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Medway P, Hutchinson A, Sweet L. In what ways does maternity care in Australia align with the values and principles of the national maternity strategy? A scoping review. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 37:100900. [PMID: 37634300 DOI: 10.1016/j.srhc.2023.100900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 07/13/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
Australia's national maternity strategy Woman-centred care: strategic directions for Australian maternity services (the Strategy) was released by the federal government in November 2019. It was developed to provide national guidance on the effective provision of woman-centred maternity care. The Strategy is structured around four values of safety, respect, choice, and access, and underpinned by twelve principles of woman-centred care. By examining previous research, this review aims to provide a baseline understanding of how maternity care provision is being met in relation to these core values. A systematic search of Australian literature was undertaken via four databases using the Strategy's values and 41 articles met the selection criteria. Include articles were predominantly published pre-2019, providing a baseline understanding of Australian maternity care provision prior to the Strategy's publication. Findings suggest that the four values align with those of women; however, women were not always receiving care in accordance with the values, particularly among women from priority populations. Women prioritised safety for themselves and their babies, articulated the need for respectful relationships with maternity care providers, wanted autonomy to make their own decisions, and desired access to appropriate, local, maternity services. Additionally, while pockets of appropriate care do exist, these are more likely to occur at a single-service level than more broadly at a population level. This implies the Strategy is needed, and its operationalisation must be prioritised through a coordinated national response to better meet the maternity care needs of Australian women. Further research is warranted to determine the Strategy's effectiveness.
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Affiliation(s)
- Paula Medway
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia. https://twitter.com/@PaulaMedway
| | - Alison Hutchinson
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia
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Reppen K, Henriksen L, Schei B, Magnussen EB, Infanti JJ. Experiences of childbirth care among immigrant and non-immigrant women: a cross-sectional questionnaire study from a hospital in Norway. BMC Pregnancy Childbirth 2023; 23:394. [PMID: 37245035 DOI: 10.1186/s12884-023-05725-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/20/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Immigrant women have higher risks for poor pregnancy outcomes and unsatisfactory birth experiences than the general population. The mechanisms behind these associations remain largely unknown, but they may result from differential care provided to immigrant women or unsatisfactory interactions with health providers. This study aimed to investigate immigrant and non-immigrant women's experiences of health care during childbirth, particularly assessing two dimensions: perceived general quality of care and attainment of health care needs during childbirth. METHODS This was a cross-sectional study carried out over 15 months in 2020 and 2021, and data were collected from a self-completed questionnaire. The labour and birth subscale from the Experience of Maternity Care questionnaire was used to assess the primary outcome of care experiences. A total of 680 women completed the questionnaire approximately within two days after birth (mean 2.1 days) at a hospital in Trondheim, in central Norway. The questionnaire was provided in eight languages. RESULTS The 680 respondents were classified as immigrants (n = 153) and non-immigrants (n = 527). Most women rated their quality of care during childbirth as high (91.5%). However, one-quarter of the women (26.6%) reported unmet health care needs during childbirth. Multiparous immigrant women were more likely than multiparous non-immigrant women to report that their health care needs were unmet during childbirth (OR: 3.31, 95% CI: 1.91-5.72, p < 0.001, aOR: 2.83, 95% CI: 1.53-5.18, p = 0.001). No other significant differences between immigrant versus non-immigrant women were found in subjective ratings of childbirth care experiences. Having a Norwegian-born partner and a high level of Norwegian language skills did not influence the immigrant women's experience of childbirth care. CONCLUSIONS Our findings indicate that many women feel they receive high-quality health care during childbirth, but a considerable number still report not having their health care needs met. Also, multiparous immigrant women report significantly more unmet health care needs than non-immigrants. Further research is required to assess immigrant women's childbirth experiences and for health care providers to give optimal care, which may need to be tailored to a woman's cultural background and individual expectations.
