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Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

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

Authors: Jane Henderson, Haiyan Gao, Maggie Redshaw

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

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Abstract

Background

According 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.

Methods

Secondary 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.

Results

A 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.

Conclusion

Women 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.
Literature
2.
go back to reference Office for National Statistics: 2011 Census population and household estimates for England and Wales. Ethnicity and national identity in England and Wales 2011. 2012, London: ONS Office for National Statistics: 2011 Census population and household estimates for England and Wales. Ethnicity and national identity in England and Wales 2011. 2012, London: ONS
3.
go back to reference Statistics N: Ethnic group statistics: a guide for the collection and classification of ethnicity data. 2003, London: HMSO Statistics N: Ethnic group statistics: a guide for the collection and classification of ethnicity data. 2003, London: HMSO
4.
go back to reference Ge L: Saving mothers’ lives: reviewing maternal deaths to make childbirth safer - 2003–2005. 2007, London: CEMACH Ge L: Saving mothers’ lives: reviewing maternal deaths to make childbirth safer - 2003–2005. 2007, London: CEMACH
5.
go back to reference Centre for Maternal and Child Enquiries: Saving Mothers’ Lives: Reviewing deaths to make motherhood safer: 2006–2008. BJOG. 2011, 118 (s1): 1-203. Centre for Maternal and Child Enquiries: Saving Mothers’ Lives: Reviewing deaths to make motherhood safer: 2006–2008. BJOG. 2011, 118 (s1): 1-203.
6.
go back to reference Knight M, Kurinczuk JJ, Spark P, Brocklehurst P: Ukoss: inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities. BMJ. 2009, 338: b542-CrossRefPubMedPubMedCentral Knight M, Kurinczuk JJ, Spark P, Brocklehurst P: Ukoss: inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities. BMJ. 2009, 338: b542-CrossRefPubMedPubMedCentral
7.
go back to reference Macfarlane A, Bakeo AC, Dattani N, Maher J, Dibben C, Singala M, Harding S: Inequalities in the outcome of pregnancy. 2006, London: City University Macfarlane A, Bakeo AC, Dattani N, Maher J, Dibben C, Singala M, Harding S: Inequalities in the outcome of pregnancy. 2006, London: City University
8.
go back to reference Hollowell J, Kurinczuk JJ, Brocklehurst P, Gray R: Social and ethnic inequalities in infant mortality: a perspective from the United Kingdom. Semin Perinatol. 2011, 35 (4): 240-244.CrossRefPubMed Hollowell J, Kurinczuk JJ, Brocklehurst P, Gray R: Social and ethnic inequalities in infant mortality: a perspective from the United Kingdom. Semin Perinatol. 2011, 35 (4): 240-244.CrossRefPubMed
9.
go back to reference Davey Smith G, Chaturvedi N, Harding S, Nazroo J: R W: Ethnic inequalities in health: a review of UK epidemiological evidence. Crit Public Health. 2000, 10 (4): 375-408.CrossRef Davey Smith G, Chaturvedi N, Harding S, Nazroo J: R W: Ethnic inequalities in health: a review of UK epidemiological evidence. Crit Public Health. 2000, 10 (4): 375-408.CrossRef
10.
go back to reference Kelly Y, Panico L, Bartley M, Marmot M, Nazroo J, Sacker A: Why does birthweight vary among ethnic groups in the UK? findings from the millennium cohort study. J Public Health. 2009, 31 (1): 131-137.CrossRef Kelly Y, Panico L, Bartley M, Marmot M, Nazroo J, Sacker A: Why does birthweight vary among ethnic groups in the UK? findings from the millennium cohort study. J Public Health. 2009, 31 (1): 131-137.CrossRef
11.
go back to reference Dhawan S: Birth weights of infants of first generation Asian women in Britain compared with second generation Asian women. BMJ. 1995, 311 (6997): 86-88.CrossRefPubMedPubMedCentral Dhawan S: Birth weights of infants of first generation Asian women in Britain compared with second generation Asian women. BMJ. 1995, 311 (6997): 86-88.CrossRefPubMedPubMedCentral
12.
go back to reference Baxter C: The case for bilingual workers within the maternity services. Br J Midwifery. 1997, 5 (9): 568-572.CrossRef Baxter C: The case for bilingual workers within the maternity services. Br J Midwifery. 1997, 5 (9): 568-572.CrossRef
13.
go back to reference D’Souza L, Garcia J: Improving services for disadvantaged childbearing women. Child Care Health Dev. 2004, 30 (6): 599-611.CrossRefPubMed D’Souza L, Garcia J: Improving services for disadvantaged childbearing women. Child Care Health Dev. 2004, 30 (6): 599-611.CrossRefPubMed
14.
