Skip to main content

Advertisement

Log in

Migrant Women’s Perceptions of Healthcare During Pregnancy and Early Motherhood: Addressing the Social Determinants of Health

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. IOM. World migration report. Communicating effectively about migration, 2011. Geneva: International Organization for Migration; 2011.

    Google Scholar 

  2. Fernandes A, Miguel J. Health and migration in the European Union: better health for all in an inclusive society. Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge; 2009.

    Google Scholar 

  3. Bunevicius R, et al. Psychosocial risk factors for depression during pregnancy. Acta Obstetr Gynecol. 2009;88:599–605.

    Article  Google Scholar 

  4. Rumbold A, et al. Delivery of maternal health care in indigenous primary care services: baseline data for an ongoing quality improvement initiative. BMC Pregnancy Childbirth. 2011;11:16.

    Google Scholar 

  5. Dias S, et al. Healthcare-seeking patterns among immigrants in Portugal. Health Soc Care Commun. 2011;19(5):514–21.

    Article  Google Scholar 

  6. Dias S, Severo M, Barros H. Determinants of health care utilization by immigrants in Portugal. BMC Health Services Res. 2008;8:207.

    Google Scholar 

  7. Dias S, Gama A, Rocha C. Immigrant women’s perceptions and experiences of health care services: insights from a focus group study. J Public Health. 2010;18:489–96.

    Article  Google Scholar 

  8. Siegrist J, Marmot M. Health inequalities and the psychosocial environment—two scientific challenges. Soc Sci Med. 2004;58:1463–73.

    Article  PubMed  Google Scholar 

  9. Marmot M, Bell R. Improving health: social determinants and personal choice. Am J Prev Med. 2011;40:S73–7.

    Article  Google Scholar 

  10. Friel S, Marmot M. Action on the social determinants of health and health inequities goes global. Annu Rev Public Health. 2011;32:225–36.

    Article  PubMed  Google Scholar 

  11. CSDH. Closing the gap in a generation: health equity through action on the social determinants of health. In: Final report of the Commission on Social Determinants of Health 2008. Geneva: World Health Organization.

  12. Machado MC, et al. Iguais ou diferentes? Cuidados de Saúde materno-infantil a uma população de imigrantes. Laboratórios BIAL; 2006.

  13. Ganann R, Sword W, Black M, Carpio B. Influence of maternal birthplace on postpartum health and health services use. J Immigr Minor Health. 2011;14(2):223–9.

    Google Scholar 

  14. Malin M, Gissler M. Maternal care and birth outcomes among ethnic minority women in Finland. BMC Public Health. 2009;9:84.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Jonkers M, et al. Severe maternal morbidity among immigrant women in the Netherlands: patients’ perspectives. Reprod Health Matters. 2011;19(37):144–53.

    Article  PubMed  Google Scholar 

  16. Schetter CD. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol. 2011;62:531–58.

    Article  Google Scholar 

  17. Zeitlin J, Mohangoo A. European perinatal health report. In: Cahn J, editor. EURO-PERISTAT Project. SCPE, EUROCAT, EURONEOSTAT; 2008.

  18. Silva S, Fraga S. Qualitative research in epidemiology. In: Lunet S, editor. Epidemiology—current perspectives on research and practice. 2012, (InTech).

  19. Bogdan R, Biklen S. Qualitative research for education. In: Pearson ES, editor. An introduction to theories and methods. 2003.

  20. Ingleby D, et al. The role of health in integration, in Social integration and mobility: education, housing and health. In: Fonseca M, Malheiros J, editors. Lisbon: Centro de Estudos Geográficos; 2005. p. 88–119.

  21. Anderson L, et al. Culturally competent healthcare systems: a systematic review. Am J Prev Med. 2003;24:68–79.

    Article  PubMed  Google Scholar 

  22. Essen B, et al. Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services? BJOG. 2002;109(6):677–82.

    Article  PubMed  Google Scholar 

  23. Fedeli U, et al. Obstetric hospitalizations among Italian women, regular and irregular immigrants in North-Eastern Italy. Acta Obstet Gynecol Scand. 2010;89(11):1432–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by Fundação para a Ciência e Tecnologia (FCT)—Portugal, under the research project “Health and Citizenship: Gaps and needs in intercultural health care to immigrant mothers”. The authors would like to thank the study participants and the welfare institutions that collaborated with this research.

Ethical Standard

The study was approved by the Research Ethics Board of the School of Psychology and Educational Sciences, at the University of Porto. Approval for the conduction of the study was also obtained from the governing boards and Ethics Committees of all involved welfare institutions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lígia Moreira Almeida.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Almeida, L.M., Casanova, C., Caldas, J. et al. Migrant Women’s Perceptions of Healthcare During Pregnancy and Early Motherhood: Addressing the Social Determinants of Health. J Immigrant Minority Health 16, 719–723 (2014). https://doi.org/10.1007/s10903-013-9834-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-013-9834-4

Keywords

Navigation