Background. The aim of this study was to investigate differences in use of antenatal care in a multi-ethnic population in Malmö, Sweden, over a 4-year period. Age, parity, cohabiting status, use of an interpreter, and tobacco-use were examined to assess the potential effects of confounding factors. Methods. A 4-year (2000–2003) retrospective community-based register study was performed. Low-risk singleton pregnancies (n = 5,373) registered for antenatal care at 5 municipal clinics and at the delivery ward at Malmö University Hospital were included, and divided into 6 subgroups by country of origin. The odds for utilisation of antenatal care were analysed by means of logistic regression. Results. Significantly increased odds of lower utilisation of planned antenatal care were found among some groups of foreign-born women. Women born in Eastern and Southern Europe, Iraq and Lebanon, and Asia had fewer antenatal visits than recommended, and all foreign-born women (except for women born in Iraq and Lebanon, and South and Central America) had a late first visit compared to Swedish-born women. Foreign-born women had, in general, fewer unplanned visits to a physician at the delivery ward, but women originating from Asia, Iraq and Lebanon, and Africa had higher utilisation visits to midwives at the delivery ward compared to Swedish-born women. Conclusions. Foreign-born women had lower utilisation of planned antenatal care. Approximately 50% of women had higher utilisation of care, by making unplanned visits to the delivery ward. This puts strain on both economical as well as staff resources. The delivery clinic at the hospital level is not intended to handle routine visits, and, moreover, some of these women do not receive the full benefits of planned routine antenatal care.

Background

Traditional patterns relating to how to handle pregnancy and birth are often challenged due to migration. The purpose of this study was to describe Middle Eastern mothers' experiences of the maternal health care services in Sweden and the involvement of their male partner.

Methods

Thirteen immigrant mothers from the Middle East who had used the maternal health services in Sweden were interviewed using focus group discussions and individual interviews. These were taped, transcribed and analysed according to Content analysis.

Results

The four main categories that developed were:

• Access to the professional midwife

• Useful counselling

• Stable motherhood in transition

• Being a family living in a different culture

Conclusion

According to the respondents in this study, understanding the woman's native language or her culture was not vital to develop a good relationship with the midwife. Instead the immigrant woman developed trust in the midwife based on the knowledge and the empathy the midwife imparted.

Increasing the amount of first trimester antenatal visits could avoid spontaneous visits to the emergency clinic. There was a greater need for involvement and support by the father during the perinatal period, such as caring for older children and carrying out household chores since the mothers' earlier female network was often lost.

Clinical implications

There is a need to involve immigrant parents in the available parental education in order to prepare them for parenthood in their new country as well as to explore their altered family situation. Collecting immigrant women and their partner's, experiences of maternal health care services offers a possibility to improve the existing care, both in content, access and availability where the timing of visits and content require further evaluation.