Expert perspectives on access to maternity care for migrant women in Austria: a qualitative study

Abstract

Abstract Background Challenges in maternal health outcomes among migrant women are well documented across Europe. These inequalities are less attributable to biological factors than to social determinants and structural barriers. This study examined expert perspectives on how migrant women experience pregnancy care and health information services, focusing on barriers, facilitators and structural gaps in maternal healthcare access relevant beyond the Austrian context. Methods This qualitative study was based on 14 semi-structured interviews including midwives, gynaecologists, social workers and psychologists. Participants were purposively selected to capture perspectives of professionals working directly with pregnant migrant women in daily practice. Data were analyzed using Braun and Clarke’s thematic analysis framework. Results Experts widely recognized “sense of security” as central to positive pregnancy experiences, encompassing emotional, social and structural dimensions. Key barriers were primarily structural rather than medical, including limited system transparency, lack of institutionalized interpreter services, fragmented referral pathways between medical and psychosocial care and regional disparities. Language barriers and limited culturally sensitive communication compromised informed consent, health literacy and timely use of preventative services. Although Austria has various pilot projects, services often operate in parallel rather than in an integrated manner. Conclusions In experts’ perceptions maternal health inequalities among migrant women are driven primarily by structural access barriers and insufficiently integrated, culturally responsive care. Sustainable solutions require nationally embedded programmes, strengthened interpreter services, enhanced cultural competence among professionals and improved coordination between healthcare and psychosocial services. Addressing these determinants is essential to advance equitable maternal health across Europe. Key messages • Structural barriers shape migrant women’s access to maternity care and drive maternal inequalities. • Integrated, culturally responsive maternity care systems with reliable interpreter services are essential to ensure equitable access and outcomes for migrant women.