Access To Maternal Services Research Articles

Qualitative service evaluation of a rural midwife-led ultrasound service: listening to women

Background/Aims Patient experience is needed to understand if a service is meeting the needs of the population it serves. In rural areas, accessing maternity services can be challenging for women. Local provision should be explored and consistently reviewed to adapt to changing social requirements and expectations. The aim of this study was to examine a rural midwifery-led ultrasound service 5 years after implementation and post COVID-19, to ascertain if the service provides a positive service user experience. Methods A qualitative service evaluation was carried out using semi-structured interviews with four service users. Data were analysed using content analysis. Results Positive aspects of the service included continuity of care, communication, time to care, financial benefits and inclusivity in care and care decisions. It was noted that the ultrasound service was in the opposite direction from their homes to the obstetric service if participants needed to be referred for consultant opinion the same day. The significant underlying theme was the positive impact on mental wellbeing and patient experience in pregnancy when attending the service. Conclusions There was a high level of satisfaction with the service. Engagement of a broader spectrum of women would provide deeper insight into the service and robust evidence for any service development.

Identifying women with a disability in Australian maternity services: Time for a change.

It is estimated that over 1 billion people worldwide have a disability. In Australia, 9% of women of childbearing age have a disability, but data on disability status for women accessing maternity services are not routinely collected and data collection processes are inconsistent. Maternal disability may affect perinatal outcomes, but to understand what factors might be amenable to interventions to improve outcomes, accurate data collection on disability status is essential. This opinion piece reflects on disability identification within maternity services in Australia, identifying areas for policy and practice change.

Exploring disability prevalence among childbearing women attending a tertiary maternity service in Melbourne, Australia using an audit and cross-sectional survey

BackgroundAlthough there is an estimated rate of 10% of women of childbearing age in Australia who have a disability, there is a lack of accurate prevalence data, with the true rate unknown. The timing and questions used to collect women's disability status in pregnancy vary, and there is limited knowledge on how women accessing maternity services in Australia would like to be asked about their disability status. ObjectiveTo explore the prevalence of women with a disability receiving maternity care using a direct and indirect disability identification question. Secondary aims were to explore how women would like to be asked about their disability status and to examine the difference between self-reported and clinician-documented disability status within medical records. Research design/SettingThe study was conducted at a tertiary maternity hospital in Melbourne, Australia, and included two components. Component one used a cross-sectional survey with two different cohorts of women administered face-to-face on the postnatal ward (Cohort 1 – February 2019, Cohort 2 – December 2019). In Cohort 1, a specific disability identification question asked: ‘Can you please tell me if you identify as someone who has a disability?’. In Cohort 2, an indirect disability identification question asked: ‘Do you require additional assistance or support?’. Other questions explored women's views on disability identification. Component two consisted of an audit of the medical records to compare disability documentation in the medical records of the women who participated with women's disability self-identification status. Results371/467 (79%) of eligible women that were approached participated in Cohort 1 and in Cohort 2, 295/346 (85%) of eligible women that were approached participated in the study. In Cohort 1, 5% (17/371) of women self-identified with having a disability. In Cohort 2 16% (46/295) of women reported needing additional assistance/support, however of these, only nine women viewed this as a disability. In Cohort 1, of the women who self-identified as having a disability, 82% had this recorded in their medical record. An additional 12% (43/354) of women in Cohort 1 who may have had a disability according to the Australian Bureau of Statistics classification, did not self-identify as having a disability. In Cohort 2, 37% (17/43) of women who self-identified as needing additional support did not have these needs documented in the medical record. Less than a quarter of women in both cohorts were asked about their disability status during their maternity care. Women with a disability or additional support needs suggested both direct and indirect ways of being asked about their disability status, and their responses were similar to women who did not self-identify with having a disability or additional support needs. ConclusionsDisability prevalence data is highly dependant on the wording of the disability identification question. It may be appropriate to ask about disability both indirectly, in terms of additional support needs, and directly, to enable disclosure for those who do identify with a disability. Disability questioning should be routine and standardised guidelines around disability identification should be developed to allow for tailored adjustments to care on an individual level.

