title: "Being flexible and creative": a qualitative study on maternity care assistants' experiences with non-Western immigrant women.
abstract: BACKGROUND
  Several studies conducted in developed countries have explored postnatal care professionals' experiences with non-western women. These studies reported different cultural practices, lack of knowledge of the maternity care system, communication difficulties, and the important role of the baby's grandmother as care-giver in the postnatal period. However, not much attention has been paid in existing literature to postnatal care professionals' approaches to these issues. Our main objective was to gain insight into how Dutch postnatal care providers--'maternity care assistants' (MCA)--address issues encountered when providing care for non-western women.
  
  
  METHODS
  A generic qualitative research approach was used. Two researchers interviewed fifteen MCAs individually, analysing the interview material separately and then comparing and discussing their results. Analytical codes were organised into main themes and subthemes.
  
  
  RESULTS
  MCAs perceive caring for non-western women as interesting and challenging, but sometimes difficult too. To guarantee the health and safety of mother and baby, they have adopted flexible and creative approaches to address issues concerning traditional practices, socioeconomic status and communication. Furthermore, they employ several other strategies to establish relationships with non-western clients and their families, improve women's knowledge of the maternity care system and give health education.
  
  
  CONCLUSIONS
  Provision of postnatal care to non-western clients may require special skills and measures. The quality of care for non-western clients might be improved by including these skills in education and retraining programmes for postnatal care providers on top of factual knowledge about traditional practices.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Agatha W
authors.initials: AW
authors.lastname: Boerleider
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands; Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Merle
authors.initials: M
authors.lastname: van de Reep
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: Manniën
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Therese A
authors.initials: TA
authors.lastname: Wiegers
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands; Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands; National Knowledge and Advisory Center on Migrants, Refugees and Health (Pharos), Utrecht, The Netherlands.
authors.forename: Walter L J M
authors.initials: WL
authors.lastname: Devillé
mesh_terms: D001291:Attitude of Health Personnel; D003405:Creativity; D054242:Emigrants and Immigrants; D005190:Family; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D033181:Information Dissemination; D011181:Postnatal Care; D036301:Qualitative Research