Experiences and needs of women from ethnic minorities in maternity healthcare: A qualitative systematic review and meta-aggregation |
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| Institution: | 1. Nursing Division, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore;2. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;5. University of Central Lancashire, UK;6. Newcastle upon Tyne Hospitals NHS Foundation Trust, UK;7. University of Manchester, UK;8. Amsterdam University Medical Center, UK;9. University of Southampton, UK;10. NHS England and NHS Improvement North West, UK;11. Royal Free Teaching Hospital in London, UK;12. Birthrights, UK;13. Kings College London, UK;14. The University of Nottingham, UK;15. East Lancashire Hospitals NHS Trust, UK;p. FivexMore, UK;q. MVP BAME Group, UK;r. The Miscarriage Association, UK;s. RCM, UK;t. International Confederation of Midwives (ICM), UK;u. Postnatal Care, UK;v. Royal College of Obstetricians and Gynaecologists (RCOG), UK;w. Fathers Included/Family Included/The Family Initiative, UK;x. Neighbourhood Midwives, UK;y. University of Liverpool, UK;z. National Maternity Voices, UK;11. SANDS, UK;12. Burnet Institute, Australia;13. National Perinatal Epidemiology Unit (NPEU), UK;14. University College London, UK;15. London Ambulance Service Trust, UK;16. NHS England, UK;17. Grace in Action, UK;18. Twins Trust, UK;19. UCL & City University, UK;110. Midwifery Unit Network, UK;111. RCM Scotland, UK;112. BirthWise NI, UK;113. British Maternal and Fetal Medicine Society, UK;114. Birth Trauma Association, Australia;1. Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, The Netherlands;2. School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, UK;3. Research Centre of Midwifery Science Maastricht, Zuyd University, The Netherlands;4. Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Reproduction and Development, The Netherlands;1. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW, Australia;2. Education Queensland, QLD 4564, Australia;3. MAK Consulting, Bruce, ACT 2617, Australia;4. Canberra Mothercraft Society, PO Box 126, Curtin, 2605 ACT, Australia;5. School of Nursing and Midwifery, Griffith University, 68 University Drive, Meadowbrook, QLD 4131, Australia;6. Transforming Maternity Care Collaborative, Australia;7. School of Law, University of Sydney, Camperdown, NSW 2006, Australia;8. Human Rights in Childbirth;9. BWLaw, Australia;1. Artesis Plantijn University College, Noorderplaats 2, 2000 Antwerp, Belgium;2. Edinburgh Napier University, School of Health and Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, United Kingdom;3. School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom;4. University of Barcelona, Faculty of Medicine and Health Sciences, Bellvitge Health Sciences Campus, Carrer de la Feixa Llarga, s/n. 08907 L′Hospitalet de Llobregat, Barcelona, Spain;5. University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain;6. Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic;7. Universitätsklinik Graz, Auenbruggerplatz 14, 8036 Graz, Austria;8. Institute for Midwifery, Charite Universitätsmedizin Berlin, Berlin, Germany |
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| Abstract: | ObjectivesTo consolidate the available evidence around ethnic minority women’s experiences and needs when accessing maternity care.MethodsA qualitative systematic review and meta-aggregation of qualitative data were conducted. Nine electronic databases were searched for qualitative or mixed-methods studies from the inception of each database until January 2022. Using the Nested-Knowledge software, meta-aggregation was conducted according to the Joanna Briggs Institute (JBI) data synthesis approach to identify all potential intersections between different themes. Methodological quality of included studies was assessed using the JBI Qualitative Assessment and Review Instrument (JBI-QARI) and the mixed-methods appraisal tool (MMAT) checklists for qualitative and mixed-methods studies, respectively.ResultsTwenty-two studies (nineteen qualitative and three mixed-methods) were included. All studies were of good methodological quality. An overarching theme ‘the struggles and fears of ethnic minority women’ was identified. The negative experiences with maternity care were attributed to barriers including ineffective communication, cultural and religious insensitivity, inattentiveness and disregard for women’s needs, and isolation-related impact due to the COVID pandemic.ConclusionsOverall, our review highlighted several significant gaps between the care provided and the expected care among ethnic minority women accessing maternity care services. This mismatch between their expectations and care resulted in negative experiences, as the women reported being discriminated against and disrespected. There is an urgent need to develop and implement maternity care policies that are inclusive of needs of the ethnic minority women to optimize their maternity care experience. |
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| Keywords: | Ethnic minority Maternity care services Perinatal period Inequity Discrimination |
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