go back to reference Rowe R, Magee H, Quigley MA, Heron P, Askham J, Brocklehurst P: Social and ethnic differences in attendance for antenatal care in England. Public health. 2008, 122 (12): 1363-1372.CrossRefPubMed Rowe R, Magee H, Quigley MA, Heron P, Askham J, Brocklehurst P: Social and ethnic differences in attendance for antenatal care in England. Public health. 2008, 122 (12): 1363-1372.CrossRefPubMed
15.
go back to reference Raleigh VS, Hussey D, Seccombe I, Hallt K: Ethnic and social inequalities in women’s experience of maternity care in England: results of a national survey. J R Soc Med. 2010, 103 (5): 188-198.CrossRefPubMedPubMedCentral Raleigh VS, Hussey D, Seccombe I, Hallt K: Ethnic and social inequalities in women’s experience of maternity care in England: results of a national survey. J R Soc Med. 2010, 103 (5): 188-198.CrossRefPubMedPubMedCentral
16.
go back to reference Jomeen J, Redshaw M: Ethnic minority women’s experience of maternity services in England. Ethn Health. 2013, 18 (3): 280-296.CrossRefPubMed Jomeen J, Redshaw M: Ethnic minority women’s experience of maternity services in England. Ethn Health. 2013, 18 (3): 280-296.CrossRefPubMed
17.
go back to reference Hayes L: Unequal access to midwifery care: a continuing problem?. J Adv Nurs. 1995, 21 (4): 702-707.CrossRefPubMed Hayes L: Unequal access to midwifery care: a continuing problem?. J Adv Nurs. 1995, 21 (4): 702-707.CrossRefPubMed
18.
go back to reference Redshaw M, Heikkila K: Ethnic differences in women’s worries about labour and birth. Ethn Health. 2011, 16 (3): 213-223.CrossRefPubMed Redshaw M, Heikkila K: Ethnic differences in women’s worries about labour and birth. Ethn Health. 2011, 16 (3): 213-223.CrossRefPubMed
19.
go back to reference House of Commons Health Services Committee: Second report: maternity services. 1992, London: House of Commons House of Commons Health Services Committee: Second report: maternity services. 1992, London: House of Commons
20.
go back to reference Department of Health: Maternity matters: choice, access and continuity of care in a safe service. 2007, London: DH Department of Health: Maternity matters: choice, access and continuity of care in a safe service. 2007, London: DH
21.
go back to reference Department of Health: Making it better for mother and baby: clinical case for change. National clinical director for children, young people and maternity services. Edited by: Shribman S. 2007, London: DH Department of Health: Making it better for mother and baby: clinical case for change. National clinical director for children, young people and maternity services. Edited by: Shribman S. 2007, London: DH
22.
go back to reference Gerrish K: Researching ethnic diversity in the British NHS: methodological and practical concerns. J Adv Nurs. 2000, 31 (4): 918-925.CrossRefPubMed Gerrish K: Researching ethnic diversity in the British NHS: methodological and practical concerns. J Adv Nurs. 2000, 31 (4): 918-925.CrossRefPubMed
24.
go back to reference Bowler I: 'They’re not the same as us’: midwives’ stereotypes of South Asian descent maternity patients. Sociol Health Illn. 1993, 15 (2): 157-178.CrossRef Bowler I: 'They’re not the same as us’: midwives’ stereotypes of South Asian descent maternity patients. Sociol Health Illn. 1993, 15 (2): 157-178.CrossRef
25.
go back to reference Vangen S, Stoltenberg C, Schei B: Ethnicity and use of obstetrical analgesia: do Pakistani women receive inadequate pain relief in labour?. Ethn Health. 1996, 1 (2): 161-167.CrossRefPubMed Vangen S, Stoltenberg C, Schei B: Ethnicity and use of obstetrical analgesia: do Pakistani women receive inadequate pain relief in labour?. Ethn Health. 1996, 1 (2): 161-167.CrossRefPubMed
26.
go back to reference Katbamna S: 'Race’ and childbirth. 2000, Buckingham: Open University Press Katbamna S: 'Race’ and childbirth. 2000, Buckingham: Open University Press
27.
go back to reference Barclay L, Kent D: Recent immigration and the misery of motherhood: a discussion of pertinent issues. Midwifery. 1998, 14 (1): 4-9.CrossRefPubMed Barclay L, Kent D: Recent immigration and the misery of motherhood: a discussion of pertinent issues. Midwifery. 1998, 14 (1): 4-9.CrossRefPubMed
28.
go back to reference McCourt C, Pearce A: Does continuity of carer matter to women from minority ethnic groups?. Midwifery. 2000, 16 (2): 145-154.CrossRefPubMed McCourt C, Pearce A: Does continuity of carer matter to women from minority ethnic groups?. Midwifery. 2000, 16 (2): 145-154.CrossRefPubMed
30.
go back to reference Heeringa SG, West BT: P.A B: applied survey data analysis. 2010, London: Chapman & Hall/CRCCrossRef Heeringa SG, West BT: P.A B: applied survey data analysis. 2010, London: Chapman & Hall/CRCCrossRef
31.
go back to reference Redshaw M, Heikkila K: Delivered with care: a national survey of women’s experience of maternity care 2010. 2010, Oxford: NPEU Redshaw M, Heikkila K: Delivered with care: a national survey of women’s experience of maternity care 2010. 2010, Oxford: NPEU
