Antenatal Education Research Articles

Utilization of Antenatal Services among Postnatal Mothers.

Antenatal care is medical supervision and care given to pregnant women to ensure, support and maintain maternal and fetal well-being throughout the pregnancy. Therefore, this study was done to find out the utilization of antenatal services among postnatal mothers. The descriptive cross sectional study design was used to identify the utilization of antenatal services among postnatal mothers who came in Maternal and Child Health Clinic for the immunization of baby. Total 367 postnatal mothers within one year of childbirth were recruited by simple random sampling technique, and data was collected with face-to-face interview by using semi structured interview schedule. Analysis was done by using descriptive and inferential statistics. All postnatal mothers consumed iron and folic acid during pregnancy, 96.2% consumed until the childbirth, 94.0% got freely, 97.0% taken anti helminths drug, 98.1% did urine test, 98.1% did blood test, 97.8% got ultrasound service, and 96.5% received Td vaccine. Likewise, higher proportion had checked weight 98.6% and lower proportion had checked height 86.9%. Similarly, majority 90.2% received counselling on danger signs and only 26.2% received the counselling on preparation of items safe delivery and care of newborns. There is significant association of antenatal care service utilization with postnatal mothers' educational level and her husband's occupation (P<0.05 level). Although most of the postnatal mothers utilized antenatal care services, some aspect of antenatal education and counselling need to be improved such as preparation of item for delivery and new born care, finance, and blood donors.

Assessment of nutrient intake and antenatal education method for pregnant women in Gianyar, Bali, Indonesia

Introduction: Nutrient intake for pregnant women was associated with the health status of young children from infancy to adolescents. Antenatal education increases the awareness of nutrient importance for pregnant women. The purpose of this study was to describe the nutritional consumption of pregnant women in terms of the method of antenatal education. Methods: Cross-sectional study involving 150 pregnant women in Gianyar Regency. They were selected using a cluster random sampling technique. Nutrition consumption data was collected using a 24-hour food recall form. The first interview was conducted on workdays to collect the sociodemographic and obstetric data, the data on the implementation of antenatal education, and 24-hour dietary recall. The second interview was conducted on the weekend, to collect the data on a 24-hour dietary recall. Results: The results showed that there was no significant difference (p&gt;0.05) in the average consumption of macro and micronutrients for pregnant women in terms of antenatal education methods. The level of consumption of macro and micronutrients was almost all below the nutritional adequacy rate, only protein consumption was in accordance with the nutritional adequacy rate. The results of the analysis of factors related to nutritional consumption showed that there was a significant relationship (p=0.021) between the education factor with calcium consumption. Age, occupation, and gravida factors were not related to the nutritional consumption of pregnant women. Conclusions: The conclusion of this study was no difference in the nutritional consumption of pregnant women in terms of antenatal education methods. The consumption of macro and micronutrients for pregnant women was almost all below the nutritional adequacy rate

Impact of Prenatal Group Healthy Relationship Education on Postpartum Contraception.

We aimed to evaluate the impact of an antenatal group healthy relationship education program on the postpartum use of long-acting reversible contraception (LARC). This is a planned subgroup analysis of a larger randomized controlled trial. Pregnant and newly parenting women were randomized to either group healthy relationship education, "MotherWise," or no additional services. An evidence-based healthy relationship education program and individual case management sessions were provided. The program did not include any prenatal care or contraception counseling. This subgroup analysis included those participants with a nonanomalous gestation randomized at <40 weeks who received care and delivered at a single safety-net hospital and were discharged home with a live infant(s). From September 2, 2016 to December 21, 2018, 953 women were randomized in the larger trial; 507 met inclusion criteria for this study; 278 randomized to program and 229 controls. Participants were mostly young, parous, Hispanic, publicly insured women. Participants randomized to program were more likely to take a prescription medicine and be delivered through cesarean; there were not any other significant differences in baseline, antenatal, or perinatal outcomes. Those randomized to program were more likely to be discharged home with immediate postpartum LARC in place (odds ratio [OR] 1.87; confidence interval [CI] 1.17-3.00), and more likely to be using LARC at the postpartum visit (OR 2.19; CI 1.34-3.56). Antenatal group healthy relationship education provided separately from prenatal care is associated with a twofold increase in the use of postpartum LARC. ClinicalTrials.gov NCT02792309; https://clinicaltrials.gov/ct2/show/NCT02792309?term=NCT02792309&draw=2&rank=1.

