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

Abstract

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.

Compromised communication: a qualitative study exploring Afghan families and health professionals’ experience of interpreting support in Australian maternity care

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Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland

“…However, women from minority cultural or ethnic groups may be less likely to have confidence and trust in staff and more likely to perceive their practitioner as lacking in competence, than other women [24,26,27]. Whether CALD identification differentially affects perceptions of maternity care staff's technical competence in Queensland is unknown.…”

“…Preserving dignity and privacy, familiarity with cultural practices, awareness of different expectations for care, and being treated as an individual are important considerations for demonstrating respect [11,23,26,28]. A large majority of Somali women surveyed by Chalmers and Hashi [24] reported that their care providers indicated a lack of respect for their cultural practices through verbal and non-verbal expressions of disgust and surprise.…”

The Quality Gap in the Services Provided by Rural Maternity Units in Southeast of Iran

“…For instance, a study that investigated the immigrant Afghan women's perspectives and experiences of maternity care in Melbourne, Australia found that interactions with caregivers, their attitudes and behavior, and receiving adequate information, explanations and support from staff were the factors important in shaping women's satisfaction with maternity care (35). Conversely, women from minority ethnic groups sometimes encounter prejudice and racial discrimination and they are less likely to be treated with compassion, or to be engaged in decision making and to have confidence and trust in the care providers, which is more likely to results in underuse of maternity services and subsequently poorer pregnancy outcomes (36). We found that the overall quality gap was associated with patients' age and level of education, which is in agreement with similar studies from developing countries such as Ethiopia (37) and Bangladesh (38).…”