Cultural diversity in the Dublin maternity services: the experiences of maternity service providers when caring for ethnic minority women

Lyons, Seán; O'Keeffe, Frances M; Clarke, Anna; Staines, Anthony

doi:10.1080/13557850801903020

Cited by 52 publications

(67 citation statements)

References 12 publications

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“…Factors contributing to these differences have been explored elsewhere [13,16,42,43]. They include discrimination and stereotyping by health professionals and difficulties in understanding and culture on both sides.…”

Section: Discussionmentioning

confidence: 99%

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Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Henderson

Gao

Redshaw

2013

BMC Pregnancy Childbirth

128

103

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BackgroundAccording to the Office for National Statistics, approximately a quarter of women giving birth in England and Wales are from minority ethnic groups. Previous work has indicated that these women have poorer pregnancy outcomes than White women and poorer experience of maternity care, sometimes encountering stereotyping and racism. The aims of this study were to examine service use and perceptions of care in ethnic minority women from different groups compared to White women.MethodsSecondary analysis of data from a survey of women in 2010 was undertaken. The questionnaire asked about women’s experience of care during pregnancy, labour and birth, and the postnatal period, as well as demographic factors. Ethnicity was grouped into eight categories: White, Mixed, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, and Other ethnicity.ResultsA total of 24,319 women completed the survey. Compared to White women, women from minority ethnic groups were more likely to be younger, multiparous and without a partner. They tended to access antenatal care later in pregnancy, have fewer antenatal checks, fewer ultrasound scans and less screening. They were less likely to receive pain relief in labour and, Black African women in particular, were more likely to deliver by emergency caesarean section. Postnatally, women from minority ethnic groups had longer lengths of hospital stay and were more likely to breastfeed but they had fewer home visits from midwives. Throughout their maternity care, women from minority ethnic groups were less likely to feel spoken to so they could understand, to be treated with kindness, to be sufficiently involved in decisions and to have confidence and trust in the staff.ConclusionWomen in all minority ethnic groups had a poorer experience of maternity services than White women. That this was still the case following publication of a number of national policy documents and local initiatives is a cause for concern.

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Section: Discussionmentioning

confidence: 99%

“…They include discrimination and stereotyping by health professionals and difficulties in understanding and culture on both sides. From the health professionals point of view, it can be stressful, time-consuming and frustrating caring for women who do not speak English and who may have different cultural expectations [42]. …”

Section: Discussionmentioning

confidence: 99%

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Henderson

Gao

Redshaw

2013

BMC Pregnancy Childbirth

128

103

View full text Add to dashboard Cite

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“…For example, women who experience communication barriers are less likely to receive adequate counselling and culturally sensitive care [20], which may result in lower satisfaction with the care [21]. In addition, HCPs may need more time with refugee and migrant women due to the use of interpreters and the time it takes to build rapport [20]. HCP’s lack of cultural competency can affect their interest and satisfaction with providing SRH care to these women [22].…”

Section: Introductionmentioning

confidence: 99%

Refugee and migrant women's engagement with sexual and reproductive health care in Australia: A socio-ecological analysis of health care professional perspectives

