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Influence of women’s legal status on pregnancy outcomes and quality of care: Findings from the Pregnancy of Migrants in Switzerland (PROMISES) program

Author

Listed:
  • Eugénie de Weck
  • Clara Noble
  • Jessica Sormani
  • Monique Lamuela Naulin
  • Cyril Jaksic
  • Sara Arsever
  • Begoña Martinez de Tejada
  • Nicole C Schmidt
  • Anya Levy Guyer
  • Anne-Caroline Benski

Abstract

In 2020, approximately 281 million people lived in a country other than their country of birth. In Geneva, Switzerland, people born in other countries constitute 40.2% of the population. We aimed to describe the population of pregnant women delivering at the University Hospitals of Geneva (HUG) maternity department and to identify associations between legal status, migration status, and economic precarity with quality care and health outcomes. We performed an exploratory cross-sectional retrospective study including all women who delivered in HUG’s maternity department in May 2019 (n=339). The group was sub-divided in three ways: by migration status (Swiss (S) or migrant (M)); by legal status (documented (D), undocumented (U), or asylum seeker (AS)); and economic precariousness (precarious (P) or non-precarious (NP)). The analysis compared the quality of care received and health outcomes across six sub-groups: Swiss non-precarious women (SNP, 25.3%), Swiss precarious women (SP, 12.2%), documented migrant non-precarious women (DMNP, 34.8%), documented migrant precarious women (DMP, 23.3%), undocumented migrants (UM, 2.4%), and asylum seekers (AS, 2.0%). Precarious patients represented 35.5% of 339 women. Economic precarity was more highly associated with poor health outcomes than legal or migration status. Due to the small samples of undocumented migrants (UM) and asylum seekers (AS), the study had limited capacity to achieve statistical significance for findings. The findings from this exploratory study suggest that, where a program exists to reach pregnant undocumented migrants, a pregnant woman’s economic status is also very important in determining her experience with the healthcare system during pregnancy and delivery. More than one third of pregnant women delivering at HUG are in a situation of vulnerability, whether economic or legal. This study had few statistically significant results due to small sample sizes. However, it clearly highlights the need for further research into how best to address various vulnerability factors during pregnancy.

Suggested Citation

  • Eugénie de Weck & Clara Noble & Jessica Sormani & Monique Lamuela Naulin & Cyril Jaksic & Sara Arsever & Begoña Martinez de Tejada & Nicole C Schmidt & Anya Levy Guyer & Anne-Caroline Benski, 2025. "Influence of women’s legal status on pregnancy outcomes and quality of care: Findings from the Pregnancy of Migrants in Switzerland (PROMISES) program," PLOS Global Public Health, Public Library of Science, vol. 5(4), pages 1-15, April.
    • Handle: RePEc:plo:pgph00:0004217
    DOI: 10.1371/journal.pgph.0004217
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    References listed on IDEAS

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    1. Paola Bollini & Philippe Wanner & Sandro Pampallona, 2011. "Trends in maternal mortality in Switzerland among Swiss and foreign nationals, 1969–2006," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(5), pages 515-521, October.
    2. Abdulkarim M. Meraya & Nilanjana Dwibedi & Xi Tan & Kim Innes & Sophie Mitra & Usha Sambamoorthi, 2018. "The dynamic relationships between economic status and health measures among working‐age adults in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1160-1174, August.
    3. Tomáš Sobotka, 2008. "Overview Chapter 7: The rising importance of migrants for childbearing in Europe," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 19(9), pages 225-248.
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