“No papers. No doctor”: undocumented immigrant women’s access to maternity care services in Denmark

Abstract

Abstract Background In Denmark, undocumented immigrants have restricted access to health care including maternity care. Nordic studies describe that undocumented immigrant women face many barriers to access maternity care during pregnancy however, literature in a Danish setting is lacking. This study aims at exploring undocumented immigrant women's experience of and their access to maternity care services in Denmark. Methods The study setting was a non-governmental Health Clinic in Denmark, that provides primary health care, including maternity care, to undocumented immigrants. We recruited 21 undocumented immigrant women, conducted semi-structured interviews from 01.2018 to 01.2019. The data was analyzed through systematic text condensation. Results Undocumented immigrant women experience several barriers to access maternity care services in Denmark. We identified four themes with subthemes. i) Access to public maternity care services; the experiences with public maternity care providers, fear of deportation and concerns about having to pay for care. ii) Use of private and non-governmental maternity care services; the feeling of being safe at the Health Clinic, reaching care is challenged by logistics and choosing to pay for private health care services. iii) Perception of entitlements to care; wishing for a fair treatment, and uncertainty of what to expect when reaching a public health care facility. iv) Being dependent; dependency on the Health Clinic, social support from network and seeking information from other sources. Conclusions Our findings contribute with insights to understand the health behavior of undocumented immigrant women. Accessing public maternity care services is, apart from legal restrictions, dominated by fear of being reported to the immigration authorities, concerns about payment, and the management of rules from the health provider's perspective. Many of them depend on the Health Clinic as well as their personal networks for care and protection. Key messages Undocumented immigrant women face many barriers to access maternity care services. Inclusive policies for access to maternity care are needed to safeguard the health of the women and children.