Exploring Caesarean Birth 2: The Midwife’s Responsibility In Antenatal And Postnatal Education

Childbirth education (CBE) and health promotion is an integral part of the midwife’s role. With today’s shorter hospital stays for women, the increasing workload and diminished midwifery workforce, women are at risk of receiving inadequate postnatal care and education. The National Centre for Clinical Excellence says “Postnatal care has long been regarded as a ‘Cinderella service’ where in comparison with some other European countries, provision is scanty and inadequate”.1

North-central Nigerian women’s experiences of obstetric fistula risk factors and their perceived treatment services: An Interpretive Description

BackgroundAn obstetric fistula also known as vesico vaginal fistula (VVF), or recto-vaginal fistula (RVF) is an abnormal opening between the urogenital tract and intestinal tract caused by prolonged obstructed labour; when the head of the baby presses on the soft tissues in the pelvis leading to loss of blood flow to the women’s bladder, vagina, and rectum. This can cause necrosis of the soft tissues resulting in debilitating fistula formations. AimThis study aimed to uncover North-central Nigerian women’s experiences of obstetric fistula and their perceived treatment services. DesignQualitative, interpretive descriptive methodology underpinned by symbolic interactionism involving face-to-face semi-structured interviews was used to explore North-central Nigerian women’s experiences of obstetric fistula and their perceived treatment services. SampleA purposive sample of 15 women who had experienced obstetric fistula at a repair Centre in North-central Nigeria were eligible. ResultsFour themes emerged from North-central Nigerian women’s experiences of obstetric fistula and their perceived treatment services i) I was left alone in the room ii) Waiting for the one vehicle in the village iii) I never knew about labour until that very day iv) and We kept following the native doctors and sorcerers. ConclusionThe findings from this study highlighted the depth of women’s experiences from the devastating complication of childbirth injury in North-central Nigeria. Analysis of insights from women’s voices directly affected by obstetric fistula demonstrated that in their views and experiences the themes identified were majorly responsible for their fistula status. Thus women need to raise their collective voices to resist oppressive harmful traditions and demand empowerment opportunities that will improve their social status. Government should improve primary healthcare facilities, train more midwives and subsidise maternal care for antenatal education and birth services spending for childbirth women may result in improved childbirth experiences for women in rural and urban communities. Tweetable AbstractReproductive women call for increased accessibility to healthcare services and the provision of more midwives to mitigate obstetric fistula in North-central Nigerian communities.

Associations between antenatal education program and mental health outcomes in Taiwan: A population-based cohort study

Universal antenatal education has been offered to expectant mothers in Taiwan since 2014. Depression screening is included in the offered education sessions. This study aimed to examine the association of antennal education and depression screening with mental health outcomes, including perinatal depression diagnosis and psychiatrist visits. Data was obtained from the antenatal education records and Taiwan's National Health Insurance claims database. A total of 789,763 eligible pregnant women were included in the current study. The psychiatric-related outcomes were measured between antenatal education and the six-month after delivery. It was found that the antenatal education was widely used in Taiwan, and the attendance rate has increased to 82.6% since its launch. The attenders were more likely to be from disadvantaged backgrounds, and 5.3% of them were screened positive for depressive symptoms. They were also more likely to visit a psychiatrist but less likely to be diagnosed with depression than the non-attenders. Factors including young age, high healthcare utilization, and comorbid psychiatric disorder history were consistently associated with depression symptoms, perinatal depression diagnoses and psychiatrist visits. Further research is needed to understand the reasons for the nonattendance at antenatal education programmes and the barriers to utilizing mental health services.

