Solution-oriented midwifery care for non-western women

Midwives caring for non-western women in the Netherlands face various difficulties such as language barriers and lack of knowledge of the maternity care system. Such difficulties require a solution-oriented approach. Knowing how to approach and deal with these problems should be included in midwifery education programmes as well as training programmes for midwives. This has been argued by researchers from the Netherlands Institute for Health Services Research (NIVEL), the Dutch Midwifery Academy (AVAG), and the VU Medical Centre in an article published in the International Journal of Nursing Studies.
 

In 2010, of the total number of births in the Netherlands, 17.4 percent of the mothers were non-western women. In Amsterdam, Rotterdam and the Hague, the proportion was nearly half. Non-western women therefore constitute a substantial part of the midwifery practice population. The diverse origins of these women, who come from regions such as Turkey, Africa, Latin America and Asia, together with the fact that they are more likely to start prenatal care late, can make it difficult for midwives to provide optimal care. Until now, little was known about how midwives dealt with these difficulties and problems.
 
Difficulties
Midwives find that providing care to non-western women can sometimes be very demanding but also very rewarding. Sometimes there are communication problems because the pregnant woman does not speak Dutch. Other difficulties are lack of knowledge of the Dutch maternity care system, socioeconomic problems, pressure from the woman’s family and a strong preference for physicians. These difficulties occur less frequently among second-generation non-western women, i.e. those who were born in the Netherlands.
 
Practical solutions
In spite of the difficulties, midwives still aim for optimal care by taking their clients by the hand and explaining how the Dutch maternity care system works, using telephone interpreters or a family member to interpret, using translated brochures, and providing clients a print out from the route map to locate the ultrasound clinic. By being proactive and finding solutions themselves, midwives are offering more than just the usual care they would provide for most native Dutch pregnant women. The quality of midwifery care to non-western women can be improved by documenting these solutions and measures and including them in midwifery education and training programmes.
 
Research
The current study is part of the national Deliver study. The aim of this study is to survey and describe the current patterns of demand and service provision in midwifery in the Netherlands. For the current study, thirteen midwives were interviewed individually and eight in a focus group. They were asked about their experiences in providing care to non-western women in primary care midwifery.
 
Funding
Academie voor Verloskunde Amsterdam-Groningen (AVAG)
Ministry of Education, Culture and Science
 
Cooperating partners
Academie voor Verloskunde Amsterdam-Groningen (AVAG)
Department of midwifery science, EMGO, Institute for Health and Care Research, VUmc