Perinatal mental health care: a multicountry comparison of migrant and non-migrant populations
A Meireles, R Costa, J Oliveira, TM Pinto, S Marques, LG Cora, M Verdecchia, M Camanni, I Mariani, M LazzeriniAbstract
Background
Perinatal mental health (PMH) problems affect approximately one in five women and are associated with adverse maternal and child outcomes. Although guidelines recommend universal screening, inequities persist, particularly among migrant populations. Evidence remains limited, constraining the development of effective policy responses. This study, using data from the IMAgiNE Research Network, aimed to analyse: the association between migrant status and the provision of PMH care (i.e., screening and support) in women, and the association between migration status and emotional difficulties during the perinatal period and childbirth experience.
Methods
We analysed cross-sectional data from the IMAgiNE study across eight European countries. Outcomes included emotional difficulties, screening coverage, perceived adequacy of support among those in need, and childbirth experience. Country-specific odds ratios were estimated, and pooled estimates were calculated.
Results
Sample size varied by outcome (17,723 for support adequacy; 41,224 for others). Migrant women had higher odds of reporting emotional difficulties (pooled OR = 1.12, p = 0.023), with the highest odds in Norway (OR = 1.38, p = 0.004). Among those in need, they had lower odds of receiving adequate support (pooled OR = 0.82, p = 0.013). They also had higher odds of reporting a negative childbirth experience (pooled OR = 1.18, p < 0.001), with the strongest association in Italy (OR = 1.23, p = 0.003). No association was observed for screening. Results varied across countries.
Conclusions
Migrant women show a higher burden of emotional difficulties but a lower likelihood of receiving adequate support, with no corresponding increase in screening. This mismatch suggests a failure in translating detection into effective care, highlighting systemic gaps in the responsiveness of PMH services, particularly for migrant populations, and the need for culturally competent care.