Dietary Practice among Pregnant Women at a Selected Hospital in Dhaka

Background: Dietary practice of women during pregnancy is critical for optimal growth and development of the fetus. Maternal and child health is strongly associated with dietary practices. Good maternal nutrition is important for the health and reproductive performance of women and development of their children. This study aimed to describe the dietary practice among pregnant women at Bangabandhu Sheikh Mujib Medical University Hospital (BSMMUH) in Dhaka. Methods: A descriptive cross sectional study was conducted to assess the dietary practice among pregnant women attending at the antenatal care unit (ANC) in BSMMUH. A total of 112 participants were conveniently selected using a standard equation. The data were collected during February to March 2022 from the eligible participants using a structured questionnaire containing socio-demographic section along with a validated dietary behavior questionnaire (DBQ). Both descriptive and inferential statistics were used to analyze the data. The inferential statistics, Pearson’s product moments correlation, independent t- test, and one-way ANOVA were used to test the relationship between socio- demographic characteristics and output variable regarding dietary behavior. Results: The study showed the dietary practice of pregnant women were significantly related with their age (f=3.50, p=0.033), education (f=3.32, p=0.023), monthly family income (r=0.52, p=0.001), gestational age (r=0.32, p=0.008), BMI (f=8.89, p=0.000), and number of antenatal visit (r=0.30, p=0.000). Conclusion: The dietary practice of pregnant women is related with number of antenatal visits and education that might promote through appropriate interventions by the nurses and other health care personnel to improve maternal nutrition.

The Effect of Antenatal Education on Expectant Fathers’ Attitudes toward Breastfeeding and Attachment to the Fetus

This study explores the effect of antenatal education on fathers' attitudes toward: (i) breastfeeding and (ii) attachment to the fetus. A secondary aim is to explore the relationship of fathers' demographic and the psycho-emotional characteristics that come with breastfeeding and attachment. This is a longitudinal study involving a group of 216 Greek expectant fathers who participated with their partners in an antenatal educational program performed by midwives in Athens, Greece (September 2020-November 2021). The Iowa Infant Feeding Attitudes Scale (IIFAS) and Paternal Antenatal Attachment Scale (PAAS) were administered at two time points: (a) 24th-28th gestation week and (b) 34th-38th gestation week. The T-test and Univariate Analyses of Variance (ANOVA) were performed. The expectant fathers' scores show that breastfeeding intention/exclusivity and prenatal attachment to the fetus were higher after their participation in the antenatal education program, but the difference was not statistically insignificant. Expectant fathers with a cohabitation agreement (p = 0.026), who felt very much supported by their partners (p = 0.001) and had no relationship difficulties with their partners (p < 0.001), as well as those who reported being very happy during pregnancy (p < 0.001), showed greater paternal antenatal attachment to the fetus. Although the difference was statistically insignificant, antenatal education appears to have an impact on paternal breastfeeding attitudes and antenatal attachment to the fetus. Additionally, several paternal characteristics were associated with greater antenatal attachment. Future research should be directed toward the investigation of additional factors that impact antenatal-paternal attachment and breastfeeding attitudes so that effective education programs can be designed.

Selected Factors of Experiencing Pregnancy and Birth in Association with Postpartum Depression.

The aim of the study is to analyse the risk of postpartum depression using dimensions of perceived support (information, emotional, and physical), antenatal education (satisfaction and attitude), and attitude toward pregnancy (wanted or unwanted). A cross-sectional study was carried out among 584 postpartum women in two university birth centres in Slovakia. The Edinburgh Postnatal Depression Scale (EPDS) score was used. Descriptive statistics and analysis of variance, as well as logistic regression, were employed in the study. Found associations were adjusted for education level, type of birth, psychiatric history, and age. As many as 95.1% of women reported their pregnancy as being wanted. Antenatal education, particularly satisfaction with it, showed a negative association with the EPDS score level. No significant differences in depression levels were found considering attitude toward pregnancy and perceived support. The study pointed out the significance of antenatal education to lower the risk of the postpartum depression. One of the important criteria of effective education is a woman's subjective satisfaction with it.

