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Obstetric interventions among native and migrant women: a survey of episiotomy in Portugal

dc.contributor.authorLorthe, Elsa
dc.contributor.authorTeixeira, Cristina
dc.contributor.authorRodrigues, Teresa
dc.contributor.authorBarros, Henrique
dc.date.accessioned2020-02-27T16:34:39Z
dc.date.available2020-02-27T16:34:39Z
dc.date.issued2019
dc.description.abstractIt is unclear whether migrant women experience worse pregnancy outcomes than native women. A better comprehension of obstetric care provision, including controversial interventions such as episiotomy, is important to improve equity of service provision, overall maternal and neonatal health and to support evidence-informed perinatal health policy-making. We aimed to determine if migrant and native women giving birth vaginally have different risks of episiotomy and if the risk differs by migrant sub-groups. Methods: This study is based on a cross-sectional survey of foreign-born women with a random sample of native women, implemented in 32 public maternity units in mainland Portugal. We included 3583 women with vaginal delivery. Migrant status was defined by the woman’s country of birth (migrants, born abroad, vs natives, born in Portugal), then as subgroups of migrants from Brasil, Portuguese-speaking African countries (PSAC) and non Portuguese-speaking countries vs natives. The association between migrant status and episiotomy was assessed using multilevel logistic regression models, stratified by delivery mode, and adjusted for main risk factors of episiotomy. Results: The overall frequencies of episiotomy were 52.6% and 48.2% among the 1707 natives and the 1876 migrants, respectively (p = 0.01). With spontaneous delivery, migrant women had decreased odds of having an episiotomy (adjusted OR 0.70 [95% CI 0.58-0.83]), especially those from PSAC (aOR 0.57 [0.46-0.71]). However, with instrumental delivery, migrant women had increased odds of episiotomy (aOR 2.47 [95% CI 1.50-4.07]), especially those from Brasil (aOR 3.24 [1.18-8.92]) and non Portuguese-speaking countries (aOR 3.75 [1.827.71]). Conclusions: These results suggest non-medically justified differential care during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use, in a country with a high frequency of medical intervention during delivery. Key messages: Portugal displays a high frequency of medical interventions during delivery, including episiotomy, highlighting the need for developing evidence-based recommendations. Migrant and native women have different risks of episiotomy, suggesting non-medically justified differential carept_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLorthe, Elsa; Teixeira, Cristina; Rodrigues, Teresa; Barros, Henrique (2019). Obstetric interventions among native and migrant women: a survey of episiotomy in Portugal. In 12th European Public Health Conference 2019. Marseille, France . p. 229-229. ISSN 1101-1262pt_PT
dc.identifier.issn1101-1262
dc.identifier.urihttp://hdl.handle.net/10198/20745
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relationPTDC/DTP-SAP/6384/2014 Migrants and Perinatal Health: Barriers, Incentives and Outcomespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectWomen healthpt_PT
dc.subjectMigrant womenpt_PT
dc.subjectObstetric interventionpt_PT
dc.subjectEpisiotomypt_PT
dc.titleObstetric interventions among native and migrant women: a survey of episiotomy in Portugalpt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.conferencePlaceMarseille, Francept_PT
oaire.citation.endPage229pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage229pt_PT
oaire.citation.titleEuropean Journal of Public Healthpt_PT
oaire.citation.volume29pt_PT
person.familyNameTeixeira
person.givenNameCristina
person.identifier.ciencia-id6E12-F2A0-568F
person.identifier.orcid0000-0001-5194-5141
person.identifier.ridO-2296-2013
person.identifier.scopus-author-id55207402700
rcaap.rightsopenAccesspt_PT
rcaap.typeconferenceObjectpt_PT
relation.isAuthorOfPublication9037c83c-43c1-4714-ad3e-9f307dd1d89f
relation.isAuthorOfPublication.latestForDiscovery9037c83c-43c1-4714-ad3e-9f307dd1d89f

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