32.
go back to reference Gupta JK, Hofmeyr GJ, Shehmar M: Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2012, 5: CD002006 Gupta JK, Hofmeyr GJ, Shehmar M: Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2012, 5: CD002006
33.
go back to reference Hodnett ED, Gates S, Hofmeyr GJ, Sakala C: Continuous support for women during childbirth. Cochrane Database Syst Rev. 2012, 10: CD003766 Hodnett ED, Gates S, Hofmeyr GJ, Sakala C: Continuous support for women during childbirth. Cochrane Database Syst Rev. 2012, 10: CD003766
34.
go back to reference Jayaweera H, Joshi H, Macfarlane A: Pregnancy and childbirth. Children of the 21st century: from birth to nine months. Edited by: Dex S, Joshi H. 2005, Bristol: The Policy Press Jayaweera H, Joshi H, Macfarlane A: Pregnancy and childbirth. Children of the 21st century: from birth to nine months. Edited by: Dex S, Joshi H. 2005, Bristol: The Policy Press
35.
go back to reference Rowe R, Puddicombe D, Hockley C, Redshaw M: Offer and uptake of prenatal screening for down syndrome in women from different social and ethnic backgrounds. Prenat Diagn. 2008, 28 (13): 1245-1250.CrossRefPubMed Rowe R, Puddicombe D, Hockley C, Redshaw M: Offer and uptake of prenatal screening for down syndrome in women from different social and ethnic backgrounds. Prenat Diagn. 2008, 28 (13): 1245-1250.CrossRefPubMed
36.
go back to reference Garcia J, Redshaw M, Fitzsimons B, Keene J: First class delivery: a national survey of women’s views of maternity care. 1998, London: Audit Commission Garcia J, Redshaw M, Fitzsimons B, Keene J: First class delivery: a national survey of women’s views of maternity care. 1998, London: Audit Commission
37.
go back to reference Small R, Rice PL, Yelland J, Lumley J: Mothers in a new country: the role of culture and communication in Vietnamese, Turkish and Filipino women’s experiences of giving birth in Australia. Women Health. 1999, 28 (3): 77-101.CrossRefPubMed Small R, Rice PL, Yelland J, Lumley J: Mothers in a new country: the role of culture and communication in Vietnamese, Turkish and Filipino women’s experiences of giving birth in Australia. Women Health. 1999, 28 (3): 77-101.CrossRefPubMed
38.
go back to reference Yelland JS, Sutherland GA, Brown SJ: Women’s experience of discrimination in Australian perinatal care: the double disadvantage of social adversity and unequal care. Birth. 2012, 39 (3): 211-220.CrossRefPubMed Yelland JS, Sutherland GA, Brown SJ: Women’s experience of discrimination in Australian perinatal care: the double disadvantage of social adversity and unequal care. Birth. 2012, 39 (3): 211-220.CrossRefPubMed
39.
go back to reference Redshaw M, Rowe R, Hockley C, Brocklehurst P: Recorded delivery: a national survey of women’s experience of maternity care 2006. 2007, Oxford: NPEU Redshaw M, Rowe R, Hockley C, Brocklehurst P: Recorded delivery: a national survey of women’s experience of maternity care 2006. 2007, Oxford: NPEU
40.
go back to reference Hirst J, Hewison J: Hospital postnatal care: obtaining the views of Pakistani and indigenous 'white’ women. Clin Eff Nurs. 2002, 6: 10-18.CrossRef Hirst J, Hewison J: Hospital postnatal care: obtaining the views of Pakistani and indigenous 'white’ women. Clin Eff Nurs. 2002, 6: 10-18.CrossRef
41.
go back to reference Health and Social Care Information Centre IR: Infant feeding survey 2010. 2012, London: Health and Social Care Information Centre Health and Social Care Information Centre IR: Infant feeding survey 2010. 2012, London: Health and Social Care Information Centre
42.
go back to reference Lyons SM, O’Keeffe FM, Clarke AT, Staines A: Cultural diversity in the Dublin maternity services: the experiences of maternity service providers when caring for ethnic minority women. Ethn Health. 2008, 13 (3): 261-276.CrossRefPubMed Lyons SM, O’Keeffe FM, Clarke AT, Staines A: Cultural diversity in the Dublin maternity services: the experiences of maternity service providers when caring for ethnic minority women. Ethn Health. 2008, 13 (3): 261-276.CrossRefPubMed
43.
go back to reference Heslehurst N, Sattar N, Rajasingam D, Wilkinson J, Summerbell CD, Rankin J: Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England. BMC Pregnancy Childbirth. 2012, 12 (1): 156-CrossRefPubMedPubMedCentral Heslehurst N, Sattar N, Rajasingam D, Wilkinson J, Summerbell CD, Rankin J: Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England. BMC Pregnancy Childbirth. 2012, 12 (1): 156-CrossRefPubMedPubMedCentral
Metadata
Title
Experiencing maternity care: the care received and perceptions of women from different ethnic groups
Authors
Jane Henderson
Haiyan Gao
Maggie Redshaw
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-196

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