et al. 2017

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BackgroundIn Australia only 2.2% of published health research has focused on multi-cultural health despite the increase of culturally and linguistically diverse populations. Research on the perceptions and experiences of health care professionals (HCPs) in engaging with refugee and migrant women is also lacking. Given the integral role of HCPs in providing sexual and reproductive health (SRH) care for these populations, an understanding of the challenges they experience is required. Therefore, this study sought to examine the perspectives and practices of Australian HCPs with regard to the provision of SRH care for refugee and migrant women.MethodsEmploying qualitative methods, twenty-one semi-structured interviews were conducted with HCPs representing various professions, work experiences, cultural backgrounds, age and healthcare sectors. The interviews were analysed using thematic analysis and the socio-ecological model was utilised to interpret the data.ResultsThe complexities of HCP’s engagement with refugee and migrant women were identified in three major themes: Being a Migrant; Gender Roles and SRH Decision-making; and Women in the Healthcare System. HCPs discussed the impact of accessing SRH care in women’s country of origin and the influence of re-settlement contexts on their SRH knowledge, engagement with care and care provision. Perception of gender roles was integral to SRH decision-making with the need to involve male partners having an impact on the provision of women-centred care. Barriers within the healthcare system included the lack of services to address sexual functioning and relationship issues, as well as lack of resources, time constraints, cost of services, and funding.ConclusionAustralian HCPs interviewed reported that migrant and refugee women do not have appropriate access to SRH care due to multifaceted challenges. These challenges are present across the entire socio-ecological arena, from individual to systemic levels. Multiple and multidimensional interventions are required to increase SRH utilisation and improve outcomes for refugee and migrant women.

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“…Pre and post migratory stressors add to the challenges of providing effective care to this group of women, as their needs are complex and multifaceted 13,14. Childbirth can be a physically and emotionally challenging journey for many women; for women who are pregnant and give birth while seeking asylum, these challenges can be complicated by psychological, social, and/or physical trauma.…”

Section: Introductionmentioning

confidence: 99%

Irish midwives' experiences of providing maternity care to non-Irish women seeking asylum

Tobin¹,

Murphy-Lawless²

2014

IJWH

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BackgroundImmigration and asylum seeking has been an important social and political phenomenon in Ireland since the mid 1990s. Inward migration to Ireland was seen in unprecedented numbers from 1995 onward, peaking in 2002 with 11,634 applications for refugee status. Asylum and immigration is an issue of national and international relevance as the numbers of displaced people worldwide continues to grow, reaching the highest level in 20 years at 45.2 million in 2012. Midwives provide the majority of care to childbearing women around the world, whether working as autonomous practitioners or under the direction of an obstetrician. Limited data currently exist on the perspectives of midwives who provide care to childbearing women while they are in the process of seeking asylum. Such data are important to midwifery leaders, educators, and policy-makers. The aims of this study were to explore midwives’ perceptions and experiences of providing care to women in the asylum process and to gain insight into how midwives can be equipped and supported to provide more effective care to this group in the future.MethodsData were collected via indepth unstructured interviews with a purposive sample of ten midwives from two sites, one a large urban inner city hospital, and the second, a smaller more rural maternity hospital. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using content analysis.ResultsFive themes emerged from the data, barriers to communication, understanding cultural difference, challenges of caring for women who were unbooked, the emotional cost of caring, and structural barriers to effective care.ConclusionFindings highlight a need to focus on support and education for midwives, improved maternity services for immigrant women, and urgent policy revision.

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Cultural diversity in the Dublin maternity services: the experiences of maternity service providers when caring for ethnic minority women

Abstract: These issues were relevant a decade ago internationally and are still pertinent today for not only Irish services but also for other European countries. There is an opportunity to improve the services for all women by learning from the experience of Dublin maternity service providers.

Cited by 52 publications

References 12 publications

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Refugee and migrant women's engagement with sexual and reproductive health care in Australia: A socio-ecological analysis of health care professional perspectives

Irish midwives' experiences of providing maternity care to non-Irish women seeking asylum

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Cultural diversity in the Dublin maternity services: the experiences of maternity service providers when caring for ethnic minority women

Abstract: These issues were relevant a decade ago internationally and are still pertinent today for not only Irish services but also for other European countries. There is an opportunity to improve the services for all women by learning from the experience of Dublin maternity service providers.

Cited by 52 publications

References 12 publications

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Refugee and migrant women's engagement with sexual and reproductive health care in Australia: A socio-ecological analysis of health care professional perspectives

Irish midwives&#39; experiences of providing maternity care to non-Irish women seeking asylum

Contact Info

Product

Resources

About

Irish midwives' experiences of providing maternity care to non-Irish women seeking asylum