TY - JOUR
T1 - Limited midwifery care for undocumented women in the Netherlands
AU - de Jonge, Ank
AU - Rijnders, Marlies
AU - Agyemang, Charles
AU - van der Stouwe, Relinde
AU - den Otter, Joost
AU - van den Muijsenbergh, Maria E. T. C.
AU - Buitendijk, Simone
AU - de Jonge, J.
PY - 2011
Y1 - 2011
N2 - Ethnic minority women in Western countries have poorer pregnancy outcomes compared to majority populations, and undocumented women are particularly vulnerable. We intended to assess whether midwives adjust their care if women are undocumented and have no health insurance. A retrospective matched cohort study in primary midwifery care practices in Amsterdam and Rotterdam, the Netherlands. Undocumented, uninsured women (N?=?141) were matched with documented, insured ethnic minority women (N?=?141). Information was extracted from patient records. Undocumented women attended their first prenatal visit 5 weeks later in their pregnancy and received care elsewhere or disappeared from care more frequently (59.6 versus 34.3%). They frequently have an excess of 110% of the number of expected antenatal visits (32.4% versus 16.9%) and had a preterm birth more frequently (OR 4.59, 95% CI 1.43 to 14.72). Midwives were equally likely to follow referral guidelines in both groups. Undocumented women were more likely to give birth at home (OR 2.14, 95% CI 1.07?4.28) and less likely to receive maternity home care assistance (56.0 versus 79.7%). Although referral guidelines are generally followed by midwives, undocumented women are more at risk of adverse perinatal outcomes and inadequate care than documented ethnic minority women
AB - Ethnic minority women in Western countries have poorer pregnancy outcomes compared to majority populations, and undocumented women are particularly vulnerable. We intended to assess whether midwives adjust their care if women are undocumented and have no health insurance. A retrospective matched cohort study in primary midwifery care practices in Amsterdam and Rotterdam, the Netherlands. Undocumented, uninsured women (N?=?141) were matched with documented, insured ethnic minority women (N?=?141). Information was extracted from patient records. Undocumented women attended their first prenatal visit 5 weeks later in their pregnancy and received care elsewhere or disappeared from care more frequently (59.6 versus 34.3%). They frequently have an excess of 110% of the number of expected antenatal visits (32.4% versus 16.9%) and had a preterm birth more frequently (OR 4.59, 95% CI 1.43 to 14.72). Midwives were equally likely to follow referral guidelines in both groups. Undocumented women were more likely to give birth at home (OR 2.14, 95% CI 1.07?4.28) and less likely to receive maternity home care assistance (56.0 versus 79.7%). Although referral guidelines are generally followed by midwives, undocumented women are more at risk of adverse perinatal outcomes and inadequate care than documented ethnic minority women
U2 - https://doi.org/10.3109/0167482X.2011.589016
DO - https://doi.org/10.3109/0167482X.2011.589016
M3 - Article
C2 - 21854222
SN - 0167-482X
VL - 32
SP - 182
EP - 188
JO - Journal of psychosomatic obstetrics and gynaecology
JF - Journal of psychosomatic obstetrics and gynaecology
IS - 4
ER -