Reproductive Health Matters
Volume 15, Issue 30, 2007, Pages 153-162

Misclassified Maternal Deaths among East African Immigrants in Sweden (Article)

Elebro K.* , Rööst M. , Moussa K. , Johnsdotter S. , Essén B.
  • a Department of Clinical Sciences, Division of Obstetrics and Gynaecology, Lund University, Malmö, Sweden
  • b Department of Health Sciences, Lund University, Malmö University Hospital MAS, Malmö, Sweden
  • c Department of Health Sciences, Lund University, Malmö University Hospital MAS, Malmö, Sweden
  • d Health and Society, Malmö University, Malmö, Sweden
  • e Department of Clinical Sciences, Division of Obstetrics and Gynaecology, Lund University, Malmö, Sweden, Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden

Abstract

Western countries have reported an increased risk of maternal mortality among African immigrants. This study aimed to identify cases of maternal mortality among immigrants from the Horn of Africa living in Sweden using snowball sampling, and verify whether they had been classified as maternal deaths in the Cause of Death Registry. Three "locators" contacted immigrants from Somalia, Eritrea, and Ethiopia to identify possible cases of maternal mortality. Suspected deaths were scrutinised through verbal autopsy and medical records. Confirmed instances, linked by country of birth, were compared with Registry statistics. We identified seven possible maternal deaths of which four were confirmed in medical records, yet only one case had been classified as such in the Cause of Death Registry. At least two cases, a significant number, seemed to be misclassified. The challenges of both cultural and medical competence for European midwives and obstetricians caring for non-European immigrant mothers should be given more attention, and the chain of information regarding maternal deaths should be strengthened. We propose a practice similar to the British confidential enquiry into maternal deaths. In Sweden, snowball sampling was valuable for contacting immigrant communities for research on maternal mortality; by strengthening statistical validity, it can contribute to better maternal health policy in a multi-ethnic society. © 2007 Reproductive Health Matters.

Author Keywords

Maternal mortality Migration Sweden research methodology Horn of Africa misclassification of deaths

Index Keywords

maternal care disease classification immigrant health care policy sampling Pregnancy Complications register human risk assessment snowball sampling priority journal Clinical Competence cultural competence Professional Competence patient coding Sweden autopsy Humans Emigrants and Immigrants female risk factor medical record Africa pregnancy Article migration midwife physician maternal mortality maternal welfare cause of death Africa, Eastern
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-35148839473&doi=10.1016%2fS0968-8080%2807%2930322-4&partnerID=40&md5=56e21fad1cf4c75c777129a75eec3f40
DOI: 10.1016/S0968-8080(07)30322-4
ISSN: 09688080
Cited by: 10
Original Language: English