Interprofessional team trust in maternity services: a service evaluation

Background/Aims A climate of trust in maternity may improve the experiences of staff and women accessing maternity services. The aim of this study was to explore how a climate of trust was promoted through creation of a regular virtual maternity multidisciplinary forum, known as a maternal medicine huddle, during the COVID-19 pandemic and what influence this had on the organisational culture of a local maternity system and the experiences of women receiving maternity care. Methods Through a critical feminist methodology, six participants were interviewed using a semi-structured interview schedule. Interviews were conducted through Miscrosoft Teams, with the six participants representing each of the six trusts in a selected local maternity and neonatal system. Results Developing trust for teamwork is valued, while at the same time interprofessional and interorganisation challenges are highlighted that can impact workplace culture. Conclusions The huddles have built a climate of trust, working to deliver safe, equitable care for those using maternity services and a supportive learning environment for those providing it.

Project20: maternity care mechanisms that improve access and engagement for women with social risk factors in the UK – a mixed-methods, realist evaluation

ObjectivesTo evaluate how women access and engage with different models of maternity care, whether specialist models improve access and engagement for women with social risk factors, and if so, how?DesignRealist...

The floods of 2022: Economic and health crisis hits Pakistan.

Pakistan is currently going through the worst-ever recorded flood crisis. The 2022 floods have created unprecedented destruction, especially in the coastal regions of the country. Almost one-third of Pakistan has drowned, merely as a consequence of climate change which is impacting many countries around the globe, with the South Asian countries at the greatest risk due to their proximity to the equator. The National Disaster Management Authority (NDMA) has reported millions of people to be affected by the catastrophic floods. The country is also going through a major economic crisis due to livestock and agriculture being destroyed, which has led to severe food shortages resulting in the flood victims being vulnerable to malnutrition as well. Health care has also been severely affected, with a serious outbreak of waterborne diseases including diarrhea, dengue fever, malaria. Thousands of pregnant women are unable to access maternity services and menstrual hygiene products are also unavailable in flood-stricken areas. The Government of Pakistan should address this urgent matter as a priority and necessary steps should be taken to try and contain this catastrophe.

O95 - Exploring disability identification within public maternity services in Australia

In Australia, it is estimated that 10% of women of childbearing age have a disability. There is some evidence that women with a disability have poorer perinatal outcomes, but limited information on the prevalence of women with a disability accessing maternity services, how they are identified and what care and services are available. To explore how public maternity services in Australia identify pregnant women with a disability and to examine the availability of specialised services for such women. A cross-sectional online survey of maternity managers in Australian public hospitals was conducted. Thirty-six percent (70/193) of managers from eligible hospitals responded, including all states and territories. Overall, 71% routinely asked women about disability status, which was usually as part of routine history taking, however there was wide variation in how this was asked. Most (63%) did not have standardised documentation processes and two thirds (65%) were unable to estimate the number of women with a disability seen at their hospital. Thirteen percent of services reported having specialised training for staff in disability identification, documentation and referral pathways. Only a quarter of respondents felt that there were adequate services for women with a disability within their health service. This is the first study to explore disability identification in maternity services in Australia. A large variation in disability identification practices was found. It is imperative that the women with a disability are routinely identified to ensure appropriate clinical care planning and provision, that such data are collected at a national level to inform policy and enable research on any associations between disability status and maternal and neonatal outcomes. National guidelines on disability identification and care pathways for women accessing maternity services are urgently needed.

How are women with a disability identified in maternity services in Australia? A cross-sectional survey of maternity managers

