Care of the migrant obstetric population

Care of pregnant migrants is a considerable challenge for all health care workers and health systems. Maternal mortality and serious morbidity are both greatly increased among migrants in western countries, particularly in Africans and asylum seekers. While in many instances, migrants are healthier than native populations and have better perinatal outcomes, this is inconsistent and poorer outcomes are described in many groups. The causes of suboptimal outcomes are numerous and are strongly influenced by the health-seeking behaviour of the parturients. Accordingly, improvement in outcome requires a multifaceted approach with a focus on early access to antenatal services and enhanced medical screening and surveillance for detection and optimisation of comorbid conditions. Provision and/or acceptance of analgesia in labour have not been well researched but existing data are sufficient to suggest that some migrant groups do not receive equivalent pain relief during labour. Provision of information and translation services are important components in improvement of standards of care.