The Impact of Immigration Status on the Experience of Obstetric Care in Quebec

To compare the experience of obstetric care in Quebec between immigrants and Canada-born persons.A cross-sectional survey was conducted among individuals who received obstetric care in Quebec between 2016 and 2023. Participants, recruited mainly via social media, completed an online questionnaire between July and December 2023. Obstetric care experiences, including autonomy measured by the MADM scale (Mothers Autonomy in Decision Making), mistreatment assessed by the MIST index (Pregnant Persons Experience of Mistreatment by Providers Index), discrimination, access to care, and satisfaction towards interpersonal skills of healthcare providers, were compared between immigrant and Canada-born participants. Among 686 participants, 11.2% were immigrants, among which 69.0% had permanent status and 14.3% temporary status. There was no significant difference in MADM scale between immigrant and Canada-born participants (p = 0.903), but immigrants with temporary status were 9.25 times more likely to have low autonomy (CI: 1.06-80.77) compared to those born in Canada controlling for confounding variables. According to the MIST index, at least one of disrespectful behaviors was reported by 28.6% of immigrants and 35.8% Canada-born individuals (p = 0.172). Among immigrant participants, 2.6% reported being treated less favorably due to their ethnic, cultural, or linguistic background, compared to 1.5% of Canada-born participants (p = 0.09). Additionally, 9.1% of immigrants had to paid for obstetric care personally versus 4.4% of Canada-born (p = 0.173). Our study highlights immigration status as a key differentiating factor in obstetric care, with lower autonomy among temporary immigrants, while no significant differences were found between permanent immigrants and Canadian-born participants.