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Immigrant women’s experiences of maternity services in Canada: a meta-ethnography

Higginbottom, Gina M.A.; Hadziabdic, Emina; Yohani, Sophie; Paton, Patricia

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Gina M.A. Higginbottom

Emina Hadziabdic

Sophie Yohani

Patricia Paton


Objective: to synthesise data on immigrant women's experiences of maternity services in Canada.
Design: a qualitative systematic literature review using a meta-ethnographic approach.
Methods: a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings.
Findings: the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings.
Key conclusions and implications for practice: in order to implement woman-centred care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care.


Higginbottom, G. M., Hadziabdic, E., Yohani, S., & Paton, P. (2014). Immigrant women’s experiences of maternity services in Canada: a meta-ethnography. Midwifery, 30(5),

Journal Article Type Article
Acceptance Date Jun 11, 2013
Online Publication Date Aug 12, 2013
Publication Date May 1, 2014
Deposit Date Jul 21, 2016
Publicly Available Date Jul 21, 2016
Journal Midwifery
Print ISSN 0266-6138
Electronic ISSN 1532-3099
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 30
Issue 5
Keywords Canada; Emigrants and Immigrants; Maternal-Child Nursing; Meta-Ethnography
Public URL
Publisher URL
Additional Information This paper using the methodology of meta-ethnography was judged to be of high scientific quality by peers and led to my invitation due to my methodological expertise to take part in the advisory group of a funded NIHR HS&DR Project: 13/114/60 study that will map the principles of best practices associated with conduct of meta-ethnography. eMERGE – developing meta-ethnography reporting guidelines. PI - Dr Emma France, University of Stirling. The advisory groups includes leading international systematic review experts including Cochrane Group members, Prof Andrew Booth, Prof Jane Noyes and Dr Karin Hannes.
The paper is co-authored by a colleagues at the University of Alberta, Canada and Linaeus University, Sweden. I formerly supervised Dr Hadziabdic as a Post-doctoral Fellow and provided mentorship for Dr Yohani, as a junior faculty member.

Funded for the study provided by a regional Emerging Team Grant. I was PI for this study. The object of the regional funding was to lay the foundations for the acquisition of national funding which was realized in a subsequent CIHR grant
Contract Date Jul 21, 2016


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