Systematic Review of Immigrant Women's Experiences With Perinatal Care in North America

Objective: To understand the perinatal care experiences of pregnant immigrant women in North America. Data Sources: We searched five electronic databases: MEDLINE, PsycINFO, SocINDEX, CINAHL, and Social Work Abstracts. Two categories of search terms, pregnancy and immigrant, were used to conduct a title/abstract and subject heading search. We manually searched the reference lists of all relevant articles to identify additional articles. Study Selection: Inclusion criteria were qualitative or mixed methods study design, focus on immigrant women's experiences of accessing perinatal care, and data collection in North America. Two reviewers were involved in a three-stage selection process: title/abstract screen, full text review, and data extraction and quality appraisal. Data Extraction: Data on authors, date, location, methodology, sample characteristics, data collection, and themes or topics were extracted from 19 articles. Data Synthesis: We followed the Thomas and Harden (2008) thematic synthesis methodology, which involved a three-stage data analysis approach: free line-by-line coding, organization of free codes into descriptive themes, and construction of analytical themes. We developed three meta-themes from the 19 articles included in our review: Expectations of Pregnancy as Derived From Home, Reality of Pregnancy in the Host Health Care System, and Support. Conclusion: Immigration is a relevant issue in North America, and pregnancy can be an entry point into the health care system for immigrant women. We provide relevant information for health care providers, policy makers, program planners, and researchers about opportunities to explain models of health care delivery, improve communication, and facilitate social support to improve the experiences of immigrant women who interact with the health care system during pregnancy.