BackgroundWomen with a disability have poorer perinatal outcomes, but little is known about the prevalence of women with a disability accessing maternity services, how they are identified and what care and services are available. Estimates suggest that nine percent of women of childbearing age have a disability. AimTo explore how public maternity services in Australia identify pregnant women with a disability, what (if any) routine disability identification questions are used, and to examine availability and adequacy of services for women. MethodsCross-sectional online survey of maternity managers in Australian public hospitals. FindingsThirty-six percent (70/193) of eligible hospitals responded including all states and territories. Overall, 71 % routinely asked women about disability status (usually as part of routine history taking), however there was wide variation in how this was asked. Most (63 %) did not have standardised documentation processes and two thirds (65 %) were unable to estimate the number of women with a disability seen at their hospital. Most (68 %) did not offer specialised services, with only 13 % having specialised training for staff in disability identification, documentation and referral pathways. Only a quarter of respondents felt that there were adequate services for women with a disability related to maternity care. ConclusionThis is the first study to explore disability identification in maternity services in Australia. How women were asked was highly varied and documentation not standardised. National guidelines on disability identification for women accessing maternity services should be developed and collection of disability identification data should be routine.

Perceptions and experiences of maternity care workers during COVID-19 pandemic in Lagos State, Nigeria; a qualitative study.

BackgroundThe COVID-19 (coronavirus disease 2019) pandemic challenges provision and access to essential maternity care in low-resilience health systems. The aim of this study was to explore maternity healthcare workers’ experiences of, and perceptions about providing maternity care during the COVID-19 outbreak in Lagos State, Nigeria.MethodsThis qualitative study conducted individual, remote, semi-structured interviews with midwives and traditional birth attendants (TBAs). Eligible participants spoke English, and provided maternity care during COVID-19 in Lagos, Nigeria. Participants were recruited via purposive and snowball sampling, from primary health facilities in seven Local Government Areas of Lagos State. Interview transcripts were analysed thematically following the framework method.ResultsSixteen midwives (n = 11) and TBAs (n = 5) were interviewed from March to April 2021. Two overarching themes were identified from the data. ‘Maternity care workers’ willingness and ability to work during the COVID-19 pandemic’ outlined negative influences (fear and uncertainty, risk of infection, burnout, transport difficulties), and positive influences (professional duty, faith, family and employer support). Suggestions to improve ability to work included adequate protective equipment, training, financial support, and workplace flexibility. ‘Perceived impact of COVID-19 on women’s access and uptake of maternity care’ highlighted reduced access and uptake of antenatal and immunisation services by women. Challenges included overstretched health services, movement and cost barriers, and community fear of health facilities. Participants reported delayed healthcare seeking and unattended home births. Midwives and TBAs identified a need for community outreach to raise awareness for women to safely access maternity services. Participants highlighted the responsibility of the government to improve staff welfare, and to implement public health campaigns.ConclusionsDespite disruption to maternity care access and delivery due to COVID-19, midwives and TBAs in Lagos remained committed to their role in caring for women and babies. Nevertheless, participants highlighted issues of understaffing and mistrust in Lagos’ underfunded maternity care system. Our findings suggest that future resilience during outbreaks depends on equipping maternity care workers with adequate working conditions and training, to rebuild public trust and improve access to maternity care.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-022-08009-y.

Cost, cost-consequence and cost-effectiveness evaluation of a practice change intervention to increase routine provision of antenatal care addressing maternal alcohol consumption

BackgroundImplementation of antenatal clinical guideline recommendations for addressing maternal alcohol consumption is sub-optimal. There is a complete absence of evidence of the cost and cost-effectiveness of delivering practice change interventions addressing maternal alcohol consumption amongst women accessing maternity services. The study sought to determine the cost, cost-consequence and cost-effectiveness of developing and delivering a multi-strategy practice change intervention in three sectors of a health district in New South Wales, Australia.MethodsThe trial-based economic analyses compared the costs and outcomes of the intervention to usual care over the 35-month period of the stepped-wedge trial. A health service provider perspective was selected to focus on the cost of delivering the practice change intervention, rather than the cost of delivering antenatal care itself. All costs are reported in Australian dollars ($AUD, 2019). Univariate and probabilistic sensitivity analyses assessed the effect of variation in intervention effect and costs.ResultsThe total cost of delivering the practice change intervention across all three sectors was $367,646, of which $40,871 (11%) were development costs and $326,774 (89%) were delivery costs. Labour costs comprised 70% of the total intervention delivery cost. A single practice change strategy, ‘educational meetings and educational materials’ contributed 65% of the delivery cost. Based on the trial’s primary efficacy outcome, the incremental cost effectiveness ratio was calculated to be $32,570 (95% CI: $32,566–$36,340) per percent increase in receipt of guideline recommended care. Based on the number of women attending the maternity services during the trial period, the average incremental cost per woman who received all guideline elements was $591 (Range: $329 - $940) . The average cost of the intervention per eligible clinician was $993 (Range: $640-$1928).ConclusionThe intervention was more effective than usual care, at an increased cost. Healthcare funders’ willingness to pay for this incremental effect is unknown. However, the strategic investment in systems change is expected to improve the efficiency of the practice change intervention over time. Given the positive trial findings, further research and monitoring is required to assess the sustainability of intervention effectiveness and whether economies of scale, or reduced costs of intervention delivery can be achieved without impact on outcomes.Trial registrationThe trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry, No. ACTRN12617000882325 (date registered: 16/06/2017).

