The experiential knowledge of migrant women about vulnerability during pregnancy : a woman-centred mixed-methods study

Problem Within maternity care policies and practice, pregnant migrant women are regarded as a vulnerable population. Background Women’s experiential knowledge is a key element of woman-centred care but is insufficiently addressed in midwifery practice and research that involves migrant women. Aim To examine if pregnant migrant women’s experiential knowledge of vulnerability corresponds with sets of criteria of vulnerability, and to explore how migrant women make sense of vulnerability during pregnancy. Methods A sequential two-phased mixed-methods study, conducted in the Netherlands, integrating survey data of 89 pregnant migrant women and focus group data obtained from 25 migrant mothers - living in deprived areas according to the Dutch socio-economic index. Results Criteria associated with vulnerability were reported by 65.2% of the participants and 62.9% of the participants reported adverse childhood experiences. On a Visual Analogue Scale, ranging from 0 (not vulnerable) to 10 (very vulnerable), participants self-reported sense of vulnerability withshowed a mean score of 4.2 (±2.56). Women’s experiential knowledge of vulnerability significantly correlated with the mean sum score of clinical criteria of vulnerability (r .46;, p .002) and with the mean sum score of adverse childhood experiences (r .48, p < .001). Five themes emerged from the focus group discussions: “Look beyond who you think I am and see and treat me for who I really am”, “Ownership of truth and knowledge”, “Don’t punish me for being honest”, “Projection of fear” and “Coping with labelling”. Conclusion Pregnant migrant women’s experiential knowledge of vulnerability is congruent with the criteria. Calling upon experiential knowledge is an attribute of the humane woman-midwife relationship.