Introduction Some migrant groups in Europe experience excess maternal morbidity and different processes may influence outcomes for specific groups. Polish women form the largest migrant group in Scotland with little data comparing their maternity experience with Scottish-born women. Qualitative findings suggest if women negotiated deliveries based on Polish not Scottish norms, they would have higher caesarean section and lower forceps deliveries rates than Scots. To assess this we compared data on access to care and maternity outcomes to identify any patterns associated with Polish migrants.
Methods NHS Scotland records detail about maternity care and maternal country of birth is required at birth registration. We matched these two datasets identifying mothers born in Poland and Scotland. Mode of delivery, use of analgesia, gestation, birth weight and proportion of live births were extracted for singleton deliveries and data adjusted for age, body mass index and smoking.
Results Polish migrants were younger, lighter, smoked less and booked maternity care later (11.2% after 20 weeks vs 5.3%). Caesarean section was less likely and forceps/ventouse more likely. Pregnancy outcomes tended to be better in Polish migrants with fewer low birth weight babies or neonatal admissions.
Conclusion Reduced Caesarian section rate and favourable birth and maternal outcomes in the Polish population, may be due to the ‘healthy migrant’ effect (as we were unable to adjust for education/socioeconomic status) and residual confounding. Reasons for excess instrumental deliveries remain unclear. Later maternity booking reflects patterns in other migrant groups, and reinforces the importance of improving health system understanding.
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