Page 19 - Non-western women in maternity care in the Netherlands • Exploring ‘inadequate’ use of prenatal care and the experiences of care professionals

because she had three children, her house was not clean and she had told me she didn’t have any money. So it all had to be arranged straight away, and so you lose a whole day. I could also have said I wasn’t going to do it and only arranged maternity care assistance, but social services need to know that this woman has had her third child and that she’s at home. [. . .] Once everything was arranged, I could leave. But it takes a lot of time. Not everybody is as easily accessible as the midwife, especially GPs. You can’t phone them in the afternoon. [. . .] and then you have to arrange it the next day. It also gives a lot of satisfaction, because then you’re thinking, ‘Okay, I’ve been very busy; all the problems have been solved and it’s all fine’. (R13)
Facing difficulties in the provision of care
Various difficulties in the provision of care to non-western clients were reported by midwives. These problems could be organised into two main groups: practical challenges that complicate the provision of care, and different cultural values that cannot always be met or may interfere with the provision of care. These difficulties were more pronounced among non- western clients born outside the Netherlands, compared to those born in the Netherlands.
Facing practical difficulties
Communication problems and suboptimal health literacy. Communicating with clients who do not have a good command of Dutch was described as difficult by midwives. This was especially the case during telephone conversations, when it was not possible to use alternative means of communication such as telephone interpreters. Besides communication problems, midwives are also confronted with health literacy problems. The impact of a limited ability to read, understand and use health information was clear in the utilisation of maternity care by some clients. Notifying the midwife in the event of delayed or missed appointments, attending appointments for laboratory or ultrasound examinations outside the midwifery practice, attending group meetings about childbirth, and applying for postnatal care do not always go smoothly.
Sometimes I find it frustrating when I can’t express myself to other people because of a language barrier. That sometimes makes it
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