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Finland study finds migrant mothers receive more emergency cesareans

Refugee and asylum-seeker mothers in Finland undergo emergency cesarean sections at nearly twice the rate of Finnish-born women, a new registry analysis of 97,000 births reveals. The gap suggests barriers to prenatal care or labor support may be driving worse outcomes—a finding with implications for healthcare systems integrating vulnerable populations across Europe.

Originaltitel: Obstetric Care Utilisation among Humanitarian Source Country Migrants in Finland

Abstrakt

Background Health care service utilization remains inadequate among pregnant migrants from humanitarian source countries after resettlement. A cross-sectional registry study compares the utilisation of obstetric care between migrants from humanitarian source countries (HSC) and Finnish-born (FiB) women in Finland. Methods Data were obtained through the medical birth registry (MBR) and the Population Information System. The sample included all births among FiB ( n = 93,600) and HSC-born ( n = 3,155) women in Finland in 2015–2016. The analysis included t-test, x2 test and logistic regression. Key outcome variables were birth mode, analgesia in vaginal birth, episiotomy, perineal tear, manual removal of placenta, uterine curettage, and length of stay (LOS) in the birth hospital. Results Caesarean delivery (CD) prevalence was higher in the HSC group compared with the Finnish-born group in elective (7.2% vs 6.5%), urgent (13.0% vs 8.9%) and emergency (1.8% vs 1.1%) procedures. In the vaginal births, episiotomy was conducted in 20.9% of the HSC and 20.6% of the FiB group ( p = .755). No differences appeared in uterine curettage (0.6% vs 0.7%; p = .801). Manual removal of placenta was required less often among migrants (1.1% vs 1.8%; p = .01), whereas perineal tears were more common in this group (2.1% vs 1.1%, p < .001) compared with the Finnish-born group. Analgesia in vaginal birth was less common in the HSC group in all but one of the controlled pain relief methods. HSC group’s mean LOS in the birth hospital was 3.59 days, and FiB group’s 3.47 days ( p = .004). Conclusion Migrant background is associated significantly with elevated CD risk, lower analgesia usage, and longer perinatal hospitalisation.

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