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Affiliation(s)
- Kristin Reppen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Berit Schei
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Obstetrics and Gynecology, St. Olavs University Hospital, Trondheim, Norway
| | - Elisabeth Balstad Magnussen
- Division of Obstetrics and Gynecology, St. Olavs University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jennifer Jean Infanti
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Asim S, Nichini E, Goggins WB, Dong D, Yeoh EK. Maternity care experience of Pakistani ethnic minority women in Hong Kong. Front Public Health 2023; 11:1009214. [PMID: 36935720 PMCID: PMC10014597 DOI: 10.3389/fpubh.2023.1009214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Background Persistent inequalities in maternity care experience and outcomes exist globally for ethnic minority (EM) and migrant women. Despite the fact that this is an important research area, no prior study has been done in Hong Kong (HK) to examine maternity care experience of EM women. Objectives To investigate maternity care experience of Pakistani EM women (both local born and immigrants) during pregnancy, birth and after birth in hospital in HK. An evaluation of their satisfaction and factors predicting satisfaction with care during the three phases of maternity care was included in the study. Methods A cross sectional survey was conducted among Pakistani EM women who had given birth in HK in last 3 years, using a structured questionnaire by a bilingual interviewer, from April to May 2020. Counts and percentages were used to describe all categorical variables. Association between predictor variables and overall satisfaction was assessed by bivariate analysis and multiple logistic regression. Results One hundred and twenty questionnaires were completed. Almost 60 percent of the women were very satisfied with the overall care. More than half of the women described the care they received as kind, respectful and well communicated. After adjusting for age and parity, HK born Pakistani women expressed relatively less satisfaction with care, especially during pregnancy and labor and birth, as compared with Pakistan born women. Women with conversational or fluent English-speaking ability also felt comparatively less satisfied particularly from intrapartum and postnatal care in hospital. Education level had a negative association with satisfaction with care during pregnancy. Conclusions Maternity care providers should take into account the diversity of EM women population in HK. Our findings suggest that effective communication and care that can meet individual needs, expectations, and values is imperative to improve experience and quality of maternity care for EM women in HK.
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Affiliation(s)
- Saba Asim
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Elena Nichini
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - William Bernard Goggins
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Hong Kong, Hong Kong SAR, China
- *Correspondence: Dong Dong
| | - Eng-King Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Hong Kong, Hong Kong SAR, China
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Väisänen H, Remes H, Martikainen P. Perinatal health among migrant women: A longitudinal register study in Finland 2000-17. SSM Popul Health 2022; 20:101298. [DOI: 10.1016/j.ssmph.2022.101298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
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Dube M, Gao Y, Steel M, Bromley A, Ireland S, Kildea S. Effect of an Australian community-based caseload midwifery group practice service on maternal and neonatal outcomes for women from a refugee background. Women Birth 2022; 36:e353-e360. [PMID: 36344389 DOI: 10.1016/j.wombi.2022.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Women from a refugee background who resettle in high-income countries experience poorer perinatal outcomes in comparison to women from host countries. There is a paucity of research on how best to improve these outcomes. AIM To report on the effectiveness of an Australian Refugee Midwifery Group Practice service on perinatal outcomes. METHODS We used inverse probability of treatment weighting to balance confounders and calculate treatment effect and compare maternal and neonatal outcomes for women from a refugee background who received Refugee Midwifery Group Practice care (n = 625), to those receiving standard care (n = 634) at a large tertiary hospital (1 January 2016-31 December 2019). Prespecified primary outcomes included: proportion of women attending ≥ 5 antenatal visits, preterm birth (<37 weeks), spontaneous onset of labour, epidural analgesia in the first stage of labour, normal birth (term, spontaneous onset, vertex, spontaneous vaginal birth, no epidural, no episiotomy), and exclusively breast-feeding at discharge. FINDINGS Women who received Refugee Midwifery Group Practice care were more likely to have spontaneous onset of labour (adjusted odds ratio 2·20, 95% CI 1·71-2·82; p < 0·0001), normal birth (1·55, 1·23-1·95; p < 0·0001), and less likely to use epidural analgesia (0·67, 0·50-0·89; p = 0·0067) and have a preterm baby (0·60, 0·36-0·99; p = 0·047). There was no difference between groups in women attending ≥ 5 antenatal visits and exclusive breastfeeding at discharge from hospital. DISCUSSION A Refugee Midwifery Group Practice is feasible and clinically effective. CONCLUSION Similar services could potentially improve outcomes for women from a refugee background who resettle in high-income countries.
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Affiliation(s)
- Mpho Dube
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Michelle Steel
- Mater Mothers Hospital, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Angela Bromley
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Sarah Ireland
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane City, Queensland 4000, Australia.