NHS trust to trial smoking cessation referrals from maternity services to community pharmacy

Patients accessing maternity services at Nottingham University Hospitals NHS Trust could be offered smoking cessation treatment at a community pharmacy under a new NHS pilot. The scheme builds on the ‘NHS community pharmacy smoking cessation advanced service‘ — which rolled out nationally in England on 10 March 2022 — through which hospitals can refer patients […]

Project20: interpreter services for pregnant women with social risk factors in England: what works, for whom, in what circumstances, and how?

BackgroundBlack and minority ethnic women and those with social risk factors such as deprivation, refugee and asylum seeker status, homelessness, mental health issues and domestic violence are at a disproportionate risk of poor birth outcomes. Language barriers further exacerbate this risk, with women struggling to access, engage with maternity services and communicate concerns to healthcare professionals. To address the language barrier, many UK maternity services offer telephone interpreter services. This study explores whether or not women with social risk factors find these interpreter services acceptable, accessible and safe, and to suggest solutions to address challenges.MethodsRealist methodology was used to refine previously constructed programme theories about how women with language barriers access and experience interpreter services during their maternity care. Twenty-one longitudinal interviews were undertaken during pregnancy and the postnatal period with eight non-English speaking women and their family members. Interviews were analysed using thematic framework analysis to confirm, refute or refine the programme theories and identify specific contexts, mechanisms and outcomes relating to interpreter services.ResultsWomen with language barriers described difficulties accessing maternity services, a lack of choice of interpreter, suspicion around the level of confidentiality interpreter services provide, and questioned how well professional interpreters were able to interpret what they were trying to relay to the healthcare professional during appointments. This resulted in many women preferring to use a known and trusted family member or friend to interpret for them where possible. Their insights provide detailed insight into how poor-quality interpreter services impact on their ability to disclose risk factors and communicate concerns effectively with their healthcare providers. A refined programme theory puts forward mechanisms to improve their experiences and safety such as regulated, high-quality interpreter services throughout their maternity care, in which women have choice, trust and confidence.ConclusionsThe findings of this study contribute to concerns highlighted in previous literature around interpreter services in the wider healthcare arena, particularly around the lack of regulation and access to high-quality interpretation. This is thought to have a significant effect on pregnant women who are living socially complex lives as they are not able to communicate their concerns and access support. This not only impacts on their safety and pregnancy outcomes, but also their wider holistic needs. The refined program theory developed in this study offers insights into the mechanisms of equitable access to appropriate interpreter services for pregnant women with language barriers.

A Midwife’s Role in Supporting Women with Childhood Sexual Abuse

Childhood sexual abuse (CSA) is a common experience for women and research from the UK and USA indicates a prevalence of 20%.1,2 Inevitably, some of these women will access maternity services. This article considers whether midwives are aware of this vulnerable group of women and explores the role of the midwife in supporting women who have experienced CSA through the perinatal period.

Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales: a linked data study

BackgroundUnder the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers.MethodsAnonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used.ResultsHalf of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% < 21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%).ConclusionThis novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women’s needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.

The impact of the COVID-19 pandemic on the perinatal mental health of women.

