Inequity in contraceptive care between migrants and native women? A retrospective study in Dutch general practice L. Raben, M. van den Muijsenbergh Liselotte Raben, MD PhD candidate Radboud University Medical Centre Department of Primary and Community care Nijmegen, The Netherlands

Background Female refugees at high risk of sexual and reproductive health problems: Sexual violence (69% versus 31% of European population) High abortion rate (1,5 times higher) High teenage birth rate (>8 times higher) Unmet contraceptive needs Little is known about contraceptive care in female refugees and other migrant in primary care setting In the Netherlands, the general practitioner plays vital role in prescription of contraceptives, and in providing information

Aim To get insight into general practitioners’ care related to contraception in refugees and other migrants compared with native Dutch women

Research question To what extent do GPs in the Netherlands discuss and prescribe contraceptives to female refugees compared with other female migrants and native Dutch women of the same age?

Methods Data collection: Patient records from 5 general practices (GPs) Women of reproductive age (15-49y) At least 2 consultations with GP between 2010 –2016

Results 3 study groups: Refugees Other migrants Native Dutch women Top 3 countries: Somalia (11.5%) Iraq (8.7%) Nigeria (8.7%) Top 3 countries: Morocco (22.4%) Turkey (21.1) Bulgaria (6.9%) Matched by age

Results Contraceptives are less often discussed with refugees and other migrant women 1 Refugees: 51% Other migrants: 67% Native Dutch women: 84% Nog toevoegen, visualisatie van ongelijkheid/weegschaap? Cijfers

Results Contraceptives are 2 less often prescribed to refugees and other migrant women 2 Refugees: 34% Other migrants: 55% Native Dutch women: 79%

Results Other findings among refugees: Contraception least discussed with refugees from Sub-Saharan Africa (29%) 14% unwanted pregnancies 12% induced abortions Unw pregnan: Migrants 9%, Native women 4% Induced abort: Migrants 7 %, Native women 4%

Conclusion More research is needed to: Explore barriers of GPs in discussing contraception Elicit contraceptive health needs of migrant women Why is this important? These insights are vital in order to provide equitable healthcare to every woman regardless of her background Elicit contraceptive health needs of migrant women and their preferences regarding general practitioners’ care

Thank you Correspondence: Liselotte.raben@radboudumc.nl