Department of Community Medicine and Global Health and Centre for Global Health, Oslo Group on Global Health Policy, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Family Medicine, Chiang Mai University, Chiang Mai, Thailand.
PLoS One. 2020 Apr 2;15(4):e0230407. doi: 10.1371/journal.pone.0230407. eCollection 2020.
Choosing where to give birth can be a matter of life and death for both mother and child. Migrants, registered or unregistered, may face different choices and challenges than non-migrants. Despite this, previous research on the factors migrant women consider when deciding where to give birth is very limited. This paper addresses this gap by examining women's decision making in a respective border and urban locale in Thailand.
We held focus group discussions [13] with 72 non-Thai pregnant migrant women at non-government clinics in a rural border area and at two hospitals in Chiang Mai, a large city in Northern Thailand in 2018. We asked women where they will go to give birth and to explain the factors that influenced their decision.
Women identified getting the relevant documentation necessary to register their child's birth, safe birth and medical advice/quality care, as the top three factors that influenced their care seeking decision making. Language of service, free or low cost care, language of services, proximity to home, and limited alternate options for care were also identified as important considerations.
Understanding factors that migrant women value when choosing where to deliver can help health care providers to create services that are responsive to migrants' preferences and encourage provision of relevant information which may influence patient decision making. The desire to obtain birth documentation for their child appears to be important for migrants who understand the importance of personal documentation for the lives of their children. Healthcare institutions may wish to introduce processes to facilitate obtaining documentation for pregnant migrant women and their newborns.
母婴的分娩地点选择可能关乎生死。与非移民相比，登记移民或未登记移民可能面临不同的选择和挑战。尽管如此，先前关于移徙妇女在决定分娩地点时考虑的因素的研究非常有限。本文通过考察泰国边境和城市地区妇女的决策来填补这一空白。
我们于 2018 年在泰国边境农村地区的非政府诊所和清迈的两家医院，与 72 名非泰籍怀孕移民妇女举行了 13 次焦点小组讨论。我们询问了妇女们她们将去哪里分娩，并解释影响她们决策的因素。
妇女们认为，获得登记孩子出生所需的相关文件、安全分娩和医疗建议/优质护理，是影响她们寻求护理决策的前三大因素。服务语言、免费或低价护理、服务语言、离家近以及护理的替代选择有限，也被认为是重要的考虑因素。
了解移徙妇女在选择分娩地点时看重的因素，可以帮助医疗保健提供者创建符合移民偏好的服务，并鼓励提供可能影响患者决策的相关信息。对于那些了解个人文件对子女生活重要性的移民来说，为孩子获得出生文件的愿望似乎很重要。医疗机构可能希望引入流程，为怀孕移民妇女及其新生儿提供获取文件的便利。
