Ethnic variation in maternity care: a comparison of Polish and Scottish women delivering in Scotland 2004-2009

Gorman, D.R., Katikireddi, S., Morris, C., Chalmers, J.W.T., Sim, J., Szamotulska, K., Mierzejewska, E. and Hughes, R.G. (2014) Ethnic variation in maternity care: a comparison of Polish and Scottish women delivering in Scotland 2004-2009. Public Health, 128(3), pp. 262-267. (doi: 10.1016/j.puhe.2013.11.008)

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Publisher's URL: http://dx.doi.org/10.1016/j.puhe.2013.11.008

Abstract

<b>Objectives</b><p></p> Birth outcomes in migrants vary, but the relative explanatory influence of obstetric practice in origin and destination countries has been under-investigated. To explore this, birth outcomes of Scots and Polish migrants to Scotland were compared with Polish obstetric data. Poles are the largest group of migrants to Scotland, and Poland has significantly more medicalized maternity care than Scotland.<p></p> <b>Study design</b><p></p> A population-based epidemiological study of linked maternal country of birth, maternity and birth outcomes.<p></p> <b>Methods</b><p></p> Scottish maternity and neonatal records linked to birth registrations were analysed for differences in modes of delivery and pregnancy outcomes between Polish migrants and Scots, and compared with Polish Health Fund and survey data.<p></p> <b>Results</b><p></p> 119,698 Scottish and 3105 Polish births to primiparous women in Scotland 2004–9 were analysed. Poles were less likely than Scots to have a Caesarean section and more likely to have a spontaneous vaginal or instrumental delivery. The Caesarean section rate in Poland is significantly higher and instrumental delivery rate lower than for either group of women in Scotland.<p></p> <b>Conclusions</b><p></p> Methodologically, comparing a large group of migrants from one country with the host population has advantages over grouping migrants from several countries into a single category, and allows more informed analysis of the effect of health services.<p></p> Polish mothers' being slightly healthier explains some of their lower Caesarean section rate compared to Scots in Scotland. However, dominant models of obstetrics in the two countries seem likely to influence the differences between Poles delivering in Poland and Scotland. Further investigation of both is required.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal
Authors: Gorman, D.R., Katikireddi, S., Morris, C., Chalmers, J.W.T., Sim, J., Szamotulska, K., Mierzejewska, E., and Hughes, R.G.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Public Health
Publisher:W.B. Saunders
ISSN:0033-3506
ISSN (Online):1476-5616
Published Online:07 March 2014
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