Department of Health Promoting Science, Sophiahemmet University, Valhallavägen 91, Stockholm SE-114 28, Sweden.
Department of Health Promoting Science, Sophiahemmet University, Valhallavägen 91, Stockholm SE-114 28, Sweden; Department of Women's and Children's Health, Karolinska Institute, Tomtebodavägen 18A, Solna SE-171 77, Sweden.
Women Birth. 2024 Jul;37(4):101621. doi: 10.1016/j.wombi.2024.101621. Epub 2024 Apr 29.
Migration continues to play a role in determining health outcomes related to pregnancy and childbirth in Sweden.
Migrant women have, compared to Swedish-born women, increased risks of adverse birth outcomes. Previous research suggests that migrant women seek care for decreased fetal movements less than Swedish-born women. Given these documented risks, understanding midwives' perspectives in this context is crucial to address maternal health inequities.
To explore midwives' experiences conveying information about fetal movement to migrant women in antenatal healthcare settings.
Semi-structured, individual interviews with midwives (n=15) experienced in providing information about fetal movements to migrant women. The interviews were analysed using reflexive thematic analysis.
The midwives' efforts to compensate for the deficiencies within the antenatal healthcare organisation and to ensure that all women received access to information and care regarding fetal movements are described in four themes: (a) building a trusting relationship; (b) empowering women through guidance and support; (c) overcoming communication challenges; and d) navigating safety measures.
Our findings suggest that the standard antenatal care programme does not support midwives to provide holistic and individualised care that aligns with midwifery care philosophy.
To reduce health inequities for migrant women, this study highlights the need for more flexible guidelines within the standard antenatal care programme. These guidelines should prioritise the individual woman's needs over institutional protocols, acknowledge the midwife-woman relationship as the core of midwifery practice and support midwives to build a partnership with women through continuity of care.
移民仍在决定瑞典与妊娠和分娩相关的健康结果方面发挥作用。
与瑞典出生的女性相比，移民女性的不良分娩结局风险增加。先前的研究表明，移民女性在胎儿运动减少时寻求医疗护理的频率低于瑞典出生的女性。鉴于这些有记录的风险，了解助产士在这种情况下的观点对于解决产妇健康不平等问题至关重要。
探讨助产士在产前保健环境中向移民妇女传达关于胎儿运动信息的经验。
对有经验向移民妇女提供关于胎儿运动信息的助产士（n=15）进行半结构化的个体访谈。使用反思性主题分析对访谈进行分析。
助产士努力弥补产前保健组织中的不足，并确保所有妇女都能获得有关胎儿运动的信息和护理，这体现在四个主题中：（a）建立信任关系；（b）通过指导和支持赋予妇女权力；（c）克服沟通挑战；以及 d）驾驭安全措施。
我们的研究结果表明，标准的产前保健计划不能支持助产士提供符合助产护理理念的整体和个性化护理。
为了减少移民妇女的健康不平等，本研究强调需要在标准的产前保健计划中制定更灵活的指导方针。这些指导方针应优先考虑个体妇女的需求，而不是机构协议，承认助产士-妇女关系是助产实践的核心，并支持助产士通过连续护理与妇女建立伙伴关系。
