Childbirth and foreign women in Iceland: organization of services, cultural competence and servant leadership

Abstract

Increase in number of immigrants in Iceland calls for a review on structure, management and outcomes of maternity services. Limited research exists in Iceland on immigrants’ issues in relation to health services. Research from abroad show that childbirth experiences of foreign women indicate lack of concern for cultural background linked to equity issues of administration laws. The purpose of the research was to gain insight into immigrants cultural views, customs and perceptions of childbirth experiences of maternity services.The aim was to gather knowledge for development of culturally competent childbirth care for foreign women in Iceland. Cultural competence and servant leadership were used for conceptual background in this qualitative research with interviews with seven foreign women before and after childbirth in Iceland. Three themes were identified related to the women’s needs, perceptions and experience of childbirth services in Iceland: Lack of social support, Care providers’ manner, communication and trust and Information provided and conflicts with the system of care. The themes refer to diverse experiences and communication with care providers. Findings showed satisfaction with care providers’ manner but indicated need for improvement in terms of education and information provided,formal communication services and support around childbirth. Emphasis should be on health literacy and empowering communication with the women. Continuous midwifery care and servant leadership seems to be relevant and provide potentials to ensure culturally competent maternal-child health service. Findings are consistent with prior research and provide knowledge for improving maternity services, based on multidisciplinary perspectives in health and welfare services.