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Miller YD, Tone J, Talukdar S, Martin E. A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia. PLoS One 2022; 17:e0271105. [PMID: 35819947 PMCID: PMC9275696 DOI: 10.1371/journal.pone.0271105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022] Open
Abstract
We aimed to directly compare women’s pregnancy to postpartum outcomes and experiences across the major maternity models of care offered in Queensland, Australia. We conducted secondary analyses of self-reported data collected in 2012 from a state-wide sample of women who had recently given birth in Queensland (response rate = 30.4%). Logistic regression was used to estimate the odds of outcomes and experiences associated with three models (GP Shared Care, Public Midwifery Continuity Care, Private Obstetric Care) compared with Standard Public Care, adjusting for relevant maternal characteristics and clinical covariates. Of 2,802 women, 18.2% received Standard Public Care, 21.7% received GP Shared Care, 12.9% received Public Midwifery Continuity Care, and 47.1% received Private Obstetric Care. There were minimal differences for women in GP Shared Care. Women in Public Midwifery Continuity Care were less likely to have a scheduled caesarean and more likely to have an unassisted vaginal birth, experience freedom of mobility during labour and informed consent processes for inducing labour, vaginal examinations, fetal monitoring and receiving Syntocinon to birth their placenta, and report highest quality interpersonal care. They had fewer vaginal examinations, lower odds of perineal trauma requiring sutures and anxiety after birth, shorter postpartum hospital stays, and higher odds of a home postpartum care visit. Women in Private Obstetric Care were more likely to have their labour induced, a scheduled caesarean birth, experience informed consent processes for caesarean, and report highest quality interpersonal care, but less likely to experience unassisted vaginal birth and informed consent for Syntocinon to birth their placenta. There is an urgent need to communicate variations between maternity models across the range of outcome and experiential measures that are important to women; build more rigorous comparative evidence for Private Midwifery Care; and prioritise experiential and out-of-pocket cost comparisons in further research to enable woman-centred informed decision-making.
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Affiliation(s)
- Yvette D. Miller
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
- * E-mail:
| | - Jessica Tone
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Sutapa Talukdar
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Elizabeth Martin
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Schönborn C, Castetbon K, Sow M, Racape J, De Spiegelaere M. Mothers' experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey. BMJ Open 2020; 10:e038400. [PMID: 33257481 PMCID: PMC7705495 DOI: 10.1136/bmjopen-2020-038400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION In Europe, the social inequalities in perinatal health are usually found to be to the disadvantage of non-European immigrants and women with lower levels of education and income. Among the possible underlying mechanisms are inadequate access to healthcare services and suboptimal care. To explore this hypothesis in the Belgian context, our research will describe detailed maternal socioeconomic and migration characteristics, explore how these factors relate to each other, and how they relate to women's perinatal care trajectories and experiences of care. METHODS Using a modified version of the Migrant-Friendly Maternity Care Questionnaire, we will survey 900 mothers of Belgian nationality or a nationality from a North or Sub-Saharan African country, and having given birth in four maternity wards in Brussels. The questionnaire has been adapted to the study objectives and the Belgian context. Interviewers will administer the 116-item questionnaire to all women agreeing to participate and meeting inclusion criteria, within 14 days of having given birth. Clinical information will be extracted from hospital records. ANALYSIS We will estimate the associations of women's socioeconomic and migration characteristics with:Women's antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.Patient experience such as feelings of discrimination, respect, and understanding of information.We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions. ETHICS AND DISSEMINATION Ethical approval has been obtained from the hospital Ethics Committees and from the Université libre de Bruxelles (No: P2017/055/B406201730877). Written informed consent will be sought from all participants.In addition to disseminating findings and recommendations to the scientific community through open-source journal articles and conferences, we will also address local organisations and healthcare professionals via a written report and seminars.
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Affiliation(s)
- Claudia Schönborn
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Katia Castetbon
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Mouctar Sow
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Judith Racape
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Myriam De Spiegelaere
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
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Haugaard A, Tvedte SL, Severinsen MS, Henriksen L. Norwegian multicultural doulas' experiences of supporting newly-arrived migrant women during pregnancy and childbirth: A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 26:100540. [PMID: 32622149 DOI: 10.1016/j.srhc.2020.100540] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/03/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study was part of a project promoted with the caption 'Vulnerable, pregnant and new in Norway - Safe during childbirth with a multicultural doula.' The project aimed to provide multicultural doulas who could strengthen maternity care and give migrant women safe births. The aim of the study was to examine how the multicultural doulas experienced their work with newly arrived migrant women during pregnancy and childbirth. METHODS A qualitative approach was used for the data collection and the data was collected from nine in-depth interviews with multicultural doulas. All the participants were educated by Oslo University Hospital, Norway, where they worked as doulas. The method of data analysis was inspired by Granheim and Lundman's qualitative content analysis. RESULTS The qualitative content analysis revealed four categories: providing important knowledge, creating continuity of care for migrant women, being aware of migrant women's vulnerability, and building a cultural bridge. One main theme emerged: Feeling like a mother for vulnerable migrant women and a person who builds a cultural bridge between them and maternity care in Norway. CONCLUSION The multicultural doulas saw themselves as a resource for both newly-arrived migrant women and midwives during pregnancy and childbirth. The findings suggested that their presence can strengthen maternity care for migrant women by providing information, continuity, and a cultural bridge between migrant women and maternity care in Norway.
