3.4.1. Migrants OPT for Private Clinics and Traditional Midwives for Antenatal Care

Due to immigration regulations, pregnant migrant workers in Malaysia inevitably become undocumented. While healthcare providers at public healthcare facilities will not deny patients necessary medical care, they are obliged to report undocumented workers to the police and immigration authorities. This medical practitioner explains that because of these restrictions, migrant women tend to opt for private healthcare.

*"They [migrants] tend not go to the 'Klinik Kesihatan' [public clinics for antenatal care], because they have to pay quite a bit for it. Some of them are scared that if they go there, and they [health authorities will] inform immigration department and they will be deported. So, they don't want to go to the government side. So, they don't get any [antenatal] follow up, they don't get anything. Sometimes you [would] ask them, 'Do you have antenatal records [home-based antenatal book given to patients at public clinics]?' No records, you know, that makes it very di*ffi*cult. But there are apparently some [private] clinics or some smaller maternity centres, who have their own follow-up for foreigners. So, they have their own [antenatal] book and they can go in for deliveries." MD-2 PRIVATE GP*

As the lack of antenatal follow-up and records prove problematic for the management of pregnancy and delivery, some more established private maternity centres provide more detailed follow-up for non-citizens.

Mainly due to the cost of private healthcare, some migrants prefer to deliver babies at home with the help of untrained traditional birth attendants. As shared by this migrant representative, this practice is likely done out of desperation, not cultural preference, and is linked with poor obstetric outcomes.

*"Some, they prefer to go to the traditional midwives. In some cases, that's why they pass away during delivery, because they don't want to go to the hospital. Because of the lack of documents and also because the payments are very high. So, they prefer to use the 'dukun beranak' [traditional midwife]. I found one [lady like that] last year, passed away in XXX. We had sent her to the hospital, but it was too late already. The baby also passed away." MW-1*
