Page 13 - Non-western women in maternity care in the Netherlands • Exploring ‘inadequate’ use of prenatal care and the experiences of care professionals

system in the Netherlands is unique, with primary care midwives being the lead professionals providing care to women with uncomplicated pregnancies and births [19]. Dutch primary care midwives may have different experiences with non-western clients, so we decided to conduct a sub study within a national midwifery study to look at their experiences. The following questions are addressed in this article:
1) What specific issues do primary care midwives in the Netherlands experience in their working relationship with non-western clients?
2) Do these primary care midwives adjust their care for non-western clients and if so in what way?
Methods
A generic qualitative approach was used, implying that not one specific qualitative methodology was used as guidance, and that a declaration of the researcher’s position, congruence between methodology and method, a clear articulation of the researcher’s approach to rigour and an explanation of the analytic lens are provided [20]. Our interest in the subjective experiences and perceptions of midwives providing care to non- western clients meant that holding qualitative interviews seemed most suitable. We conducted both individual interviews and a focus group interview with midwives, letting these two methods complement each other. Particularly delicate topics might be more readily discussed in individual interviews, whereas for other topics this might be the case in a group interview, where there is a more dynamic interaction between participants.
Recruitment and sample
The individual interviews
Initially, convenience sampling was carried out by recruiting midwives from the 20 midwifery practices participating in the national DELIVER study, a large research project in the Netherlands focusing on the quality, organisation and accessibility of primary care midwifery in the Netherlands [21]. The representatives of these midwifery practices to the DELIVER study were all approached. Eight practices were willing to participate: four by their representative and four by another midwife of the practice. The main
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