Obstetric care in a migrant population with free access to health care.
OBJECTIVE
To evaluate differences in obstetric care between immigrant and native women in a country with free access to health care.


METHODS
A cross-sectional study was carried out of immigrant mothers delivering in one of the four public hospitals in the Porto, Portugal, metropolitan area between February and December 2012. The comparison group included native Portuguese mothers who delivered in the same institutions. The participants (89 immigrant mothers and 188 Portuguese mothers) were recruited by telephone and completed a written questionnaire during a home visit.


RESULTS
Immigrant women were more likely to have their first pregnancy appointment after 12 weeks of pregnancy (27.0% vs 14.4%, P = 0.011) and to have fewer than three prenatal visits (2.2% vs 0.0%, P < 0.001). They were also more likely to have had a cesarean delivery (48.3% vs 31.4%, P = 0.023), perineal laceration (48.8% vs 11.6%, P < 0.001), or postpartum hemorrhage (33.5% vs 12.3%, P < 0.001).


CONCLUSIONS
Migrants were more prone to late prenatal care and to intrapartum complications. Unsatisfactory interactions with healthcare staff may play an important role in these findings.
Institute of Public Health, University of Porto Medical School, Porto, Portugal; Centre for Research and Intervention in Education, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal; Iberoamerican Observatory of Health and Citizenship, Porto, Portugal. Electronic address: ligia_almeida@fpce.up.pt.
Lígia M
LM
Almeida
Centre for Research in Health Technologies and Information Systems, Department of Information Sciences and Decision in Health, University of Porto Medical School, Porto, Portugal.
Cristina C
CC
Santos
Centre for Research and Intervention in Education, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal; Iberoamerican Observatory of Health and Citizenship, Porto, Portugal.
José P
JP
Caldas
Department of Obstetrics and Gynecology, University of Porto Medical School and São João Hospital, Porto, Portugal.
Diogo
D
Ayres-de-Campos
Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal.
Sónia
S
Dias
D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D018743:Perinatal Care / Q000592:standards / Q000706:statistics & numerical data*; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011785:Quality Assurance, Health Care; D012959:Socioeconomic Factors
Immigrants; Maternal health services; Patient satisfaction; Portugal; Pregnancy complications; Prenatal care