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Open Access 01-12-2015 | Research

Immigrant women’s experiences of maternity-care services in Canada: a systematic review using a narrative synthesis

Authors: Gina MA Higginbottom, Myfanwy Morgan, Mirande Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay, Rubina Barolia

Published in: Systematic Reviews | Issue 1/2015

Abstract

Background

Canada’s diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. Our focus was on (a) the accessibility and acceptability of maternity-care services for immigrant women and (b) the effects of the perceptions and experiences of these women on their birth and postnatal outcomes.

Methods

We conducted a systematic review using a systematic search and narrative synthesis of peer-reviewed and non-peer-reviewed reports of empirical research, with the aim of providing stakeholders with perspectives on maternity-care services as experienced by immigrant women. We partnered with key stakeholders (‘integrated knowledge users’) to ensure the relevancy of topics and to tailor recommendations for effective translation into future policy, practice and programming. Two search phases and a three-stage selection process for published and grey literature were conducted prior to appraisal of literature quality and narrative synthesis of the findings.

Results

Our knowledge synthesis of maternity care among immigrants to Canada provided a coherent evidence base for (a) eliciting a better understanding of the factors that generate disparities in accessibility, acceptability and outcomes during maternity care; and (b) improving culturally based competency in maternity care. Our synthesis also identified pertinent issues in multiple sectors that should be addressed to configure maternity services and programs appropriately.

Conclusions

Although immigrant women in Canada are generally given the opportunity to obtain necessary services, they face many barriers in accessing and utilising these services. These barriers include lack of information about or awareness of the services, insufficient supports to access these services and discordant expectations between the women and their service providers.

Systematic review registration

PROSPERO registration number: CRD42012002185.

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Statistics Canada: Chart 2: Immigrant population. In 2006 Census of the Population. Ottawa, ON: Statistics Canada; 2007. http://www.statcan.gc.ca/pub/12-581-x/2010000/c-g/desc/desc-c-g2-eng.htm

Statistics Canada: Projections of the diversity of the Canadian population. Ottawa, ON: Statistics Canada Demography Division; 2010. http://www.statcan.gc.ca/pub/91-551-x/91-551-x2010001-eng.pdf

Justice Laws Websites: Constitution Act. 1982. See http://laws-lois.justice.gc.ca/eng/const/page-15.html

Newbold KB: Self-rated health within the Canadian immigrant population: Risk and the healthy immigrant effect. Soc Sci Med. 2005, 60: 1359–70. 10.1016/j.socscimed.2004.06.048CrossRefPubMed

Hyman I: Immigration and health: reviewing evidence of the healthy immigrant effect in Canada. CERIS Working Paper # 55. Toronto, ON: Joint Centre of Excellence for Research on Immigration and Settlement; 2007. http://ceris.metropolis.net/wp-content/uploads/pdf/research_publication/working_papers/wp55.pdf

Gagnon AJ, Zimbeck M, Zeitlin J, ROAM Collaboration, et al.: Migration to western industrialized countries and perinatal health: a systematic review. Soc Sci Med. 2009, 69: 934–46. 10.1016/j.socscimed.2009.06.027CrossRefPubMed

Small R, Gagnon A, Gissler M, Zeitlin J, Bennis M, Glazier RH, et al.: Somali women and their pregnancy outcomes postmigration: data from six receiving countries. BJOG. 2008, 115: 1630–40. 10.1111/j.1471-0528.2008.01942.xCrossRefPubMedPubMedCentral

Urquia M, Frank JW, Glazier RH: From places to flows. International secondary migration and birth outcomes. Soc Sci Med 2010, 71: 1620–6. 10.1016/j.socscimed.2010.08.006CrossRefPubMed

Guendelman S, Buekens P, Blondel B, Kaminski M, Notzon FC, Masuy-Stroobant G: Birth outcomes of immigrant women in the United States, France and Belgium. Matern Child Health J. 1999, 3: 177–87. 10.1023/A:1022328020935CrossRefPubMed

10.