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Affiliation(s)
- Aina Haugaard
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
| | - Signe Larsson Tvedte
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
| | - Marit Stene Severinsen
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
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De Freitas C, Massag J, Amorim M, Fraga S. Involvement in maternal care by migrants and ethnic minorities: a narrative review. Public Health Rev 2020; 41:5. [PMID: 32280558 PMCID: PMC7137324 DOI: 10.1186/s40985-020-00121-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/16/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Guidelines for improving the quality of maternal health services emphasise women's involvement in care. However, evidence about migrant and ethnic minorities' preferences for participation in maternal care remains unsystematised. Understanding these populations' experiences with and preferred forms of involvement in care provision is crucial for imbuing policies and guidelines with sensitivity to diversity and for implementing people-centred care. This paper presents a narrative synthesis of empirical studies of involvement in maternal health care by migrants and ethnic minorities based on four key dimensions: information, communication, expression of preferences and decision-making. METHODS Studies indexed in PubMed and Scopus published until December 2019 were searched. Original quantitative, qualitative and mixed methods studies written in English and reporting on migrant and ethnic minority involvement in maternal care were included. Backward reference tracking was carried out. Three researchers conducted full-text review of selected publications. RESULTS In total, 22 studies met the inclusion criteria. The majority of studies were comparative and addressed only one or two dimensions of involvement, with an emphasis on the information and communication dimensions. Compared to natives, migrants and ethnic minorities were more likely to (1) lack access to adequate information as a result of health care staff's limited time, knowledge and misconceptions about women's needs and preferences; (2) report suboptimal communication with care staff caused by language barriers and inadequate interpreting services; (3) be offered fewer opportunities to express preferences and to have preferences be taken less into account; and (4) be less involved in decisions about their care due to difficulties in understanding information, socio-cultural beliefs and previous experiences with care provision less attuned with playing an active role in decision-making and care staff detracting attitudes. CONCLUSION Constraints to adequate and inclusive involvement in maternal care can hinder access to quality care and result in severe negative health outcomes for migrant and ethnic minority women. More research is needed into how to tailor the dimensions of involvement to migrant and ethnic minorities' needs and preferences, followed by provision of the resources necessary for effective implementation (e.g. sufficient time for consultations, optimal interpreter systems, health care staff training).
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Affiliation(s)
- Cláudia De Freitas
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Centre for Research and Studies in Sociology, University Institute of Lisbon (ISCTE-IUL), Lisbon, Portugal
| | - Janka Massag
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal
| | - Mariana Amorim
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal
| | - Sílvia Fraga
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Clesse C, Lighezzolo-Alnot J, De Lavergne S, Hamlin S, Scheffler M. Factors related to episiotomy practice: an evidence-based medicine systematic review. J OBSTET GYNAECOL 2019; 39:737-747. [DOI: 10.1080/01443615.2019.1581741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Christophe Clesse
- Interpsy Laboratory (EA4432), Université de Lorraine, Nancy, France
- Hospital Centre of Jury-les-Metz – Route d’Ars Laquenexy, Jury-Lesmetz, France
- Polyclinic Majorelle, Nancy, France
| | | | | | | | - Michèle Scheffler
- Polyclinic Majorelle, Nancy, France
- Cabinet de Gynécologie Médicale et Obstétrique, Nancy, France
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Satisfaction with obstetric care in a population of low-educated native Dutch and non-western minority women. Focus group research. PLoS One 2019; 14:e0210506. [PMID: 30703116 PMCID: PMC6354976 DOI: 10.1371/journal.pone.0210506] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/24/2018] [Indexed: 11/30/2022] Open
Abstract
Background Low-educated native Dutch and non-western minority women have inadequate access to obstetric care. Moreover, the care they receive lacks responsiveness to their needs and cultural competences. Gaining a deeper understanding of their experiences and satisfaction with antenatal, birthing and maternity care will help to adjust healthcare responsiveness to meet their needs during pregnancy, childbirth and the postpartum period. Methods We combined the World Health Organization conceptual framework of healthcare responsiveness with focus group research to measure satisfaction with antenatal, birthing and maternity care of women with a low-educated native Dutch and non-western ethnic background. Results From September 2011 until December 2013, 106 women were recruited for 20 focus group sessions. Eighty-five percent of the women had a non-western immigrant background and 89% a low or intermediate educational attainment. The study population was mostly positive about the provided care during the antenatal phase. They were less positive about the other two phases of care. Moreover, the obstetric healthcare systems’ responsiveness in all phases of care (antenatal, birthing and maternity) did not meet these women’s needs. The ‘respect for persons’ domains ‘autonomy’, ‘communication’ and ‘dignity’ and the ‘client orientation’ domain ‘prompt attention’ were judged most negatively. Conclusions The study findings give contextual meaning and starting points for improvement of responsiveness in the provision of obstetric care within a multi-ethnic women’s population.
