Internationals and professionals discuss perinatal care

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November 1st about 20 internationals and professionals met do discuss the needs and expectations of internationals with regards to perinatal care. This includes all healthcare services that are concerned with conception, pregnancy, giving birth and care for mother and child. Professionals present included the GP of SGE International, a gynaecologist of the Maxima Medisch centre, midwifes of Kinderrijk and professional of Zuidzorg, involved in maternity care and the services of the ‘consultatiebureau’.

A team of these organisations is now working to define how perinatal care can better meet the needs and expectations of internationals as voiced below. The results will potentially benefit not only healthcare providers and internationals in Eindhoven, but all over the Netherlands.

Experiences shared by internationals:

  • Many heard stories about not being able to get pain relief or having to deliver at home, before they got in touch with the system.
  • The role of the midwife is not known. In some countries everyone can be a midwife. It is unknown that a midwife is a trained professional.
  • In many countries only a gynaecologist oversees pregnancy and delivery, and is available virtually 24/7 for questions or support.
  • In the Netherlands the gynaecologist only is involved if there are complications.
  • In NL pregnancy and delivery is seen as a natural process, in other countries often as a medical process.
  • Going home directly after delivery actually is nice and Kraamzorg is generally a positive experience.
  • There is little focus on the psychological effects of giving birth, far away from your home country and family.
  • Process at the consultatiebureau is unclear. Nurse and doctor could not explain wat the ‘hieleprik’ is testing for. Information beforehand, or better a visit of the nurse could help.
  • Various experiences with lack of communications between professionals, duplicate tests and having to repeat giving information. Sometimes the international is the one that has to make sure that no information is overlooked.
  • There seem to be different protocols that midwifes/gynaecologists use, but no information why a certain protocol is followed or involvement of the international is making a shared decision about it.
  • Some worry that they may be too late to go to hospital for a delivery, whereas in their home country they are admitted well before the expected delivery time.
  • Different cultures have different ways of treating mother and child. e.g. 40 days of special care for Chinese mothers after delivery. Professionals need to take this into account.
  • Support groups, like breast feeding groups, do exist but are mostly Dutch only.
  • The GP takes over again after birth, after a few month the child will develop common diseases. Visit by GP is well appreciated, even though it is not medically required.
  • Some tell about having to pay for tests that the doctor does not deem necessary, but the international is asking for anyway, like a pap smear or blood test.
  • It is felt that cost plays a role in the decision not to do a test or intervention.
  • One international said that she used to bring antibiotics from China, but she stopped doing this, now that she has gotten used to the Dutch system.

Conclusions as voiced during the meeting

  • More information is required about the system, role and experience of midwifes, the consultatiebureau etc.
  • Better communication is needed between parties in the chain
  • There should be more focus on shared decision making.
  • The GP is in many cases best positioned to provide information and guidance
  • A website and brochures are important but don’t forget the human factor. There is a need for someone as a fall back.
  • Support groups for internationals during pregnancy and after delivery