious positions have an impact on reasoning about termination of pregnancy if a fetal anomaly is detected during prenatal screening procedures [21, 22], and that maternal ethnic origin is associated with the decision to terminate the pregnancy following a prenatal diagnosis of congenital heart defects (CHD) [23, 24]
The analysis resulted in five categories: “Trustworthy information”, “Language barriers”, “Psychosocial situation”, “Peer support” and “Religious positions”

Summary

Introduction

Immigrants experience significant challenges when in contact with healthcare and report less satisfaction with maternity care compared to native Swedes. Research that gives voice to pregnant immigrant women and their partners following a prenatal diagnosis of a fetal anomaly is scarce. The aim of this study was to explore experiences and preferences of care following a prenatal diagnosis of congenital heart defect among Swedish immigrants. The detection rate of congenital heart defects (CHD) in the fetus has greatly increased since the introduction of routine ultrasound screening of pregnant women [9]. Pregnant women have optimistic expectations of the routine ultrasound screening [10,11,12], resulting in unpreparedness for a prenatal diagnosis of a fetal anomaly [10, 11, 13, 14]. Previous studies have observed that religious positions have an impact on reasoning about termination of pregnancy if a fetal anomaly is detected during prenatal screening procedures [21, 22], and that maternal ethnic origin is associated with the decision to terminate the pregnancy following a prenatal diagnosis of CHD [23, 24]

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Discussion

Conclusion