Bollini P, Pampallona S, Wanner P, Kupelnick B: Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med. 2009, 68: 452–61. 10.1016/j.socscimed.2008.10.018CrossRefPubMed

11.

Urquia M, Frank JW, Glazier RH, Moineddin R: Birth outcomes by neighbourhood income and recent immigration in Toronto. Health Rep. 2007, 18: 1–10.

12.

Malin M, Gissler M: Maternal care and birth outcomes among ethnic minority women in Finland. BMC Public Health. 2009, 9: 84. 10.1186/1471-2458-9-84CrossRefPubMedPubMedCentral

13.

Gissler M, Alexander S, MacFarlane A, Small R, Stray-Pedersen B, Zeitlin J, et al.: Stillbirths and infant deaths among immigrants in industrialized countries. Acta Obstet Gynecol Scand. 2009, 88: 134–48. 10.1080/00016340802603805CrossRefPubMed

14.

Hyman I, Dussault G: Negative consequences of acculturation on health behaviour, social support and stress among pregnant Southeast Asian immigrant women in Montreal: an exploratory study. Can J Public Health. 2000, 91: 357–60.PubMed

15.

Urquia ML, Frank JW, Moineddin R, Glazier RH: Immigrants’ duration of residence and adverse birth outcomes: a population-based study. BJOG. 2010, 117: 591–601. 10.1111/j.1471-0528.2010.02523.xCrossRefPubMedPubMedCentral

16.

Renzaho A, Skouteris H, Oldroyd J: Preventing gestational diabetes mellitus among migrant women and reducing obesity and type 2 diabetes in their offspring: a call for culturally competent lifestyle interventions in pregnancy. J Am Diet Assoc. 2010, 110: 1814–7. 10.1016/j.jada.2010.09.017CrossRefPubMed

17.

Urquia M, Glazier RH, Berger H: Gestational diabetes among immigrant women. Epidemiology. 2011, 22: 879–80. 10.1097/EDE.0b013e31823199eeCrossRefPubMed

18.

Grewal SK, Bhagat R, Balneaves LG: Perinatal beliefs and practices of immigrant Punjabi women living in Canada. J Obstet Gynecol Neonatal Nurs. 2008, 37: 290–300. 10.1111/j.1552-6909.2008.00234.xCrossRefPubMed

19.

Nybo M, Friis-Hansen L, Felding P, Milman N: Higher prevalence of anemia among pregnant immigrant women compared to pregnant ethnic Danish women. Ann Hematol. 2007, 86: 647–51. 10.1007/s00277-007-0305-7CrossRefPubMed

20.

Matthey S, Panasetis P, Barnett B: Adherence to cultural practices following childbirth in migrant Chinese women and relation to postpartum mood. Health Care Women Int. 2002, 23: 567–75. 10.1080/07399330290107331CrossRefPubMed

21.

Essen B, Johnsdotter S, Hovelius B, Gudmundsson S, Sjoberg N-O, Friedman J, et al.: Qualitative study of pregnancy and childbirth experiences in Somalian women resident in Sweden. Brit J Obstet Gynaecol. 2000, 107: 1507–12. 10.1111/j.1471-0528.2000.tb11676.xCrossRef

22.

Wang L, Rosenburg M, Lo L: Ethnicity and utilisation of family physicians: a case study of Mainland Chinese immigrants in Toronto. Canada. Soc Sci Med. 2008, 67: 1410–22. 10.1016/j.socscimed.2008.06.012CrossRefPubMed

23.

Hyman I: Immigration and health. Working Paper 01–05. Ottawa, ON: Health Canada; 2001.

24.

Reitmanova S, Gustafson DL: “They can’t understand it”: maternity health and care needs of immigrant Muslim women in St John’s, Newfoundland. Matern Child Health. 2008, 12: 101–11. 10.1007/s10995-007-0213-4CrossRef

25.

Karlsen S, Nazroo JY: Agency and structure: the impact of ethnic identity and racism on the health of ethnic minority people. Sociol Health Illn. 2002, 24: 1–20. 10.1111/1467-9566.00001CrossRef

26.

