Etniciteit en zorg rondom zwangerschap en ... - Rijksoverheid.nl

Abstract
Ethnic origin and care during pregnancy and birth: an exploration of Dutch research
In general pregnancy outcomes in non-western women and children in the Netherlands are less
favourable as compared to the women and children of Dutch descent. Children belonging to an ethnic
minority have on average a lower birth weight. Premature birth and birth defects occur more frequently.
Mortality around birth is less favorable in women and children of non-western ethnic groups.
These conclusions can be drawn from different studies into health differences, and the underlying
causes, in the Netherlands between pregnant women and children of Dutch and those of non-western
ethnic groups. In this report an overview is presented of recently finished and currently ongoing studies
that focus on differences in pregnancy outcomes, in risk factors, in health care use and in use of
preventive measures.
The mortality differences can partly be explained by differences in known risk factors. Women from
non-western ethnic origin are less familiar with preventive measures such as the periconceptional use
of folic acid, have a late start in antenatal care and use maternity care less frequently. In this way they
miss opportunities to be adequately informed about preventive measures they might take to promote a
better health for their unborn children and themselves.
The researches described in this overview offer starting points for improvement of pregnancy outcomes
especially of women and children of non-western origin. Sometimes further research is needed to
identify the causal pathways for the observed differences and to indicate which culture-specific
guidance or other preventive measures are needed.
Reduction of perinatal health inequalities between Dutch pregnant women requires an integrated public
health policy. The fact is, part of these differences in perinatal health outcomes are due to underlying
mechanisms that lay beyond the scope of health care, such as a lack of fluency in the Dutch language or
socio-economic inequalities.
Key words:
Perinatal mortality; maternal mortality; cot death; ethnicity; risk factor; health care utilization; health
inequalities.
RIVM Rapport 270032004 5