Ethnic variation in maternity care: a comparison of Polish and Scottish women delivering in Scotland 2004–2009

Gorman, Dermot; Katikireddi, Srinivasa Vittal; Morris, Carole; Chalmers, Jim; Sim, Judith; Szamotulska, Katarzyna; Mierzejewska, Ewa; Hughes, Rhona

doi:10.1016/j.puhe.2013.11.008

Cited by 11 publications

(15 citation statements)

References 21 publications

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“…We identified eight quantitative studies that all used a questionnaire for data collection 40–47. These population-based studies and cohort surveys were all cross-sectional: none were longitudinal.…”

Section: Resultsmentioning

confidence: 99%

Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

et al. 2019

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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 methodsA 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.ResultsWe 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.ConclusionsThe 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.

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Section: Resultsmentioning

confidence: 99%

Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

et al. 2019

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“…We identified eight quantitative studies that used a questionnaire as a tool for data collection. 14,49,[128][129][130][131][132][133] All of these population-based studies and cohort surveys were cross-sectional; none was longitudinal.…”

Section: Quantitative Studiesmentioning

confidence: 99%

“…More than half of the included studies (26 in total 4,47,49,107,111,112,115,[119][120][121][123][124][125][126][128][129][130][131][132][133][134][135][136][138][139][140] ) did not clearly specify the immigrant category of the population they studied (such as economic migrant, asylum seeker or refugee).…”

Section: Studies Sorted By Immigrant Category Of the Participantsmentioning

confidence: 99%

“…Of the included studies, 17 studies 3,20,47,[108][109][110]112,[118][119][120][121][123][124][125]133,134,136,140 were undertaken across all phases of maternity care (antenatal, intrapartum and postnatal). Nine studies 14,49,111,[114][115][116][117]128,138 reported on antenatal care alone and six studies 116,119,126,131,135,137 focused on postnatal care. Two studies 122,129 focused on antenatal and postnatal care, but did not include the intrapartum phase.…”

Section: Studies Sorted By Phase Of Maternity Carementioning

confidence: 99%

“…Findings from a review by Gorman et al 131 indicated that Polish immigrant mothers had higher rates of instrumental delivery in Scotland than in their country of origin. Somali immigrant women perceived hospital birth to be safer and they had a strong preference for this over home birth.…”

Section: Utilisation Of Servicesmentioning

confidence: 99%

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Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review

Higginbottom

Evans

Morgan

et al. 2020

Health Serv Deliv Res

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Background In 2016, over one-quarter of births in the UK (28.2%) were to foreign-born women. Maternal and perinatal mortality are disproportionately higher among some immigrants depending on country of origin, indicating the presence of deficits in their care pathways and birth outcomes. Objectives Our objective was to undertake a systematic review and narrative synthesis of empirical research that focused on access and interventions to improve maternity care for immigrant women, including qualitative, quantitative and mixed-methods studies. Review methods An information scientist designed the literature database search strategies (limited to retrieve literature published from 1990 to 2018). All retrieved citations (45,954) were independently screened by two or more team members using a screening tool. We searched grey literature reported in related databases and websites. We contacted stakeholders with subject expertise. In this review we define an immigrant as a person who relocates to the destination country for a minimum of 1 year, with the goal of permanent residence. Results We identified 40 studies for inclusion. Immigrant women tended to book and access antenatal care later than the recommended first 10 weeks of pregnancy. Primary factors included limited English-language skills, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Immigrant women had mixed perceptions regarding how health-care professionals (HCPs) had delivered maternity care services. Those with positive perceptions felt that HCPs were caring, confidential and openly communicative. Those with negative views perceived HCPs as rude, discriminatory or insensitive to their cultural and social needs; these women therefore avoided accessing maternity care. We found very few interventions that had focused on improving maternity care for these women and the effectiveness of these interventions has not been rigorously evaluated. Limitations Our review findings are limited by the available research evidence related to our review questions. There may be many aspects of immigrant women’s experiences that we have not addressed. For example, few studies exist for perinatal mental health in immigrant women from Eastern European countries (in the review period). Many studies included both immigrant and non-immigrant women. Conclusions Available evidence suggests that the experiences of immigrant women in accessing and using maternity care services in the UK are mixed; however, women largely had poor experiences. Contributing factors included a lack of language support, cultural insensitivity, discrimination and poor relationships between immigrant women and HCPs. Furthermore, a lack of knowledge of legal entitlements and guidelines on the provision of welfare support and maternity care to immigrants compounds this. Future work Studies are required on the development of interventions and rigorous scientific evaluation of these interventions. Development and evaluation of online antenatal education resources in multiple languages. Development and appraisal of education packages for HCPs focused on the provision of culturally safe practice for the UK’s diverse population. The NHS in the UK has a hugely diverse workforce with a vast untapped linguistic resource; strategies could be developed to harness this resource. Study registration This study is registered as PROSPERO CRD42015023605. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 14. See the NIHR Journals Library website for further project information.

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The impact of China's latest population policy changes on maternity insurance—a case study in Jiangsu Province

Zhang

Zhou

Antwi

2018

Health Planning & Management

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SummaryThis study aims to examine the impact of China's population policy changes on social insurance. Nearly 4 decades ago, China ushered in the 1‐child policy as a family planning policy to control the adverse effect of high population growth. The current maternity insurance system in China is designed to fit the operations of the 1‐child policy. However, the implementation of the comprehensive 2‐child policy can pose a challenge to the sustainability of the current maternity insurance scheme hence the call for reform.The study empanels a novel and comprehensive system dynamic model that incorporates all the related factors that influence the income and expenditure of maternity insurance in the Jiangsu Province. Data are mainly derived from the historical data of the Statistical Yearbook of Jiangsu Province and the National Bureau of Statistics of China. These are used to construct and simulate a system dynamic model to determine a sustainable contribution rate for maternity insurance.In conclusion, if the rate of contribution of the current maternity insurance policy is not increased, the burden of implementing the comprehensive 2‐child policy will exacerbate the current deficit balance of the maternity insurance fund. The existing maternity insurance benefits thus cannot be maintained, and women's health will be threatened. In the short term, the study proposes an increase in the rate of premium payment to prolong the life of the maternity insurance. In the long term, there is a need to improve the level of coordination and expand the coverage of maternity insurance.

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Ethnic variation in maternity care: a comparison of Polish and Scottish women delivering in Scotland 2004–2009

Cited by 11 publications

References 21 publications

Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review

The impact of China's latest population policy changes on maternity insurance—a case study in Jiangsu Province

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