Objectives The physical health impact of the coronavirus disease infection (COVID-19) has received attention worldwide; however, data around the psychological impact of the pandemic is still emerging and little has been reported on psychological effects among vulnerable groups. This study was undertaken with the aim of studying the impact of the COVID-19 pandemic and related restrictions on perinatal mental health among women in Qatar. Methods A cross- sectional survey of women accessing maternity services in Qatar was carried out during the months of June and July 2020 at the local peak of the pandemic. Background data including relevant demographic details, pregnancy and mental health history, concerns, as well as helpful stress-reducing factors reported by women was collected. Depression and anxiety symptomatology was studied using the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS). Results The survey results revealed a high prevalence of anxiety and Depressive symptomatology (34.4 and 39.2% respectively), based on PHQ-ADS scoring. These rates appeared much higher than the reported pre-pandemic prevalence and were not affected by occupation, previous mental health problems or pregnancy complications. Women's most commonly reported concerns as well as coping factors are discussed. Conclusions Results indicate a marked increase in anxiety and depressive symptoms during the COVID-19 pandemic, among pregnant and puerperal individuals, who constitute a vulnerable group with respect to mental health morbidity. These findings can be used to inform public health interventions, among which, consideration should be given to routine mental health screening of vulnerable groups during major health crises.

Exploring the views of undocumented migrant women on access to maternity services in the UK

Abstract Background Migrant women face inequalities in access to health-care services and are known to experience poorer maternal and child outcomes than women born in the UK. The development of more restrictive health policies in the UK and Europe, including being denied or charged for healthcare at maternity services, may be exacerbating these outcomes, particularly among undocumented migrant women without permission to reside. We investigated undocumented migrant women's experiences of accessing maternity services in the UK and their impact on health outcomes. Methods We did semi-structured in-depth qualitative interviews with a purposive sample of migrant women (born outside the UK) who were aged 18 and over, and had experiences of pregnancy in the UK whilst undocumented. Participants were recruited through the Doctors of the World UK clinic. Interviews were transcribed and analysed using thematic analysis. Results We did interviews with 20 undocumented women (age range 31-40 years; mainly from Africa and Asia). Among participants, of whom 13 were pregnant at the time of interview, 10 (50%) first accessed antenatal care late (after the national target of 13 weeks). Women described an ongoing cycle of precariousness, defined by their legal status, social isolation, and poor economic status. Women reported receiving bills of up to £11,500 for maternity services (range £3,072 to £11.500). The impact of their experiences meant that they were deterred from seeking timely health care and were reluctant to present to health services, with women reporting fear and loss of trust in the health system. Conclusions These women's narratives illustrated the potential deterrent and detrimental impact of increasingly restrictive health policies on women's access to care and their health. UK and European health policies must be equitable, non-discriminatory, and better align with our commitments to promote universal health coverage among all individual residing in the region. Key messages Increasingly restrictive health policies may have a deterrent and detrimental impact on migrant women’s access to health care. Undocumented migrant women in the UK reported fear and loss of trust in the health system.

Maternal Death in Northern Nigeria: What the Community Knows and is Saying

Women's death from childbirth is common place in the developing world. WHO, 2017, estimated 67000 maternal deaths for Nigeria. Principal among the contributing factors to this tragedy is poverty. The growing poverty, especially among women greatly limits women's access to highly needed maternity care. The aim of the study is to identify the views of community of the commonness and causes of maternal death and ways to ameliorate the carnage in Northern Nigeria.This was a community-based qualitative study undertaken in four states in northern Nigeria: Benue and Plateau states, north central Nigeria; Gombe and Taraba states, north eastern Nigeria. The instruments of the study were: (i) Focus group discussion (FGD) and (ii) Semi-structured interviews (SSI). Jos University Teaching Hospital (JUTH) ethics committee approved the study. It was found across the states that maternal deaths were common occurrences. The deaths were on the increase and often attributed to poverty, ignorance and poor infrastructure. The majority of the population in the states under study was peasants that generate no surplus. Subsequently, little or nothing is left to pregnant women to access maternity services when needed. There were few sparsely spread functional health care facilities across the states. Furthermore, the health facilities lacked trained staff, were poorly equipped and needed basic infrastructure such as water, electricity and referral systems. Community engagement is advocated on safe motherhood issues. The communities know that maternal death is common and are frequently related to poverty, ignorance and poor infrastructure. The community said they need fertilizer to tackle poverty and maternal deaths among them will drastically reduce.