Newbold KB: Health status and health care of immigrants in Canada: a longitudinal analysis. J Health Serv Res Policy. 2005, 10: 77–83A. 10.1258/1355819053559074CrossRefPubMed

27.

Napoles-Springer AM, Santoyo J, Houston K, Perez-Stable EJ, Stewart AL: Patients’ perceptions of cultural factors affecting the quality of their medical encounters. Health Expect. 2005, 8: 4–17. 10.1111/j.1369-7625.2004.00298.xCrossRefPubMedPubMedCentral

28.

Public Health Agency of Canada: What Mothers Say: The Canadian Maternity Experiences Survey. Ottawa, ON: Public Health Agency of Canada, Maternal and Infant Health Section; 2009. http://www.publichealth.gc.ca/mes

29.

Gagnon AJ, Carnevale FA, Saucier JF, Clausen C, Jeannotte J, Oxman-Martinez J: Do referrals work? Responses of childbearing newcomers to referrals for care. J Immigr Minor Health. 2010, 12: 559–68. 10.1007/s10903-009-9242-yCrossRefPubMed

30.

Gagnon AJ, Dougherty G, Platt RW, Wahoush O, George A, Stanger E, et al.: Refugee and refugee-claimant women and infants post-birth: migration histories as a predictor of Canadian health system response to needs. Can J Public Health. 2007, 98: 287–91.PubMed

31.

Bharj K, Salway S: Addressing ethnic inequalities in maternity service experiences and outcomes: responding to women’s needs and preferences. A Race Equality Better Health Briefing Paper No. 11. London, UK: Race Equality Foundation; 2008. http://www.better-health.org.uk/sites/default/files/briefings/downloads/health-brief11.pdf

32.

Davies M, Bath PA: The maternity information concerns of Somali women in the United Kingdom. J Adv Nurs. 2001, 36: 237–45. 10.1046/j.1365-2648.2001.01964.xCrossRefPubMed

33.

D’Souza L, Garcia J: Improving services for disadvantaged childbearing women. Child Care Health Dev. 2004, 30: 599–611. 10.1111/j.1365-2214.2004.00471.xCrossRefPubMed

34.

Small R, Yelland J, Lumley J, Brown S, Liamputtong P: Immigrant women’s views about care during labor and birth: an Australian study of Vietnamese, Turkish, and Filipino women. Birth. 2000, 29: 266–77.CrossRef

35.

Gagnon AJ, Edgar L, Kramer MS, Papageorgiou A, Waghorn K, Klein MC: A randomized trial of a program of early postpartum discharge with nurse visitation. Am J Obstet Gynecol 1997,176(1 Pt 1):205–11.CrossRefPubMed

36.

Carolan M, Cassar L: Antenatal care perceptions of pregnant African women attending maternity services in Melbourne, Australia. Midwifery. 2010, 26: 189–201. 10.1016/j.midw.2008.03.005CrossRefPubMed

37.

Fisher JA, Bowman M, Thomas T: Issues for South Asian Indian patients surrounding sexuality, fertility, and childbirth in the US health care system. J Am Board Fam Pract. 2003, 16: 151–5. 10.3122/jabfm.16.2.151CrossRefPubMed

38.

Hammoud M, White CB, Fetters MD: Opening cultural doors: providing culturally sensitive healthcare to Arab American and American Muslim patients. Am J Obstet Gynecol. 2005, 193: 1307–11. 10.1016/j.ajog.2005.06.065CrossRefPubMed

39.

Canadian Institute of Health Research (CIHR): Guide to Knowledge Translation Planning at CIHR: Integrated and End‒of‒Grant Approaches. Ottawa, ON, Canada: Canadian Institutes of Health Research; 2009. http://www.cihr-irsc.gc.ca/e/45321.htm

40.

Canadian Council of Refugees: Refugees and immigrants: A Glossary. http://ccrweb.ca/sites/ccrweb.ca/files/static-files/glossary.PDF

41.

