Abstract
Background. Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care.
Objective. To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women.
Methods. A retrospective descriptive study of patient records of refugees, other migrants and native Dutch women was carried out in five general practices in the Netherlands. The prevalence of discussions about contraception and prescriptions of contraceptives over the past 6 years was compared in women of reproductive age (15–49 years).
Results. In total, 104 refugees, 58 other migrants and 162 native Dutch women were included. GPs in our study (2 male, 3 female) discussed contraceptives significantly less often with refugees (51%) and other migrants (66%) than with native Dutch women (84%; P < 0.001 and P = 0.004, respectively). Contraceptives were less often prescribed to refugees (34%) and other migrants (55%) than to native Dutch women (79%; P < 0.001 and P = 0.001). Among refugees from Sub- Saharan Africa, contraception was significantly less often discussed (28.9%) compared with refugees from other regions (67.8%; P < 0.001). More refugees and other migrants had experienced unwanted pregnancies (14% respectively 9%) and induced abortions (12% respectively 7%) than native Dutch women (4% respectively 4%).
Conclusion. Contraceptives were significantly less often discussed with and prescribed to refugees and other migrant women compared with native Dutch women. More research is needed to elicit the reproductive health needs and preferences of migrant women regarding GP’s care and experiences in discussing these issues. Such insights are vital in order to provide equitable reproductive healthcare to every woman regardless of her background. Key words: Contraception, contraceptive needs, general practitioner’s care, immigrant, migrant, primary care, refugee, sexual and reproductive health. Introduction the Netherlands with at least one parent who is also born outside the Netherlands. Refugees are a specific type of migrants who came Today a growing number of refugees are settling in high-income countries such as the Netherlands, and migrants constitute an essential part involuntarily to the Netherlands because of conflict or fear for perof the European population (1). Migrants are all persons born outside secution in the country of origin. They are protected by international 468 For permissions, please e-mail: journals.permissions@oup.com. Inequity in contraceptive care 469 law and s