Differences in perinatal mental health care utilization among migrant and Dutch-born women: a population-based retrospective cohort study

Aim Migrant women in the perinatal period face high risk of mental disorders, with one in four experiencing depression and one in five anxiety disorders. Yet, even in high-income countries like the Netherlands, they encounter barriers to accessing care. This study examines differences in perinatal utilization of specialized mental health care between migrant and Dutch-born individuals in the Netherlands. Method This is a population-based retrospective cohort study based on Statistics Netherlands (CBS) microdata (2015–2018). The study included mothers of children born in the Netherlands who were residing in the country during the perinatal period. Cox proportional hazards regression estimated the association between migration status and time to specialized mental health care start by diagnoses. Results Data were available for 343,026 women, of whom 15% were migrants. Specialized care was utilized by 279.39 per 10,000 person-years among Dutch-born and 205.11 per 10,000 migrant women perinatally. Overall, migrants had a 39% lower rate of specialized mental health care utilization than Dutch-born individuals [adjusted hazard ratio (aHR) = 0.61, 95% CI (0.58–0.64)]. Utilization was significantly lower among migrants across all analysed diagnostic categories (anxiety, depressive, bipolar and mood, substance use, personality, and other disorders), except schizophrenia and psychotic disorders, where utilization was non-significantly higher than in Dutch-born women. Subgroup analyses indicated lower utilization among women from conflict-affected countries, and among recent migrants. Conclusions Migrant women utilize specialized perinatal mental health care less frequently than Dutch-born women, with variations by migration characteristics. These findings underscore the need to strengthen the pathways to mental health care in this population.