Page 15 - Non-western women in maternity care in the Netherlands • Exploring ‘inadequate’ use of prenatal care and the experiences of care professionals

hold a small focus group within one of the group’s regular meetings. A total of 8 primary care midwives were present at this regional midwifery meeting, which we were allowed to attend. They were all females of native Dutch origin, aged between 28 and 58, whose experience with non-western clients ranged from 6 to 19 years.
Interviews; data collection
The individual interviews
A semi-structured topic list was used to guide the interviews, although the interviewees were also encouraged to raise issues that were relevant to them but not included in the topic list. As Dutch midwives provide care in the prenatal, natal and postnatal periods, the list explored their experiences in all these three stages of care. It was reviewed by six research experts (including two midwives) and was drawn up using existing literature and the model of Foets et al. The latter is an elaboration of the Andersen model of healthcare utilisation in which ethnic differences in healthcare use are explained by various underlying factors such as migration-related characteristics, cultural factors, socioeconomic status, social network, accessibility of healthcare, personal treatment by healthcare professionals and communication [22]. Prior to data collection, the topic list and semi- structured interview style were tested in a pilot interview with a midwife. The interviews were conducted in Dutch, varying in length between approximately 60 and 90 min. They were conducted at the preferred location of the midwives: eleven in the midwifery practice, one at the coordinating health centre to which the midwifery practice was connected, and two at home. The number of midwives to be interviewed was not predetermined. Interviewing was continued until data saturation was attained, i.e. the point at which no new information or themes were observed in additional data [23].
The focus group interview
The focus group was conducted after finalisation of the individual interviews. Like the individual interviews, it was guided by a semi- structured topic list and participants were also encouraged to bring forward any other relevant information. The topic list also covered all three stages of care and focused on the subthemes and main themes that emerged from the individual interviews.
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