Malin Ahrne1, Erica Schytt2, Ewa Andersson3, Rhonda Small4, Aisha Adan5, Birgitta Essén6, Ulrika Byrskog7. 1. Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 8th floor, SE-171 77 Stockholm, Sweden. Electronic address: malin.ahrne@ki.se. 2. Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 8th floor, SE-171 77 Stockholm, Sweden; Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden; Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway. Electronic address: Erica.Schytt@ltdalarna.se. 3. Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 8th floor, SE-171 77 Stockholm, Sweden. Electronic address: Ewa.Andersson@ki.se. 4. Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 8th floor, SE-171 77 Stockholm, Sweden; Judith Lumley Centre, La Trobe University, Melbourne, Australia. Electronic address: R.Small@latrobe.edu.au. 5. Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 8th floor, SE-171 77 Stockholm, Sweden. 6. Women's and Children's Health, IMCH, Uppsala University, Sweden. Electronic address: birgitta.essen@kbh.uu.se. 7. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden. Electronic address: uby@du.se.
Abstract
OBJECTIVE: To explore Somali-born parents' experiences of antenatal care in Sweden, antenatal care midwives' experiences of caring for Somali-born parents, and their respective ideas about group antenatal care for Somali-born parents. DESIGN: Eight focus group discussions with 2-8 participants in each were conducted, three with Somali-born mothers, two with fathers and three with antenatal care midwives. The transcribed text was analysed using Attride-Stirling's tool "Thematic networks". SETTING: Two towns in mid-Sweden and a suburb of the capital city of Sweden. PARTICIPANTS: Mothers (n = 16), fathers (n = 13) and midwives (n = 7) were recruited using purposeful sampling. FINDINGS: Somali-born mothers and fathers in Sweden were content with many aspects of antenatal care, but they also faced barriers. Challenges in the midwife-parent encounter related to tailoring of care to individual needs, dealing with stereotypes, addressing varied levels of health literacy, overcoming communication barriers and enabling partner involvement. Health system challenges related to accessibility of care, limited resources, and the need for clear, but flexible routines and supportive structures for parent education. Midwives confirmed these challenges and tried to address them but sometimes lacked the support, resources and tools to do so. Mothers, fathers and midwives thought that language-supported group antenatal care might help to improve communication, provide mutual support and enable better dialogue, but they were concerned that group care should still allow privacy when needed and not stereotype families according to their country of birth. KEY CONCLUSIONS: ANC interventions targeting inequalities between migrants and non-migrants may benefit from embracing a person-centred approach, as a means to counteract stereotypes, misunderstandings and prejudice. Group antenatal care has the potential to provide a platform for person-centred care and has other potential benefits in providing high-quality antenatal care for sub-groups that tend to receive less or poor quality care. Further research on how to address stereotypes and implicit bias in maternity care in the Swedish context is needed.
OBJECTIVE: To explore Somali-born parents' experiences of antenatal care in Sweden, antenatal care midwives' experiences of caring for Somali-born parents, and their respective ideas about group antenatal care for Somali-born parents. DESIGN: Eight focus group discussions with 2-8 participants in each were conducted, three with Somali-born mothers, two with fathers and three with antenatal care midwives. The transcribed text was analysed using Attride-Stirling's tool "Thematic networks". SETTING: Two towns in mid-Sweden and a suburb of the capital city of Sweden. PARTICIPANTS: Mothers (n = 16), fathers (n = 13) and midwives (n = 7) were recruited using purposeful sampling. FINDINGS: Somali-born mothers and fathers in Sweden were content with many aspects of antenatal care, but they also faced barriers. Challenges in the midwife-parent encounter related to tailoring of care to individual needs, dealing with stereotypes, addressing varied levels of health literacy, overcoming communication barriers and enabling partner involvement. Health system challenges related to accessibility of care, limited resources, and the need for clear, but flexible routines and supportive structures for parent education. Midwives confirmed these challenges and tried to address them but sometimes lacked the support, resources and tools to do so. Mothers, fathers and midwives thought that language-supported group antenatal care might help to improve communication, provide mutual support and enable better dialogue, but they were concerned that group care should still allow privacy when needed and not stereotype families according to their country of birth. KEY CONCLUSIONS: ANC interventions targeting inequalities between migrants and non-migrants may benefit from embracing a person-centred approach, as a means to counteract stereotypes, misunderstandings and prejudice. Group antenatal care has the potential to provide a platform for person-centred care and has other potential benefits in providing high-quality antenatal care for sub-groups that tend to receive less or poor quality care. Further research on how to address stereotypes and implicit bias in maternity care in the Swedish context is needed.