Low knowledge of newborn danger signs among pregnant women in Papua New Guinea and implications for health seeking behaviour in early infancy – findings from a longitudinal study

BackgroundGlobally, 2.5 million babies die in the first 28 days of life each year with most of these deaths occurring in low- and middle-income countries. Early recognition of newborn danger signs is important in prompting timely care seeking behaviour. Little is known about women’s knowledge of newborn danger signs in Papua New Guinea. This study aims to assess this knowledge gap among a cohort of women in East New Britain Province.MethodsThis study assessed knowledge of newborn danger signs (as defined by the World Health Organization) at three time points from a prospective cohort study of women in East New Britain Province, factors associated with knowledge of danger signs after childbirth were assessed using logistic regression. This study includes quantitative and qualitative interview data from 699 pregnant women enrolled at their first antenatal clinic visit, followed up after childbirth (n = 638) and again at one-month post-partum (n = 599).ResultsKnowledge of newborn danger signs was very low. Among the 638 women, only 9.4% knew three newborn danger signs after childbirth and only one knew all four essential danger signs defined by Johns Hopkins University ‘Birth Preparedness and Complication Readiness’ Index. Higher knowledge scores were associated with higher gravidity, income level, partner involvement in antenatal care, and education.ConclusionLow levels of knowledge of newborn danger signs among pregnant women are a potential obstacle to timely care-seeking in rural Papua New Guinea. Antenatal and postnatal education, and policies that support enhanced education and decision-making powers for women and their families, are urgently needed.

Fathers' Educational Needs Assessment in Relation to Their Participation in Perinatal Care: A Systematic Review.

All studies written in English and published between 1997 and 2021 relevant to the theme were included in the review. The electronic databases of various mainstream journals were used to evaluate 87 studies. In total, the validity of 17 studies was determined based on their compliance with the inclusion criteria. According to the review, men's participation in antenatal education can significantly influence pregnancy, childbirth, parenting, couple's relationship, and overall family functioning. Providing face-to-face antenatal education to men by doctors or midwives is emphasized as an important component of perinatal care preparation because it leads to positive outcomes.

Can prenatal online education improve pregnancy outcomes compared to classic education?

Aim: Cesarean section rates have increased, and although various measures such as antenatal education programs have been introduced to correct this, these could not be performed face-to-face due to the COVID-19 pandemic, and were largely carried out online. This study was planned to determine the effect on the rate of cesarean deliveries and pregnancy outcomes of classic education received in the antenatal period and its online replacement in such and similar extraordinary situations. Material and Method: The research was designed as a retrospective, cohort study. Fifty women undergoing childbirth in our hospital and who received online antenatal education (Group 1), 101 women who received classic education (Group 2), and 77 women receiving no education (Group 3) took part in the study. Patient data were retrieved from the hospital information system and patient records. Results: This study involved 228 pregnant women. Fifty pregnant women (22%) receiving antenatal online education were assigned to Group 1, 101 women (44%) receiving classic face-to-face education to Group 2, and 77 women (34%) receiving no education to Group 3. Forty percent of Group 1, given online education, and 62.4% of Group 2, given classic education, were able to give birth via the normal vaginal route, and the difference was statistically significant (0.001). Cesarean delivery rates were significantly higher in Group 1 (60%) than in Group 2 (37.6%) (0.001). Statistically similar results were determined in all three groups in terms of birth weight, birth length, and low birth weight. No significant difference was also observed between the three groups in terms of premature birth (&lt;37 weeks) (p=0.67). Conclusion: Online antenatal education does not reduce cesarean delivery rates compared to classic education. However, neonatal outcomes are similar.

