Etnische verschillen in het gebruik van kraamzorg

To examine the ethnic differences in the uptake of professional maternity care assistance (MCA) in the Netherlands, and the factors that may explain these differences. Additionally the effect of MCA on health risk behaviour around infants is examined. Questionnaire survey. Questionnaire data from 3967 mothers from the ABCD study (Amsterdam Born Children and their Development) included during pregnancy in 2003-2004, were used. We examined the explanatory role of ethnicity, age, socioeconomic status, mastery of the Dutch language, parity, housing situation and place of giving birth on MCA uptake, and the effect of MCA uptake on health risk behaviour around infants, such as smoking indoors, infant sleep behaviour, infant nutrition, and response to infant crying. Mothers of non-Western origin less often used MCA than Dutch mothers (Ghanaian: 70%; Turkish: 75%; Moroccan: 79%; Surinamese: 81%; Dutch Caribbean: 85% vs. Dutch: 95%). Higher educational level, better mastery of the Dutch language, having a paid job and home delivery were all independently associated with the uptake of MCA, and also partially explained ethnic differences in the uptake of MCA. Mothers who received MCA more often breastfed, more often gave vitamin K when not breastfeeding, and more often lived in smoke-free homes. The protective effect of MCA was stronger for non-Western mothers than for Dutch mothers. Mothers of non-Western origin make less use of professional MCA. Given that the use of MCA is associated with a less risk behaviour around infants, efforts should be made to improve the accessibility of professional MCA for mothers of non-Western origin