Objective To evaluate differences in obstetric care between immigrant and native women in a country with free access to health care. Methods A cross-sectional study was carried out of immigrant mothers delivering in one of the four public hospitals in the Porto, Portugal, metropolitan area between February and December 2012. The comparison group included native Portuguese mothers who delivered in the same institutions. The participants (89 immigrant mothers and 188 Portuguese mothers) were recruited by telephone and completed a written questionnaire during a home visit. Results Immigrant women were more likely to have their first pregnancy appointment after 12 weeks of pregnancy (27.0% vs 14.4%, P = 0.011) and to have fewer than three prenatal visits (2.2% vs 0.0%, P < 0.001). They were also more likely to have had a cesarean delivery (48.3% vs 31.4%, P = 0.023), perineal laceration (48.8% vs 11.6%, P < 0.001), or postpartum hemorrhage (33.5% vs 12.3%, P < 0.001). Conclusion Migrants were more prone to late prenatal care and to intrapartum complications. Unsatisfactory interactions with healthcare staff may play an important role in these findings. © 2014 International Federation of Gynecology and Obstetrics.

maternal health services Portugal immigrants Prenatal care Pregnancy complications Patient satisfaction

urban population immigrant multicenter study prenatal care Portugal health care personnel human epidemiology statistics and numerical data prenatal period controlled study priority journal professional practice Databases, Factual factual database Cross-Sectional Studies Young Adult cross-sectional study migrant Humans Emigrants and Immigrants female clinical evaluation Socioeconomic Factors perineum injury socioeconomics perineal laceration telephone interview questionnaire pregnancy postpartum hemorrhage public hospital standards Article pregnancy outcome major clinical study mother adult health care quality health care access Quality Assurance, Health Care vaginal delivery Perinatal Care Brazil pregnant woman obstetric procedure laceration gestational age cesarean section Health Services Accessibility health care delivery