The Experiences of Black, Asian and Minority Ethnic Women of Maternity Services in the UK

Abstract

There is little research into Black, Asian and Minority Ethnic (BAME) women’s experiences of maternity care in the United Kingdom. However, with 28.2% of lives births in England and Wales and almost 50% of live births in Birmingham being to non-UK born women in 2016, it is an important area to investigate as maternity care is such a crucial part of pregnancy and labour. The aim of this review is to assess these experiences and determine if they can be improved. A literature search took place for guidelines, systematic reviews, and primary evidence that were conducted in the UK, including women of ethnic minorities. Guideline searches were conducted through NICE, GMC, and SIGN, systematic reviews through NICE, Cochrane, and MEDLINE, and primary evidence through EMBASE, BMJ, MEDLINE, and PLoS. Each finding was then appraised using the appropriate AGREE II, CASP, and AXIS appraisal tools. We summarised the literature findings in Table 4 of this review. One guideline was found detailing advice on the needs of refugee and asylum-seeking women, as well as those with difficulty reading and speaking English. Searches also found 36 systematic reviews, of which one was included, and 1,091 primary studies were found, of which four were included (two qualitative and two cross-sectional). Both the systematic review and the four primary evidence studies showed that BAME women’s experiences were generally more negative and engagement with maternity services was poor. Some of the themes which emerged were poor communication, lack of respect for the culture, and lack of support. One study, however, did show that more recent migrants described their overall experiences as much more positive than migrants who had been in the UK longer. This review suggests that BAME women generally perceive their maternity care more negatively than White women. Specific areas that were highlighted for requiring improvement include poor communication and cultural insensitivity despite current guidelines. However, these guidelines do not sufficiently target the BAME group; with more research, these guidelines could be improved and adhered to so BAME women can experience the same level of care as White women in the UK.