Urquia M, Gagnon AJ: Glossary: migration and health. J Epidemiol Community Health. 2011, 65: 467–72. 10.1136/jech.2010.109405CrossRefPubMed

42.

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al.: Guidance on the conduct of narrative synthesis in systematic reviews: a product from the ESRC Methods Programme. Lancaster, UK: Institute for Health Research, Lancaster University; 2006. http://www.lancs.ac.uk/shm/research/nssr/research/dissemination/publications/NS_Synthesis_Guidance_v1.pdf

43.

Academy Health National Institutes of Health: United States National Library of Medicine. Health Services Research and Health Policy Grey Literature Project: summary report 2006. http://www.nlm.nih.gov/nichsr/greylitreport_06.html

44.

Higginbottom GM, Morgan M, Dassanayake J, Eyford H, Alexandre M, Chiu Y, et al.: Immigrant women’s experiences of maternity-care services in Canada: a protocol for systematic review using a narrative synthesis. Syst Rev 2012,1(1):27. 10.1186/2046-4053-1-27CrossRefPubMedPubMedCentral

45.

Joanna Briggs Institute: Reviewers’ manual. 2011. http://www.joannabriggs.edu.au/Documents/sumari/Reviewers%20Manual-2011.pdf

46.

Critical Appraisal Skills Programme: Making sense of evidence. Oxford, UK: Better Value Healthcare; http://www.casp-uk.net/#!casp-tools-checklists/c18f8

47.

Crombie LK: The pocket guide to critical appraisal. London: BMJ Publishing Group; 1996.

48.

Higginbottom GM, Hadziabdic E, Yohani S, Paton P: Immigrant women’s experience of maternity services in Canada: a meta-ethnography. Midwifery 2014,30(5):544–59. 10.1016/j.midw.2013.06.004CrossRefPubMed

49.

Gough D: Weight of evidence: a framework for the appraisal of the quality and relevance of evidence. Res Pap Educ 2007, 22: 213–28. http://eprints.ioe.ac.uk/5532/ 10.1080/02671520701296189CrossRef

50.

Roen K, Arai L, Roberts H, Popay J: Extending systematic reviews to include evidence on implementation: methodological work on a review of community-based initiatives to prevent injuries. Soc Sci & Med. 2006, 63: 1069–71.CrossRef

51.

Denzin N, Lincoln Y, Tuhiwai Smith L (Eds): Handbook of critical and indigenous methodologies. Thousand Oaks, CA: Sage Publications; 2008. Dinzi

52.

Brar S, Tang S, Drummond N, Palacios-Derflingher L, Clark V, John M, et al.: Perinatal care for South Asian immigrant women and women born in Canada: telephone survey of users. J Obstet Gynaecol Can 2009,31(8):708–16.CrossRefPubMed

53.

Chalmers B, Omer-Hashi K: 432 Somali women’s birth experiences in Canada after earlier female genital mutilation. Birth 2000,7(4):227–34.CrossRef

54.

Jarvis C, Munoz M, Graves L, Stephenson R, D’Souza V, Jimenez V: Retrospective review of prenatal care and perinatal outcomes in a group of uninsured pregnant women. J Obstet Gynaecol Can 2011,33(3):235–43.CrossRefPubMed

55.

Kingston D, Heaman M, Chalmers B, Kaczorowski J, O’Brien B, Lee L, et al.: Comparison of maternity experiences of Canadian-born and recent and non-recent immigrant women: findings from the Canadian Maternity Experiences Survey. J Obstet Gynaecol Can 2011,33(11):1105–15.CrossRefPubMed

56.

Loiselle CG, Semenic SE, Cote B, Lapointe M, Gendron R: Impressions of breastfeeding information and support among first-time mothers within a multiethnic community. Can J Nurs Res 2001,33(3):31–46.PubMed

57.

Poole GD, Ting K: Cultural differences between Euro-Canadian and Indo-Canadian maternity patients. J Soc Psychol 1995,135(5):631–44. 10.1080/00224545.1995.9712236CrossRef

58.

