Vulnerable pregnant women throughout Europe: an international project

  • Maria Anabela Ferreira dos Santos
  • Luísa Sotto-Mayor


Vulnerability in pregnancy and all related problems are an important theme in the daily practice of caregivers. Vulnerability is a major risk factor for maternal and perinatal mortality and morbidity (Steegers, Denktaş, de Graaf, & Bonsel, 2013; Vos, Denktas, Borsboom, Steegers, & Bonsel, 2015). Due to the high prevalence of vulnerability and its consequences for mothers and babies, this is not only an important issue for childbirth professionals, but also for education, research and policy makers in this area.

Vulnerability is a broad concept in which medical and non-medical risk factors are equally important. When they coexist, these risk factors can reinforce their negative effect. Examples of vulnerability indicators are: mental aspects (such as fear or depression), psychosocial aspects (such as poor housing or poor social networking) or substance abuse. These aspects often coexist with a lack of personal resources, such as low or non-existent salaries, or low educational level. Assessing the prevalence of vulnerability during pregnancy is difficult due to the lack of consensus on the definition of the concept. The prevalence of vulnerability is higher in large cities than in rural areas (de Graaf, J. P., A. C. Ravelli, M. A. de Haan, 2013; Vos et al., 2015). Vulnerability is a risk factor for several adverse pregnancy outcomes for mother and child, such as high blood pressure or preeclampsia during pregnancy, intrauterine growth restriction, premature birth, low Apgar score, congenital anomalies or even perinatal mortality (de Graaf, JP, AC Ravelli, MA de Haan, 2013; Steegers et al., 2013; Vos et al., 2015). The National Institute for Health and Care Excellence (NICE, 2010) has developed a directive for vulnerable pregnant women, which describes how care can be improved for pregnant women with complex social factors, including substance abuse, newcomer migrant, asylum seeker or refugee, difficulty speaking or understanding the language of the country in which he/she is located, under the age of 20, victim of domestic violence, poverty, homelessness, homelessness or poor housing conditions, among others.

The project objectives are:

  1. Improve the knowledge and skills of childbirth care professionals, teachers, students and researchers on vulnerable pregnancies through international exchanges between the partners concerned on:

- Definitions of vulnerable pregnancy leading to mutual definition

- Organization of health systems in various countries

- Organization of childbirth care in different countries

- Characteristics of the vulnerable pregnant population

- Existing Best Practices for Vulnerable Pregnancies

- Content of midwifery curricula of higher education institutions involved in the theme.

  1. Develop a toolkit to (a) use existing best practices in midwifery and (b) improve the incorporation of knowledge and skills related to midwifery in the curricula of participating educational institutions. Both aspects contribute to improved care for vulnerable pregnant women.
  2. Improve future international cooperation between project partners