Experience of and access to maternity care in the UK by women who are immigrants
Citation: Higginbottom GMA, Evans C, Morgan M, et al. Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review. BMJ Open. 2019;9:e029478.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: This project was funded by the National Institute for Health Research (UK) Health Services and Delivery Research Programme (Grant No. HS&DR-15/55/03).
What is this? About a quarter of births in the UK are to immigrant women, who experience higher rates of maternal and perinatal mortality than women born in the UK. In this systematic review, the authors searched in June 2017 for articles related to access and experience of maternity care by immigrant women in the UK. They included 40 studies: 22 qualitative, 8 quantitative, and 10 mixed methods.
What was found: Women who were born outside of the UK often accessed antenatal care later than the recommended first 10 weeks of pregnancy. Factors associated with late booking included English language proficiency, immigration status, awareness of the services, understanding the purpose of the services, income barriers, the presence of female genital mutilation, differences between the maternity care systems of their countries of origin and the UK, arrival in the UK late in the pregnancy, frequent relocations, poor reputation of antenatal services in specific communities, and perceptions of antenatal care as medicalisation of childbirth.
Women born outside of the UK faced challenges in communication because of language fluency, confusing professional jargon, and culturally defined nonverbal communication. Women who were not entitled to free maternity care in the UK were deterred due to concerns about costs and confidentiality about their status. Lastly, discrimination and cultural insensitivity influenced access and experiences.
Some women who had immigrated to the UK had positive perceptions of health care professionals as caring, confidential, and communicative. Women with negative views perceived health professionals as rude, discriminatory, and insensitive to their cultural and social needs.
Implications: The authors of this review stated that women who were immigrants have both positive and negative experiences of accessing and utilising maternity services in the UK. Strategies that address negative experiences are needed to improve services.
Other considerations: The authors of the review discussed their findings in the context of place of residence and race, ethnicity, culture, and language.
This summary was prepared by Joly Ghanawi, checked by Sydney Johnson, and finalized by Helen Worthington.