On a global scale, Sweden has consistently demonstrated exceptionally low rates of maternal and infant mortality. It is unfortunate that foreign-born mothers are not eligible for these accomplishments; they are at a higher risk of enduring adverse pregnancy outcomes of any kind.
The COVID-19 pandemic served as a stark reminder of the evident health disparities that existed in relation to the care of these women. Foreign-born mothers reported higher rates of infection, intensive care admission, preterm birth, underweight offspring, and stillbirths in comparison to Swedish-born mothers.
One such example is her given name, Afra. Her unborn infant died shortly after she contracted COVID-19 during the third trimester. She expressed her disappointment with the healthcare system’s complete failing as she was referred for a consultation at the university hospital. She clarified, “I was not informed that the neonate was at risk of contracting COVID.” “My midwifery facility did not respond to my inquiries.” I was not even advised to receive the vaccination.
The obstacles that mothers of foreign descent face within the Swedish healthcare system are illustrate by a number of examples, such as Afra’s. Why does one of the world’s most prominent healthcare systems neglect to safeguard its foreign-born citizens, despite the fact that it is both free and universally accessible to all mothers?
The justification is uncomplicated. The Swedish healthcare system is founded on the fundamental principles of impartiality and the equitable allocation of resources to all individuals. The system fails to recognize that foreign-born mothers require additional resources to achieve the same results as Swedish-born mothers due to their ethnic background and socioeconomic status.
Mothers who were born outside of Sweden account for approximately one-third of all pregnancies in Sweden. This percentage has increased since the 1970s, when only 11% of all births were attributed to non-native mothers. Given this increasing figure, it is essential that we investigate the root causes of these disparities and implement strategies to alleviate them.
For example, the instruments that are currently available to us could be employed to identify and pinpoint the locations of these disparities. The implementation of evidence-based guidelines in the Swedish healthcare system is supported by a number of reputable registries that monitor patient outcomes on a population-wide scale.
The Swedish Medical Birth Register, which has been collecting maternal, neonatal, and medical data for nearly five decades, records the care provided during childbirth. The register captures only a small number of socioeconomically specific details, such as race or ethnicity, despite the fact that it covers 99 percent of all births in Sweden.
Another of the restricted number of variables that have been collected is career status. This essentially renders the most valuable instrument at the discretion of maternal healthcare professionals for determining how health disparities can impact birth outcomes ineffective.
Challenges associated with language
In this context, effective communication is significantly impeded by the limited proficiency of foreign-born mothers in the Swedish language. This is a significant challenge, as numerous professionals in maternal healthcare, such as midwives, express difficulty in comprehending non-Swedish-speaking mothers proficiently.
In high-risk situations, such as an emergency caesarean section, communication barriers of this nature can be life-threatening.
Additionally, the level of impact that these language barriers have on the overall comprehension of foreign-born mothers with respect to the care they are receiving and their perceptions of the quality of care provided is not well understood. In order to understand this discrepancy in knowledge, additional research is necessary.
An intriguing solution is the utilization of so-called “cultural doulas” to enhance the accessibility of healthcare and provide support for foreign-born mothers during their pregnancies, particularly during childbirth.
Due to their cultural and linguistic proficiency, doulas are individuals who lack specialized medical training but can provide emotional, social, and psychological support to women during their pregnancies and childbirths. Research has demonstrated that they improve the overall standard of care and reduce the frequency of caesarean sections. Support personnel frequently facilitate communication between the mother and medical personnel and advocate for the mother’s preferences.
The capacity to effect considerable change is possessed by individuals who assist women during their pregnancies, known as doulas.
It is evident that this concept does not resonate with all individuals. Maternal healthcare and research have never been the top priorities, given the healthcare system’s annual loss of many millions of Swedish kronor and an already encumbered population.
Nevertheless, the implementation of these modifications could significantly enhance the outcomes for foreign-born mothers and their infants in Swedish maternal healthcare. By explicitly confronting this issue, we can guarantee that all mothers, regardless of their background, receive the comprehensive care to which they are entitled.
