Abstract Overview:
Sub-Saharan African (SSA) migrant women navigate multifaceted challenges in the host country that influence their lived experiences of pregnancy and childbirth and predispose them to unfavourable perinatal health outcomes. However, this population remains underrepresented in research.

Aims and Objectives:
This study aimed to compare maternal and neonatal health outcomes between Sub-Saharan African (SSA) migrant women and a cohort of Maltese women, while also exploring SSA women’s perceptions and experiences of the perinatal period in Malta.

Method:
This research comprised two studies. The first was a retrospective cohort analysis of national obstetrics data registered in Malta (2007-2016). The records contained data on 36,981 Maltese women, SSA women, and their neonates (37,650 in total). Statistical comparison was conducted using the Pearson’s chi-square test. The second study employed an interpretative phenomenological analysis methodology. Following ethical clearance (7904_26022021), in-depth interviews were conducted with a purposive sample of eight SSA women. Data was analysed through close, line-by-line analysis in accordance with the double hermeneutic circle. Quality and rigour were ensured using Yardley’s four criteria.

Results:
Results from the retrospective study revealed that SSA migrants were significantly more likely to be younger, less educated, and multiparous compared to Maltese women. They were also statistically less likely to access antenatal care, and had higher risks of maternal complications (e.g., pre-eclampsia-eclampsia, haemorrhage, infection), neonatal morbidity (e.g., prematurity, low birthweight, sepsis), and mortality (stillbirths, neonatal deaths). The second study recognised the adversities faced by SSA women, particularly poverty and the lack of community support. Women expressed strong beliefs in the normality of pregnancy due to cultural and religious influences, often leading to conflicts with local medical practices.

Conclusion:
This study underscores the need for improved community support services for SSA migrant women. It suggests the implementation of integration policies that safeguards migrant women’s health and specialised perinatal services to better address their healthcare and social needs.