Estudio cualitativo de los factores relacionados con un control inadecuado del embarazo en mujeres inmigrantes y autóctonas en Huelva

Abstract

The prenatal care is considered an effective prevention of maternal morbidity and mortality procedure. Research from other countries show the existence of inequalities in health of immigrant women compared to native. In Spain these women have a deficit of prenatal care because barely access to health consultations for checking, doing laboratory tests or maternal care education classes. In Andalusia the differences relate to socio-economic inequalities affect either lack of education, exclusion and poverty native women or immigrant women. So the indicators presented by immigrant women are worse than native women. These show bad prenatal care die to start health care so late, little continuity or lack of diagnostic tests detected; the delay in the arrival at the hospital with advanced stages of labor, which increases the risk of maternal and fetal mortality and morbidity. The purpose of this study was to answer the question: What reasons do immigrant and native women have for not conducting an adequate prenatal care from a health and social perspective?, with the aim to know, understand and interpret the reasons, circumstances and situations what are present in inadequate prenatal care immigrants and native women in Huelva. In this qualitative research 32 people were interviewed, they were : women in pregnancy, childbirth and postpartum process with inadequate prenatal care women, healthcare professionals and social agents. In addition, two focus groups, 16 people, were created, one of them was composed by people from various disciplines of public health sector and the other one representative of various social non-profit organization that work with eligible women. Grounded Theory and Atlas ti 6.0 was used to data analysis. Triangulation was performed during the research conduction and data analysis. The results suggest the most relevant factors are related to personal characteristics such as immaturity and youth, cultural values, lack of economic means or poverty, low socio-educational level and mental health disorders. On the other hand, institutional and functional factors which respond mainly to bureaucratic barriers, legal and geographic accessibility. Relative to sense and experience, loneliness for lack of support networks, family or couple, were evidenced on migrant and native women. Poor training due to cultural and gender issues and the lack of knowledge about the functioning of the Social and Health Systems. The need to hard work to survive. In conclusion this research confirmed that there are differences and inequalities in prenatal care accessibility; the lack of support networks, loneliness, fear of the unknown, and poverty are associated with lack of prenatal care. The most affected were Moroccan, Romanian and Polish women social exclusion process. The various cultural concepts of reproductive health make clear the need to establish models of health care based on a concept of Transcultural Health who are able to integrate more adjusted to multicultural population.