Women from migrant and refugee backgrounds’ perceptions and experiences of the continuum of maternity care in Australia: A qualitative evidence synthesis

Billett, Hannah; Corona, Martha Vazquez; Bohren, Meghan A.

doi:10.1016/j.wombi.2021.08.005

Cited by 14 publications

(23 citation statements)

References 47 publications

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“…There was poor antenatal clinic attendance in 50% of women in one of the studies and this was deemed due to fear of cost and uncertainty of their appointment dates (Shortall et al, 2015). In similar studies in other European countries, being undocumented led to fear of rejection at health centers (Billett et al, 2021) and, based on previous experiences, migrant women were scared that if they presented to access maternity services it might lead to their deportation (Fair et al, 2020). Researchers in the United Kingdom have proposed that collecting fees for maternity services for migrant women by the NHS is a barrier to accessing necessary healthcare and negatively impacts physical and mental health (Feldman, 2020).…”

Section: Main Findingsmentioning

confidence: 99%

UK maternity care experiences of ethnic minority and migrant women: Systematic review

Obionu,

Onyedinma,

Mielewczyk

et al. 2023

Public Health Nursing

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BackgroundThe increasing population of immigrant and migrant women in the United Kingdom has implications to the provision of healthcare and for healthcare experiences. Eliciting women's experiences and perceptions of maternity care received is an important way of monitoring and evaluating the quality of maternity services. This study was designed to explore the maternity care experiences of ethnic minority and migrant women in the United Kingdom.MethodsA literature search for relevant studies was carried across seven databases. We included nine studies carried out between 2015 and February 2022 that met the inclusion criteria. Data were analyzed using a thematic analysis approach.ResultsFindings showed that ethnic minority women and migrant women have had mixed experiences while utilizing maternity services in the United Kingdom. However, most of the experiences were negative and included issues related to communication, discrimination, culture, access to care, physical comfort, and continuity of care. Only one of the studies reported that the respondents had a wholly positive communication experience, one found that a few women felt the staff were respectful and one reported that the midwives gave the women treatment options that would respect their cultural and religious beliefs.ConclusionThis study has highlighted some important gaps in the maternity care experiences specific to ethnic minority and migrant women in the United Kingdom which provides useful insights to future policy and clinical practice.

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Section: Main Findingsmentioning

confidence: 99%

UK maternity care experiences of ethnic minority and migrant women: Systematic review

Obionu,

Onyedinma,

Mielewczyk

et al. 2023

Public Health Nursing

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“…The heterogeneity in migrant communities may lead to conflicts in healthcare 43. This is a key aspect for guaranteeing culturally competent healthcare services and for building trust-based relationships with migrant patients 44. This was also noted in our study, in which GPs recognised how their own prejudices towards the migrant population could affect their clinical practice, and likewise, the feeling that they could stigmatise migrants by offering screening of certain infections, which were of relevance only to members of migrant communities.…”

Section: Discussionmentioning

confidence: 99%

Usefulness and practicality of a multidisease screening programme targeting migrant patients in primary care in Spain: a qualitative study of general practitioners

et al. 2022

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ObjectivesSome migrant groups are disproportionately affected by key infectious diseases in European countries. These pose a challenge for healthcare systems providing care to these groups. We aimed to explore the views of general practitioners (GPs) on the acceptability, adaptability and feasibility of a multidisease screening programme based on an innovative clinical decision-support system for migrants (the ISMiHealth tool), by examining the current gaps in healthcare provision and areas of good practice and the usefulness and limitations of training in the health needs of migrants.MethodsWe undertook a qualitative descriptive study and carried out a series of focus groups (FGs) taking a pragmatic utilitarian approach. Participants were GPs from the four primary healthcare (PHC) centres in Catalonia, Spain, that piloted an intervention of the ISMiHealth tool. GPs were recruited using purposive and convenience sampling. FG discussions were transcribed and analysed using thematic content analysis.ResultsA total of 29 GPs participated in four FGs. Key themes identified were: (1) GPs found the ISMiHealth tool to be very useful for helping to identify specific health problems in migrants, although there are several additional barriers to screening as part of PHC, (2) the importance of considering cultural perspectives when caring for migrants, and of the impact of migration on mental health, (3) the important role of PHC in healthcare provision for migrants and (4) key proposals to improve screening of migrant populations. GPs also highlighted the urgent need, to shift to a more holistic and adequately resourced approach to healthcare in PHC.ConclusionsGPs supported a multidisease screening programme for migrant populations using the ISMiHealth tool, which aided clinical decision-making. However, intercultural participatory approaches will need to be adopted to address linguistic and cultural barriers to healthcare access that exist in migrant communities.

