Migrant women, especially women from Somalia and Ethiopia, are at a higher risk of losing their child during pregnancy or childbirth compared to Swedish women. Despite the higher risk of complications, these women do not receive the same quality of health care as women born in Sweden. This is due to structural discrimination in the Swedish health care system; lack of communication and cultural differences can create misunderstandings, lack of trust and insecurity. To overcome this, efforts must be made to ensure good health care for everybody regardless of their background or country of origin. The goal of the project is to educate women of migrant background, who have been living in the country for many years, to act as doulas. Doulas are women who provide support to other women before, during and after childbirth.

Pregnant foreign-born women, who do not speak Swedish.

Women benefiting from the project in 2009-12-31: 90

Women benefiting from the project in 2010: 124

A support person is assigned to pregnant women who do not speak Swedish during pregnancy, childbirth and postnatal care. The doula provides information, a sense of security and assists the communication between the woman and nursing staff. There is no charge for the pregnant woman.

·          A hightened sense of security for the mother. The doula helps the mother to relax, thereby increasing the chance of delivery without complications.

·          Better communication between the midwives and the mother. The doula helps by translating and providing cultural knowledge.

·          Better interaction in the delivery room. The doula and the midwife work together, focusing on the laboring mother.

·          Increased ability to create a trans-cultural health care.

·          Less use of analgesics and reduced risk of complications.

·          Increased patient confidence and satisfaction.

·          Better understanding of the patient’s needs.

·          Increased quality in the health care system

·          Better conditions for integration due to an increased number of women attending parent education and language learning courses.

Evaluation performed by med Dr. Sharareh Akhavan of the University of Skövde in November 2009. Ten foreign born mothers (all supported by doulas) were selected for interviews together with ten midwives.

Based on the evaluation it was found that the project did have a great impact on the sense of security for the mothers-to-be and has contributed to an improvement of health care quality. The project has the potential to offer the kind of support needed by foreign-born women before, during and after delivery. It is safe to say that the project indeed contributes to a more equal and qualitative health care system. The evaluation of this project is the first study in Sweden on doula-support for immigrant women.

In the spring of 2009, the project received approval for funding from the European Integration Fund to further develop their ideas. Just over six months later, the politicians of North East Gothenburg decided to finance the activities for 2010 (EUR 70 000). Funding is committed for 2011.