Stewart DE, Gagnon A, Saucier J, Wahoush O, Dougherty G: Postpartum depression symptoms in newcomers. Can J Psychiatry 2008,53(2):121–4.CrossRefPubMed

59.

Wallace D, Faber AJ, Chatur F, Chen S: Family-centered care: determining the programming needs and key access issues of Calgary’s ethnocultural communities. Calgary, AB, Canada: Calgary Health Region; 2002. [Obtained from one of the authors.]

60.

Sutton J, He M, Despard C, Evans A: Barriers to breastfeeding in a Vietnamese community: a qualitative exploration. Can J Diet Pract Res 2007,68(4):195–200. 10.3148/68.4.2007.195CrossRefPubMed

61.

Sabotka T: Overview Chapter 7: The rising importance of migrants for childbearing in Europe. Demogr Res 2008,19(9):225–48.CrossRef

62.

Ardal F, Sulman J, Fuller-Thomson E: Support like a walking stick: parent-buddy matching for language and culture in the NICU. Neonatal Netw 2011,30(2):89–98. 10.1891/0730-0832.30.2.89CrossRefPubMed

63.

Katz D, Gagnon AJ: Evidence of adequacy of postpartum care for immigrant women. Can J Nurs Res 2002,34(4):71–81.PubMed

64.

Morrow M, Smith JE, Lai Y, Jaswal S: Shifting landscapes: immigrant women and postpartum depression. Health Care Women Int 2008,29(6):593–617. 10.1080/07399330802089156CrossRefPubMed

65.

Chalmers B, Omer-Hashi K: What Somali women say about giving birth in Canada. J Reprod Infant Psychol 2002,20(4):267–82. 10.1080/0264683021000033183CrossRef

66.

Spitzer DL: In visible bodies: minority women, nurses, time, and the new economy of care. Med Anthropol Q 2004,18(4):490–508. 10.1525/maq.2004.18.4.490CrossRefPubMed

67.

Wiebe A, Young B: Parent perspectives from a neonatal intensive care unit: a missing piece of the culturally congruent care puzzle. J Transcult Nurs. 2011,22(1):77–82. http://dx.doi.org/10.1177/1043659609360850 10.1177/1043659609360850CrossRefPubMed

68.

Minde K, Tidmarsh L, Hughes S: Nurses’ and physicians’ assessment of mother-infant mental health at the first postnatal visits. J Am Acad Child Adolesc Psychiatry 2001,40(7):803–10. 10.1097/00004583-200107000-00015CrossRefPubMed

69.

Sword W, Watt S, Krueger P: Postpartum health, service needs, and access to care experiences of immigrant and Canadian-born women. J Obstet Gynecol Neonatal Nurs 2006,35(6):717–27. 10.1111/j.1552-6909.2006.00092.xCrossRefPubMed

70.

Ahmed A, Stewart DE, Teng L, Wahoush O, Gagnon AJ: Experiences of immigrant new mothers with symptoms of depression. Arch Womens Ment Health. 2008,11(4):295–303. http://dx.doi.org/10.1007/s00737-008-0025-6 10.1007/s00737-008-0025-6CrossRefPubMed

71.

Merry LA, Gagnon AJ, Kalim N, Bouris SS: Refugee claimant women and barriers to health and social services post-birth. Can J Public Health 2011,102(4):286–90.PubMed

Title: Immigrant women’s experiences of maternity-care services in Canada: a systematic review using a narrative synthesis
Authors: Gina MA Higginbottom
Myfanwy Morgan
Mirande Alexandre
Yvonne Chiu
Joan Forgeron
Deb Kocay
Rubina Barolia
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Systematic Reviews / Issue 1/2015
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/2046-4053-4-13

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Immigrant women’s experiences of maternity-care services in Canada: a systematic review using a narrative synthesis

Abstract

Background

Methods

Results

Conclusions

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Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Systematic review registration

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