Needs of Migrant Arab Muslim Childbearing Women in the United Kingdom.

Introduction: This study aims to examine the challenges faced by migrant Arab Muslim women in accessing maternity services and to suggest ways to improve the childbirth experience for them. Methodology: An interpretive ontological-phenomenological perspective guided by the philosophical tenets of Heidegger was used to examine the childbirth experiences of Arab Muslim women. Results: The sample size was 24 in-depth semistructured audiotaped interviews with eight women in the United Kingdom. The "Vulnerable Woman" was the main theme of our findings, which was discussed in five subthemes: language exclusion, discrimination and prejudice, bureaucracy and "stiff upper lip," conflicting ideology, and the conventional as strange. Conclusions: Maternity care should be culturally competent and emphasize the importance of recognizing differences as well as creating trusting relationships. At the same time, midwives should be aware of the dangers of labeling women because of their cultural and religious beliefs.

Assessing mental health during pregnancy: An exploratory qualitative study of midwives’ perceptions

BackgroundMental health disorders are estimated to affect between 10% and 20% of women who access maternity services and can be defined as a public health issue due to the potential consequences for women, children and families. Detecting problems early in pregnancy can significantly improve outcomes for women and their families. However, mental health problems are not being consistently identified in routine midwifery practice and little is known from current literature about midwives’ practice in relation to current national guidelines or the impact models of care have on assessing maternal mental health. ObjectiveTo identify midwives’ views about barriers and facilitators to screening for mental health in pregnancy using current UK guidelines. DesignNine community midwives from a single district general hospital in the south of England were recruited to take part in focus groups. Thematic analysis was used to extract key themes from the data. FindingsThree key themes were identified from the focus groups and included system factors, social factors and trust. Barriers and facilitators to screening maternal mental health were associated with the initial ‘booking’ appointment’ and differences in models of care. Barriers to screening were defined as high workload, poor continuity, and a lack of trust between women and midwives. ConclusionsThis study highlights key barriers and facilitators associated with mental health screening during pregnancy, including issues of trust and uncertainty about women's willingness to disclose mental health conditions. Further research is required to evaluate the relationship between women and midwives in contemporary practice and the influence this may have on maternal mental health.

Maternal health service utilisation of adolescent women in sub-Saharan Africa: a systematic scoping review

IntroductionSub-Saharan Africa has the highest rate of adolescent pregnancy in the world. While pregnancy during adolescence poses higher risks for the mother and the baby, the utilisation of maternity care to mitigate the effects is low. This review aimed to synthesise evidence on adolescent mothers’ utilisation of maternity care in Sub-Saharan Africa and identify the key determinant factors that influence adolescent mothers’ engagement with maternity care.MethodA systematic review of scholarly literature involving seven databases: ProQuest, PubMed, EMBASE/Elsevier, SCOPUS, PsycINFO, CINAHL and Infomit was conducted. Studies published in English between 1990 and 2017 that examined Sub-Saharan adolescent mothers’ experiences of utilising biomedical maternity care during pregnancy, delivery and the post-partum period were included.ResultsFrom 296 relevant articles 27 were identified that represent the experience of adolescent mothers’ maternal health service utilisation in Sub-Saharan Africa. The review indicates that maternal health service utilisation in the majority of Sub-Saharan African countries is still low. There is also a wide discrepancy in the use of maternity care services by adolescent mothers across countries in Sub-Saharan Africa.ConclusionsThe review reveals that a significant number of adolescents in Sub-Saharan Africa do not access and use maternity services during pregnancy. Several factors from individual to systemic levels contributed to low access and utilisation. This implies that interventions targeting the women, their partners, healthcare professionals, communities and the organisations (local to national) are necessary to improve adolescent mother’s engagement with maternity care in Sub-Saharan Africa.