Late booking amongst African women in a London borough, England: implications for health promotion

Abstract

The National Institute for Health and Clinical Excellence guidance is that a pregnant woman should see a midwife within the first 13 weeks into her pregnancy, in what is known as the 'booking appointment' or the 'full assessment' where she discusses with the midwife her care plan, medical and family histories and social circumstances. Significant numbers of black African women present after 13 weeks into the pregnancy. This study explores why black African women access the booking appointment after 13 weeks of pregnancy in a London borough. The study took a qualitative approach and used semi-structured interviews with 23 women who self-identified as black African migrants born in a sub-Saharan African country, and had experience of using ante-natal services in the borough. Participants discussed how their cultural understandings of pregnancy influenced timing of the booking appointment. The data was analysed using the thematic approach. Cultural, economic and political contexts within which they experienced pregnancy influenced the timing. Whilst acknowledging the benefits of early booking, this was said to be at odds with their cultural beliefs where pregnancy disclosure within 13 weeks was considered inappropriate. Lack of information about the booking appointment and unresolved immigration issues led to perceptions that they were being brought under the Immigration Department's radar through the booking appointment. Whilst most health promotion information regarding the booking appointment is designed in a top-down fashion, health planners should also recognize ethnic diversities so as to market the booking appointment using downstream approaches that take account of the cultural, political and economic contexts in which migrants/ethnic minority populations live.

Exploring ethnic minority women’s experiences of maternity care during the SARS-CoV-2 pandemic: a qualitative study

“…There is little qualitative research on the lived experiences of all ethnic minority women during or immediately following pregnancy in the UK. Previous qualitative literature in the UK has tended to focus on nuanced aspects of maternal care, 15 particular health conditions during pregnancy 16 or specific ethnic groups. 17 This study aimed to explore the experiences of pregnancy, childbirth, antenatal and postnatal care in all women belonging to ethnic minority communities and to identify any specific challenges that these women faced during the SARS-CoV-2 pandemic.…”

Barriers to accessing preventive health care among African-born individuals in King County, Washington: A qualitative study involving key informants

“…Recent research has revealed high prevalence but low awareness of cardiometabolic disease among African immigrants in the U.S. [8,9]. Other studies of African immigrants living in high-income settings have found low levels of health insurance [10] and linkage to primary care [11,12] as well as low or delayed uptake of vaccination [13,14], cancer screening [15,16], antenatal care [17], and diabetes screening [18]. Therefore, identifying and addressing specific barriers to engagement in preventive health care (defined here as proactive measures taken to prevent or mitigate future illness) is needed to improve health outcomes of African immigrant populations in the U.S.…”

Clay Ingestion During Pregnancy Among Black African Women in a North London Borough: Understanding Cultural Meanings, Integrating Indigenous and Biomedical Knowledge Systems

“…This propels the argument that IK is deeply embedded in a society's cultural values and practices. As postulated by Chinouya and Madziva (2017), culture is often a crucial determinant of reproductive health behaviors including those relating to accessing antenatal care within the timeframes prescribed by clinicians, namely 12 weeks into the pregnancy. Helman (1984, p. 3) defines culture as "a set of guidelines (explicit and implicit) which an individual inherits as a member of society, and which tells him how to view the world and how to behave in it in relation to other people, to supernatural forces or gods and the environment.…”