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“…11 13-15 Although these experiences may not be unique to women from migrant backgrounds, intersecting social identities and experiences (such as race, ethnicity, religion, economic status, employment status) add to layers of stigma discrimination and mistreatment. [15][16][17] Migrant women in high-income settings value empathetic and respectful healthcare providers, who listen to and address their concerns and cultural differences. 11 14 18-20 These positive healthcare interactions increase rapport, and increase confidence and sense of identity in maternity settings.…”

Section: How This Study Might Affect Research Practice or Policymentioning

confidence: 99%

“… 11 13–15 Although these experiences may not be unique to women from migrant backgrounds, intersecting social identities and experiences (such as race, ethnicity, religion, economic status, employment status) add to layers of stigma discrimination and mistreatment. 15–17 …”

Section: Introductionmentioning

confidence: 99%

“…Migrant women may experience communication barriers and mistreatment, such as discrimination, racism, physical and verbal abuse 4 9 10. They may feel rushed through appointments, ignored in decision-making or disregarded during maternity care11 12 and experience frustration with a lack of continuity of care and trust 11 13–15. Although these experiences may not be unique to women from migrant backgrounds, intersecting social identities and experiences (such as race, ethnicity, religion, economic status, employment status) add to layers of stigma discrimination and mistreatment 15–17…”

Section: Introductionmentioning

confidence: 99%

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Community-based doulas for migrant and refugee women: a mixed-method systematic review and narrative synthesis

et al. 2022

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BackgroundCommunity-based doulas share the same cultural, linguistic, ethnic backgrounds or social experiences as the women they support. Community-based doulas may be able to bridge gaps for migrant and refugee women in maternity settings in high-income countries (HICs). The aim of this review was to explore key stakeholders’ perceptions and experiences of community-based doula programmes for migrant and refugee women during labour and birth in HICs, and identify factors affecting implementation and sustainability of such programmes.MethodsWe conducted a mixed-method systematic review, searching MEDLINE, CINAHL, Web of Science, Embase and grey literature databases from inception to 20th January 2022. Primary qualitative, quantitative and mixed-methods studies focusing on stakeholders’ perspectives and experiences of community-based doula support during labour and birth in any HIC and any type of health facility were eligible for inclusion. We used a narrative synthesis approach to analysis and GRADE-CERQual approach to assess confidence in qualitative findings.ResultsTwelve included studies were from four countries (USA, Sweden, England and Australia). There were 26 findings categorised under three domains: (1) community-based doulas’ role in increasing capacity of existing maternity services; (2) impact on migrant and refugee women’s experiences and health; and (3) factors associated with implementing and sustaining a community-based doula programme.ConclusionCommunity-based doula programmes can provide culturally-responsive care to migrant and refugee women in HICs. These findings can inform community-based doula organisations, maternity healthcare services and policymakers. Further exploration of the factors that impact programme implementation, sustainability, strategic partnership potential and possible wider-reaching benefits is needed.

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Women from migrant and refugee backgrounds’ perceptions and experiences of the continuum of maternity care in Australia: A qualitative evidence synthesis

Cited by 14 publications

References 47 publications

UK maternity care experiences of ethnic minority and migrant women: Systematic review

UK maternity care experiences of ethnic minority and migrant women: Systematic review

Usefulness and practicality of a multidisease screening programme targeting migrant patients in primary care in Spain: a qualitative study of general practitioners

Community-based doulas for migrant and refugee women: a mixed-method systematic review and narrative synthesis

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