| dc.description.abstract | Every woman who resides in Norway is entitled to free and comprehensive antenatal, labor, and postpartum care through the Norwegian maternity service, irrespective of migration status. Located at the center of the service are midwives, maternal health practitioners that provide the majority of routine perinatal care. Past studies have determined that migrant women suffer disproportionately worse maternal and neonatal health outcomes compared to Norwegian women. This study aimed to determine how midwives working in greater Oslo, Norway, construct and act upon the vulnerability of migrant women, before and during the first year of the COVID-19 pandemic. To elucidate this, a qualitative study was performed, using a combination of semi-structured interviews and textual analysis of previously-collected interviews from 2019. Midwives working in the greater Oslo area, with experience working with women with a migration background were recruited to participate. This study is in partnership with the MiPreg project, which aims to map the current status of the Norwegian maternity care system in its care for women with a migration background. Face-to-face interviews with recruited participants were conducted in several locations around Oslo, Norway. The interviews analyzed using textual analysis were collected from interviews conducted December 2019 to February 2020, and the in-person interviews were performed from August to December 2021. A total of 13 midwives were interviewed, and they shared several challenges in providing migrant-centered care, including accessing translation services, communicating across cultural and linguistic boundaries, providing supplemental patient education, and explaining the Norwegian health and social services structures. In addition, the midwives reported general workplace dissatisfaction, related to low staffing levels, increased workload, lack of care continuity, and increased medicalization of pregnancy and birth, which were reported to add additional strain on providing migrant-centered care. During the COVID-19 pandemic, the midwives reported suspensions of certain maternity service offerings, increased workloads, increased social isolation and decreased social support for migrant women. Additionally, higher proportions of COVID-19 vaccine hesitancy amongst pregnant migrant women were reported. This study’s findings suggest that midwives working in the Norwegian maternity service need more support, resources, and training in order to provide higher quality migrant-centered care. The COVID-19 and infection control guidelines drastically increased midwives’ workload and decreased staffing levels and available maternity service offerings, which made providing migrant-centered care more challenging. The implications of midwife burnout and lack of training in migrant-centered care have implications in quality of care provision, maternal and neonatal health outcomes in migrant populations, and migrant patients’ satisfaction in care. | eng |