Public Health
Volume 128, Issue 3, 2014, Pages 262-267

Ethnic variation in maternity care: A comparison of Polish and Scottish women delivering in Scotland 2004-2009 (Article)

Gorman D.R.* , Katikireddi S.V. , Morris C. , Chalmers J.W.T. , Sim J. , Szamotulska K. , Mierzejewska E. , Hughes R.G.
  • a Department of Public Health, NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh EH1 3EG, United Kingdom
  • b Department of Public Health, NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh EH1 3EG, United Kingdom, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ, United Kingdom
  • c Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, United Kingdom
  • d Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, United Kingdom
  • e Department of Public Health, NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh EH1 3EG, United Kingdom
  • f Department of Epidemiology, National Research Institute of Mother and Child, Kasprzaka, 17 a 01-211 Warsaw, Poland
  • g Department of Epidemiology, National Research Institute of Mother and Child, Kasprzaka, 17 a 01-211 Warsaw, Poland
  • h Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom

Abstract

Objectives: Birth outcomes in migrants vary, but the relative explanatory influence of obstetric practice in origin and destination countries has been under-investigated. To explore this, birth outcomes of Scots and Polish migrants to Scotland were compared with Polish obstetric data. Poles are the largest group of migrants to Scotland, and Poland has significantly more medicalized maternity care than Scotland. Study design: A population-based epidemiological study of linked maternal country of birth, maternity and birth outcomes. Methods: Scottish maternity and neonatal records linked to birth registrations were analysed for differences in modes of delivery and pregnancy outcomes between Polish migrants and Scots, and compared with Polish Health Fund and survey data. Results: 119,698 Scottish and 3105 Polish births to primiparous women in Scotland 2004-9 were analysed. Poles were less likely than Scots to have a Caesarean section and more likely to have a spontaneous vaginal or instrumental delivery. The Caesarean section rate in Poland is significantly higher and instrumental delivery rate lower than for either group of women in Scotland. Conclusions: Methodologically, comparing a large group of migrants from one country with the host population has advantages over grouping migrants from several countries into a single category, and allows more informed analysis of the effect of health services.Polish mothers' being slightly healthier explains some of their lower Caesarean section rate compared to Scots in Scotland. However, dominant models of obstetrics in the two countries seem likely to influence the differences between Poles delivering in Poland and Scotland. Further investigation of both is required. © 2013 The Royal Society for Public Health.

Author Keywords

Migration Maternity care Ethnicity

Index Keywords

maternal care instrumental delivery primipara maternal health human epidemiology Poland ethnic group comparative study epidemiological data Humans ethnic difference health services research Infant, Newborn female pregnancy population research health services Article pregnancy outcome adult migration public health Scotland United Kingdom polish Scottish Maternity care vaginal delivery ethnicity Transients and Migrants Delivery, Obstetric Healthcare Disparities cesarean section obstetrics registration health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84896494435&doi=10.1016%2fj.puhe.2013.11.008&partnerID=40&md5=23fb3c827b9b27843f2d117cf78e0cbe
DOI: 10.1016/j.puhe.2013.11.008
ISSN: 00333506
Cited by: 4
Original Language: English