Undocumented pregnant women are more often severely ill when seeking help at the ED

A new UiO study published in the Scandinavian Journal of Primary Health Care shows that pregnant, undocumented women are more often severely ill and must be admitted to the hospital, when they seek help at the emergency room in Oslo.

"In the study, we found that 1 out of 5 pregnant, undocumented women who came to the emergency room were seriously ill or needed immediate help. This was over twice as many as among the Norwegian pregnant women who sought help here, where the same applied to 1 out of 10," Frode Eick says.

He is a Ph.D. research fellow at the Department of Community Medicine and Global Health at the University of Oslo (UiO), and first author of the study.

"One out of three undocumented, pregnant women had to be admitted to the hospital after they visited the emergency room. Among Norwegian pregnant women, the same applied to 1 out of 5," he says.

In the study, Eick looked at undocumented women's use of the emergency room in Oslo, from 2009 to 2019. During this period, the highest number of undocumented women sought help in 2012.

"Among the undocumented women who sought help at the emergency room, around 15% came in with a pregnancy-related issue. In comparison, less than 2% of the Norwegian women who visited the emergency room came in with an issue related to pregnancy," Eick says. "The most common reasons for seeking help among the pregnant, undocumented women were bleeding during pregnancy or morning sickness."

The undocumented women who visited the general emergency room in Oslo came from 73 different countries, and most from Somalia, Nigeria, and Iraq.

Pregnant, undocumented women have the right to maternal health care in Norway

Pregnant, undocumented women in Norway have, since 2011, had the right to receive maternal health care in the municipalities they live in, and have the right to give birth in a hospital. However, they are not included in the general practitioner and reimbursement schemes in Norway.

Through UN's sustainability goals, Norway has committed to offer universal health care to everyone, to reduce illnesses and mortality among mothers and newborns.

"The study shows that there is a need for better access to primary health care services for pregnant, undocumented women in Norway. It is important that undocumented women staying in Norway know where they can seek help, that it is safe, and that the help they receive do not become a financial burden afterwards," Eick says.

Pregnant women seeking asylum in Norway and women who were homeless were, like the undocumented women, more often severely ill when they sought help at the emergency room in Oslo, compared to the Norwegian women.

"In these groups, one out of five were also severely ill when they came to the emergency room and around one out of three had to be admitted to the hospital, but there are some methodological uncertainties around these numbers," Eick says.

The study is part of the Ph.D. project Maternal Health Care for Undocumented Migrant Women in Norway at the Department of Community Medicine and Global Health at UiO.

"In this research project, I look at the use of health services and pregnancy outcomes among pregnant, undocumented women in Norway," Eick says.