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

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.-B., 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), Article e029478. 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: Oct 25, 2019
• 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