Midwives’ experiences with telephone triage for migrant women prior to admission to Norwegian labour wards, when language barriers exist

Telephone triage by a hospital midwife is important for ensuring safe assessments and providing appropriate advice prior to women's admission to the labour ward. Weather this aspect of labour care functions well for migrant women when language barriers exist remains unknown. The aim was to explore midwives' experiences of telephone triage for migrant women prior to admission to Norwegian labour wards, when language barriers exist. Semi-structured individual interviews with eight midwives from five different hospitals in Norway. The manifest and latent content of transcribed text was analysed using inductive qualitative content analysis according to Graneheim and Lundman (2004). Midwives experience with telephone triage for migrant women prior to admission to the labour ward was summarized in one overarching theme: When communication fails, midwives go beyond ordinary procedures and established routines to ensure safety for women and infants. The following categories were identified: Barriers to communication and safe assessments exist - Addressable through technical and supportive measures; Midwives turn to other sources of information when verbal communication with the woman is unsuccessful; Language barriers over the phone creates feelings of uncertainty for midwives, and Lack of information triggers time- and resource-demanding responses. With enhanced communication tools for triage prior to admission to the labour ward, midwives would feel more confident in their assessments, women's needs would be addressed more efficiently, and resources could be used more effectively. The development and evaluation of such tools is urgently needed.