Maternity care for asylum seekers "unacceptably" poor researchers say
Maternity care for asylum seekers is unacceptably poor and unnecessarily increases the health risks for pregnant women and their unborn children, researchers from the Erasmus MC concluded in a study into maternity care for asylum seekers and refugees. Arie Franx, a professor of obstetrics who was involved in the study, called the poor care “unacceptable,” NOS reports.
“Every woman in the Netherlands, regardless of background or status, has the right to the same quality of maternity care,” Franx told the broadcaster. “You care for your patient as you would care for your mother, sister, or daughter. We are not doing that now.”
The researchers studied 80 maternity care files of asylum seekers. In almost half of the cases, pregnant asylum seekers only meet with a healthcare provider after 12 weeks of pregnancy, resulting in important tests not being performed on time. In a quarter to half of the cases, this was because the women were more than 12 weeks pregnant upon arrival. But for the other women, medical intakes were not performed when they arrived due to capacity problems at the Central Agency for the Reception of Asylum Seekers (COA).
Even if maternity care providers see pregnant asylum seekers before 12 weeks, they often disappear due to transfers between COA locations, which often happen without consultation with healthcare providers. The woman’s medical files aren’t transferred with her, which means that complications can be missed.
This is a big problem because 70 percent of the studied women were transferred at least once. Almost a third were transferred between COA locations twice or more times.
All COA locations have contracts with maternity care practices, but asylum seekers have to find their own way there by public transport. This often long journey can be stressful for women who are not used to the Netherlands' public transport system and don’t know the language yet. As a result, a third of patients miss their appointments.
According to the research, this limited accessibility to maternity care has a significant impact on its quality. Especially because it causes extra stress on pregnant women already in a very stressful situation. And stress increases the risks that can lead to complications.
An earlier study by this same research team found that the birth mortality rate for asylum seekers’ babies is at least 1.5 times higher than for Dutch babies. Low birth weight occurs twice as often. “The outcomes of pregnancies of asylum seekers and women without a refugee background is significant,” Franx said.
The researchers recommended designating a few asylum centers for pregnant women and providing maternity care at the location itself. According to Franx, this measure would solve many problems at once.
“There are 600 births per year among asylum seekers. That is not a lot. If you do at least 50 births per location, you can build up expertise there and do all the tests on-site, which prevents delays or missed appointments. And the problem of traveling to the midwife is also gone.” They made dozens of other recommendations too.
The COA told NOS that it recognizes the problems outlined in the court, but would not speculate on concentrating maternity care at certain locations. A spokesperson for Minister Marjolein Faber of Asylum said that asylum seekers are entitled to full maternity care and the Ministry would examine whether the researchers’ recommendations can be followed. It seems unlikely that this will happen given Faber’s plans for drastic cuts to asylum reception.
