TOG Release: Factors Impeding Access To Good Maternal Healthcare For Ethnic Minority Women In The UK

Main Category: Pregnancy / Obstetrics
Also Included In: Nursing / Midwifery
Article Date: 17 Jul 2008 - 1:00 PDT

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The lack of a fall in the maternal death rate in the latest report by the Confidential Enquiry into Maternal and Child Health (CEMACH) has been partly attributed to the increasing percentage of births from immigrant women.

Women from ethnic minority groups (defined as those other than white British women), immigrants, refugees, asylum seekers and those from the gypsy population have been identified as being significantly more at risk of maternal mortality. Many of these women experience a range of complex medical and personal problems. A new paper to be published in The Obstetrician & Gynaecologist (TOG) examines why the maternal death rate is higher in these sections of UK society.

Researchers looked at the evidence from previous CEMACH reports and 34 relevant published papers. They examined the particular obstetric risks which such women are prone to, their access to care, the quality of care received and their perceptions of the maternity care received.

Several organisational issues were detected as risk factors:

- Communication problems - there are inadequate translation services for non-English speaking women and the written information provided to them is usually poor.

- Poor access to care - many were unlikely to attend antenatal classes or were more likely to present late when compared to white British women.

- Substandard care provision - the expectations of many of these women were not met. This was a result of systemic failures within maternity services to cater to these women's special needs and also down to the women themselves and their poor understanding of the services available to them.

Levels of healthcare for these women vary from trust to trust. The authors of the paper suggest better monitoring and evaluation of the strategies implemented and for more research to be conducted into the healthcare needs of this particular group of women.

Nynke van den Broek, Senior Clinical Lecturer in Sexual and Reproductive Health at the Liverpool School of Tropical Medicine who co-authored the paper said, "Women belonging to an ethnic minority group, in particular asylum seekers and refugees, have an increased risk of maternal mortality. The women most affected are those who are newly arrived in the UK.

"There is evidence to suggest that care received by these women is substandard and that these women experience barriers to accessing maternal health care."

Professor Neil McClure, TOG editor-in-chief said, "Caring for women from ethnic backgrounds is a complex issue facing all NHS staff working in maternity services. Although we would seek to individualise care for all patients, we must be particularly aware of the need to be sensitive to different cultural attitudes towards pregnancy and childbirth and to the often frightening experience of attending hospital. Many new immigrants see hospitals as a place of last resort and not for routine obstetric care. "Ultimately, we must offer high quality safe care, for all mothers, regardless of their nationality and circumstances."

Notes

The Obstetrician & Gynaecologist (TOG) is published quarterly and is the Royal College of Obstetricans and Gynaecologists' (RCOG) medical journal for continuing professional development. TOG is an editorially independent, peer reviewed journal aimed at providing health professions with updated information about scientific, medical and clinical developments in the specialty of obstetrics and gynaecology.

Reference

Increased risk of maternal death among ethnic minority women in the UK.
Ameh CA, van den Broek N.
The Obstetrician & Gynaecologist 2008;10:177-182.

Royal College of Obstetricans and Gynaecologists