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Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

G., Higginbottom; Evans, Catrin; M., Morgan; K., Kaur-Bharj; J., Eldridge; B., Hussain

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Authors

Higginbottom G.

Dr CATRIN EVANS CATRIN.EVANS@NOTTINGHAM.AC.UK
Professor of Evidence Based Healthcare

Morgan M.

Kaur-Bharj K.

Eldridge J.

Hussain B.



Abstract

© 2019 Author(s). One in four births in the UK is to foreign-born women. In 2016, the figure was 28.2%, the highest figure on record, with maternal and perinatal mortality also disproportionately higher for some immigrant women. Our objective was to examine issues of access and experience of maternity care by immigrant women based on a systematic review and narrative synthesis of empirical research. Review methods: A research librarian designed the search strategies (retrieving literature published from 1990 to end June 2017). We retrieved 45 954 citations and used a screening tool to identify relevance. We searched for grey literature reported in databases/websites. We contacted stakeholders with expertise to identify additional research. Results: We identified 40 studies for inclusion: 22 qualitative, 8 quantitative and 10 mixed methods. Immigrant women, particularly asylum-seekers, often booked and accessed antenatal care later than the recommended first 10 weeks. Primary factors included limited English language proficiency, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Maternity care experiences were both positive and negative. Women with positive perceptions described healthcare professionals as caring, confidential and openly communicative in meeting their medical, emotional, psychological and social needs. Those with negative views perceived health professionals as rude, discriminatory and insensitive to their cultural and social needs. These women therefore avoided continuously utilising maternity care. We found few interventions focused on improving maternity care, and the effectiveness of existing interventions have not been scientifically evaluated. Conclusions: The experiences of immigrant women in accessing and using maternity care services were both positive and negative. Further education and training of health professionals in meeting the challenges of a super-diverse population may enhance quality of care, and the perceptions and experiences of maternity care by immigrant women.

Citation

G., H., Evans, C., M., M., K., K., J., E., & B., H. (2019). Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review. BMJ Open, 9(12), https://doi.org/10.1136/bmjopen-2019-029478

Journal Article Type Article
Acceptance Date Oct 17, 2019
Online Publication Date Dec 31, 2019
Publication Date Dec 31, 2019
Deposit Date Oct 24, 2019
Publicly Available Date Mar 28, 2024
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 9
Issue 12
Article Number e029478
DOI https://doi.org/10.1136/bmjopen-2019-029478
Keywords General Medicine
Public URL https://nottingham-repository.worktribe.com/output/2957212
Publisher URL https://bmjopen.bmj.com/content/9/12/e029478

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