Page 20 - Non-western women in maternity care in the Netherlands • Exploring ‘inadequate’ use of prenatal care and the experiences of care professionals

difficult to explain what you mean, and so you sometimes also get the feeling that maybe you are holding things back from them... even if you’re trying really hard with an iPod or Google Translate. (F)
The second generation often speaks Dutch reasonably or very well. But there are still people from the second generation who have trouble with Dutch and then. . . When they can speak a bit of Dutch or a bit of English, it can be dangerous. We think, ‘Okay, we can communicate’ – but then it sometimes turns out that they didn’t understand. (R4)
And it’s sometimes awkward with laboratory examinations, because then we have to explain that they need to go somewhere else at a certain time or for their next appointment, for example. That doesn’t always happen. They may have forgotten, or not understood us, or only handed in one of the two forms given to them so we receive only half the results. But if they have someone with them who does understand, someone who understands the language and goes along with them to take care of things, then it goes very well. (R9)
Lack of knowledge of the maternity care system. The second practical problem midwives reported was limited knowledge of the Dutch maternity care system. Non-western clients, especially those not born in the Netherlands, do not always understand the role of primary care midwives and sometimes are surprised to hear that uncomplicated pregnancies and births are supervised by midwives. The appointments system in midwifery practices is also not always understood. Non-western clients are more often late for appointments, but often assume that they will still be seen by a midwife. When that is not possible and a new appointment needs to be made, they do not always understand. Another area where knowledge is lacking concerns the place of birth. They are not always aware that they can choose to give birth either at home or during a short stay at the hospital under the supervision of the primary care midwife (if they have a low risk of complications) and sometimes expect an obstetrician to lead these short stay hospital births. When the midwife informs non-western clients about postnatal care by maternity care assistants, it sometimes becomes clear
136 Non-western women in maternity care in the Netherlands