Transnational prenatal care among migrant women from low-and-middle-income countries who gave birth in Montreal, Canada

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Objectives
There is little research examining transnational prenatal care (TPC) (i.e., prenatal care in more than one country) among migrant women. Using data from the Migrant-Friendly Maternity Care (MFMC) - Montreal project, we aimed to: (1) Estimate the prevalence of TPC, including TPC-arrived during pregnancy and TPC-arrived pre-pregnancy, among recently-arrived migrant women from low- and middle-income countries (LMICs) who gave birth in Montreal, Canada; (2) Describe and compare the socio-demographic, migration and health profiles and perceptions of care during pregnancy in Canada between these two groups and migrant women who received no TPC (i.e., only received prenatal care in Canada); and (3) Identify predictors of TPC-arrived pre-pregnancy vs. No-TPC.

Methods
The MFMC study used a cross-sectional design. Data were gathered from recently-arrived (< 8 years) migrant women from LMICs via medical record review and interview-administration of the MFMC questionnaire postpartum during the period of March 2014-January 2015 in three hospitals, and February-June 2015 in one hospital. We conducted a secondary analysis (n = 2595 women); descriptive analyses (objectives 1 & 2) and multivariable logistic regression (objective 3).

Results
Ten percent of women received TPC; 6% arrived during pregnancy and 4% were in Canada pre-pregnancy. The women who received TPC and arrived during pregnancy were disadvantaged compared to women in the other two groups (TPC-arrived pre-pregnancy and No-TPC women), in terms of income level, migration status, French and English language abilities, access barriers to care and healthcare coverage. However, they also had a higher proportion of economic migrants and they were generally healthier compared to No-TPC women. Predictors of TPC-arrived pre-pregnancy included: ‘Not living with the father of the baby’ (AOR = 4.8, 95%CI 2.4, 9.8), ‘having negative perceptions of pregnancy care in Canada (general experiences)’ (AOR = 1.2, 95%CI 1.1, 1.3) and younger maternal age (AOR = 1.1, 95%CI 1.0, 1.1).

Conclusion
Women with more capacity may self-select to migrate during pregnancy which results in TPC; these women, however, are disadvantaged upon arrival, and may need additional care. Already-migrated women may use TPC due to a need for family and social support and/or because they prefer the healthcare in their home country.
OriginalsprogEngelsk
Artikelnummer292
TidsskriftBMC Pregnancy and Childbirth
Vol/bind23
Udgave nummer1
Antal sider18
ISSN1471-2393
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The current work was funded by The Fonds de recherche du Québec – Société et culture (FRQSC), Research Support for New Academics 2018–2019 competition (Application 2019-NP-252729). The “Migrant-Friendly Maternity Care (MFMC)- Montreal project” was funded by the Canadian Institutes of Health Research (CIHR) (2013–2016). LM was supported by a research scholar junior 1 award from The Fonds de recherche du Québec- Santé (FRQS), support for early career researchers (2019–2023).

Publisher Copyright:
© 2023, The Author(s).

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