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Benza S, Liamputtong P. Becoming an 'Amai': Meanings and experiences of motherhood amongst Zimbabwean women living in Melbourne, Australia. Midwifery 2016; 45:72-78. [PMID: 28056404 DOI: 10.1016/j.midw.2016.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 12/08/2016] [Accepted: 12/11/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND little is known about the meanings and experiences of motherhood among Zimbabwean migrant women. This paper discusses the meanings and experiences of motherhood from the perspectives of Zimbabwean migrant women living in Melbourne, Australia. METHODS qualitative methods (in-depth interviewing, photo elicitation and drawing) were conducted with 15 Zimbabwean women who had children in Zimbabwe and in Australia. Data were analysed using thematic analysis method. FINDINGS Zimbabwean women defined motherhood in varied ways. Common to all women was that becoming a mother had a significant meaning. Motherhood came with a sense of responsibility for children which resulted from their compromise and sacrifice. The dedication was exhibited by participants who demonstrated commitment to motherhood when striving to be a good mother. While motherhood provided pleasure and joy, some women found the role of motherhood burdensome in their new homeland. Due to cultural expectations of motherhood, women kept their difficulties silent for fear of being judged a 'bad mother'. The unfamiliarity with the health and social care systems in Australia presented challenges to these women. Often, they were treated without respect and felt discriminated against. CONCLUSIONS our findings reveal the paradox of motherhood. Although motherhood can be burdensome, there are positive changes brought about by the process of motherhood. Due to a lack of knowledge about the health and social care system and the negative experiences with health care in Australia, the women felt overwhelmed about becoming a mother in Australia. IMPLICATIONS healthcare providers, including midwives, need to understand how migrant women perceive and experience motherhood and their mothering role as this will help to improve the health and social care for these women and their children. Findings from this study provide a basis for further investigation into the formation and strengthening of support networks for Zimbabwean mothers in particular, and to other migrant women in general.
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Affiliation(s)
- Sandra Benza
- Department of Public Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Pranee Liamputtong
- School of Science and Health, Western Sydney University, Penrith, New South Wales 2176, Australia.
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Maternity health care: The experiences of Sub-Saharan African women in Sub-Saharan Africa and Australia. Women Birth 2016; 30:298-307. [PMID: 27955951 DOI: 10.1016/j.wombi.2016.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care. OBJECTIVE The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia. DESIGN Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark's approach to thematic analysis. FINDINGS Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care. CONCLUSION The study provides an understanding of Sub-Saharan African women's experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women's health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women.
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Porter M, Todd A, Zhang L. Ethnicity or cultural group identity of pregnant women in Sydney, Australia: Is country of birth a reliable proxy measure? Women Birth 2016; 29:168-71. [DOI: 10.1016/j.wombi.2015.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/05/2015] [Accepted: 10/04/2015] [Indexed: 11/26/2022]
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15
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Another country, another language and a new baby: A quantitative study of the postnatal experiences of migrant women in Australia. Women Birth 2015; 28:e124-33. [DOI: 10.1016/j.wombi.2015.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/03/2015] [Accepted: 07/06/2015] [Indexed: 11/15/2022]
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16
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Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland. J Racial Ethn Health Disparities 2015; 3:83-98. [PMID: 26896108 DOI: 10.1007/s40615-015-0118-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 03/22/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland's health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically diverse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified; however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.
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17
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Higher prevalence of childbirth related fear in foreign born pregnant women – Findings from a community sample in Sweden. Midwifery 2015; 31:445-50. [DOI: 10.1016/j.midw.2014.11.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 10/20/2014] [Accepted: 11/30/2014] [Indexed: 01/13/2023]
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18
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Hennegan J, Kruske S, Redshaw M. Remote access and care: A comparison of Queensland women's maternity care experience according to area of residence. Women Birth 2014; 27:281-91. [DOI: 10.1016/j.wombi.2014.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/28/2014] [Accepted: 06/29/2014] [Indexed: 11/28/2022]
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