Barrier-free Communication in Maternity Care of Allophone Migrants

In Switzerland pregnant migrant women and their families are burdened in multiple ways: pregnancy requires an adjustment process and women have to deal with foreign living conditions, limited communication or the uncertainty of their residence status. An increased maternal and child health morbidity and mortality in migrants is well documented. A poor health outcome seems also to be correlated with a limited access to obstetric and maternity care services for migrants. Nearly 10% of foreigners living in Switzerland for more than one year do not speak any of the official languages. In women native of non-EU27 and -EFTA countries and asylum seekers, these rate is considerably higher.

To improve maternity care services for migrants in Switzerland several measures have been taken in the past, e.g. Hospitals for Equity, promotion of transcultural skills, written multilingual health information and interpreter services in hospitals. The availability of comparable measures in outpatient or home care services is rather an exception. One example is the midwives network "FamilyStart", an outpatient institution that offers a helpline and home visiting services for mothers and thier newborns. It collaborates with the National Telephone Interpreter Service.

It is currently unclear how successfully midwives and other health care professionals communicate with allophone migrants, if they use and benefit from any of the currently available support measures and thus may improve the access of migrant women to maternity care in Switzerland.

The study aims

• to describe the access and communication barriers of allophone women with different migration backgrounds in maternity and obstetric health services from the perspective of users, health care professionals and Interpreters
• to make prioritized recommendations on behalf of the Swiss Midwives Association and other professional associations for improving the quality and access of maternity care Services; the transcultural understanding between professionals and users; and the coordination between the different involved services.

It is an exploratory study in three parts:

• User perspective: Qualitative assessment of the women's experiences. The participants have different migration backgrounds: representatives of the resident foreign population of Switzerland (from Kosovo or Albania with native language Albanian) and asylum seekers (from Eritrea with native language Tigrinya) will be interviewed.
• Perspective of professionals: Qualitative assessment of the health care professionals experiences and quantitative analysis of protocols of counseling sessions from midwives who have used the telephone interpreting service during a home visit on behalf of FamilyStart.
• Perspective of interpreters: Qualitative assessment of experiences of professional Interpreters.

Group 1: Inclusion criteria:

• healthy women speaking Albanian or Tigrinja
• mothers of a healthy infant up to one year after birth

Exclusion criteria

• women speaking fluent German
• women with a serious illness during pregnancy, childbirth and/or postpartum or who's infant was seriously ill or died

Group 2: Inclusion criteria:

• Minimum one year working experience
• Experience with allophone Tigrinya or Albanian speaking women

Group 3: Inclusion criteria:

• Female
• Minimum one year working experience
• having either telephone or face-to-face interpreting Expertise

Group 4: No limitation