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The influence of migration on women’s satisfaction during pregnancy and birth: results of a comparative prospective study with the Migrant Friendly Maternity Care Questionnaire (MFMCQ)

  • Maternal-Fetal Medicine
  • Published:
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Abstract

Introduction

Approximately 21% of Germany’s inhabitants have been born abroad or are of direct descent of immigrants. A positive birth experience has an effect on a woman’s mental health and her future family planning choices. While international studies showed that immigrant women are less satisfied with their birth experience, no such study has been conducted in Germany until now.

Methods

At our center of tertiary care in Berlin, with approximately 50% immigrants among patients, pregnant women of at least 18 years of age were offered participation in this study. A modified version of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) designed by Gagnon et al. in German, English, French, Spanish, Arabic and Turkish was used. We compared non-immigrant women to immigrant women and women with direct descent of immigrants. For certain analysis, the latter two groups were included together under the category “migration background”.

Results

During the study period, 184 non-immigrant, 214 immigrant women and 62 direct descendants of immigrants were included. The most frequent countries of origin were Syria (19%), Turkey (17%), and Lebanon (9%). We found a slight difference between groups regarding age (non-immigrants: mean 33 years versus women with any migration background: mean 31) as well as parity with more non-immigrants delivering their first child.

No difference in the satisfaction with care was observed between immigrant and any migration background groups (p ≥ 0.093 in the two-sided Fisher’s exact test). At least 75.8% of all participating women reported complete satisfaction with care during labor, birth and after birth. Interestingly, the level of German language proficiency did not influence the immigrant patient’s satisfaction with care.

Conclusion

The study results show no difference regarding overall satisfaction with care during labor and birth despite a relevant language barrier. We are for the first time providing the MFMCQ in German and Turkish. Further future analyses on the impact of patient expectations on satisfaction with care will be conducted.

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Acknowledgements

Dr. Seidel was a participant in the BIH-Charité Junior Clinical Scientist Program funded by the Charité-Universitätsmedizin Berlin and the Berlin Institute of Health.

Funding

Dr. Seidel was a participant in the BIH-Charité Junior Clinical Scientist Program funded by the Charité-Universitätsmedizin Berlin and the Berlin Institute of Health.

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Authors and Affiliations

  1. Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    C. Großkreutz, M. Vortel, W. Henrich & V. Seidel

  2. Alice Salomon Hochschule, Berlin, Germany

    T. Borde

  3. Clinic of Gynecology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

    M. David

  4. Berlin Institute of Health (BIH), Berlin, Germany

    V. Seidel

  5. Clinic of Obstetrics, Universitätsklinikum Leipzig, Leipzig, Germany

    B. Gürbüz & H. Stepan

  6. Bielefeld School of Public Health and Centre for Statistics, Bielefeld University, Bielefeld, Germany

    O. Sauzet

  7. Division of ‘Experimental Obstetrics’, Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany

    R. C. Rancourt

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Contributions

BG: data collection and management, manuscript writing and editing; CG: data collection and management; MV: data collection and management; TB: project development and manuscript editing; RCR: manuscript writing and editing; HS: manuscript editing; OS: statistical analysis; WH: manuscript editing; MD: project development and manuscript editing; VS: project development, data collection and management, and manuscript writing and editing. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to V. Seidel.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Ethical approval

The study had local ethics committee approval (EA1/322/16). All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All women gave oral informed consent for study participation after reading the information leaflet and were given ample time to answer all questions to the study assistant. The study information leaflet was available in all languages in which the questionnaire was available (German, English, Turkish, Arabic, Spanish and French). If a potential participant was illiterate the leaflet was read out to her.

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Appendices

Appendix 1: List of changes

Q33 (supply rooms for newborns).

Q40 (aftercare midwives).

Q90 (age instead of date of birth).

Q93/96 (adaptation to German legislation).

Q101 (German insurance system).

Q105 (resumption of occupation).

Q107 (net household income).

Appendix 2: Migrant Friendly Maternity Care Questionnaire (MFMCQ)

Available under https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-200.

Appendix 3: Classification of immigrant groups according to residence status

1. “Permanent”: Settlement permit, citizenship of a country of the EU, EEA or Switzerland.

2. “Temporary”: Residence for the purpose of employment, education (e.g. student), for family reasons, former Germans who wish to return to Germany, tourist visa.

3. “Refugees”: Asylum seekers (proof of arrival for asylum seekers/asylum applications made, ongoing asylum procedure), refugees, toleration (temporary suspension of deportation).

4. “German”: German citizenship and dual citizenship (when one is German).

5. “Unknown”: not documented.

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Gürbüz, B., Großkreutz, C., Vortel, M. et al. The influence of migration on women’s satisfaction during pregnancy and birth: results of a comparative prospective study with the Migrant Friendly Maternity Care Questionnaire (MFMCQ). Arch Gynecol Obstet 300, 555–567 (2019). https://doi.org/10.1007/s00404-019-05227-4

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