How should online antenatal and parenting education be structured according to parents? Qualitative findings from a mixed-methods retrospective study.

Over the past 50 years, the content and structure of antenatal education classes have varied to reflect social norms of the time, the setting and context in which they have been held and who has facilitated them. In recent times, antenatal and parenting education classes have become a smorgasbord of information, offering a range of diverse content. Where and how parents-to-be may access formal antenatal and parenting education classes are also varied. Even before the lockdown challenges of the Covid-19 pandemic, many antenatal and parenting education classes had become available and accessible online. While the flexibility and accessibility of this option are apparent, scant research to date has reported on parents' experiences of undertaking online antenatal education. The objectives of this study were to explore new parents' experiences of engaging in online antenatal education, and to discover how consumers of online antenatal education perceive it should be designed and delivered. A mixed-methods design was used for this study, which was conducted with 294 past enrolees in a range of online antenatal and early parenting education programmes delivered by one private provider in Australia. The past enrolees were invited to participate in the study by email, wherein a link to an online information sheet and survey containing closed- and open-ended questions was provided. The responses to the open-ended questions that are reported in this article were analysed using a thematic approach that involved coding, sub-categorizing and then categorizing the data. A total of 108 participants provided qualitative data about the delivery and design of online antenatal education and information. The data were captured in three themes: video control and content, accessibility and pre-/intra-programme support. The results of this study provide important insights for the development of online antenatal education programmes and courses that will be of interest to antenatal educators, maternity services and maternity care policy developers. Specifically, millennial parents want trustworthy and accurate antenatal education that is delivered in a framework that aligns with and builds on adult-learning principles. The diversity of families and of expectant parents' learning styles is also important to recognize in antenatal education curricula.

Antenatal Education Services in Oman: A Descriptive Qualitative Inquiry of Healthcare Provider's Perspective.

To ensure positive pregnancy and birth outcomes, healthcare providers working in antenatal clinics are expected to provide regular antenatal education to enable early detection and timely treatment of pregnancy-related morbidities to prevent complications during labor, birth, and postnatal period. Although antenatal education and services are provided through standard programs in developed countries, presently there are no well-structured programs in many developing countries. The study compares the current service with the national and international guidelines. To identify the current practices of healthcare providers in antenatal education service in Oman with the aim of identifying any major implementation gaps. A qualitative inquiry was implemented through semi-structured in-depth interviews guided by open-ended questions. The study population were healthcare providers who routinely provide antenatal services at healthcare facilities. A purposive non-probability sampling technique was used to select the key informants. Data was analyzed manually using the thematic analysis framework. The antenatal education services provided fall under four themes: In relation to "Education for safe pregnancy," the findings revealed that healthcare providers did not adequately address the needs. In relation to "Education for Safe labor and Birth," the pregnant women are briefed with inadequate information about labor and birth during the antenatal period. In relation to "Education related to Postpartum," healthcare providers generally do not provide information regarding pregnant women's psychological wellbeing, breastfeeding, family planning, hygiene, and nutrition during antenatal visits. In relation to "Education related to Newborn Care," the study findings indicate that contrary to what was stipulated by the WHO (2016) to establish antenatal educational programs to help pregnant women gain the skills and knowledge regarding proper newborn care, our findings demonstrated a lack of education about newborn care by providers. The findings have the capacity to contribute towards the development of remedial strategies to improve maternal and neonatal outcomes in Oman. This can be achieved by addressing the practice gaps identified when comparing the current practices with international standards.

A Qualitative Inquiry of Women's Perspective of Antenatal Education Services in Oman.

Antenatal care (ANC) provides an opportunity for systematic assessment and follow-up of pregnant women to ensure positive outcomes for mother and foetus. Pregnant women should be offered evidence-based information with support to enable them to make informed decisions. To identify the gap between the current practices and the recommended guidelines for antenatal education services in Oman. A qualitative inquiry was implemented through semistructured in-depth interviews guided by open-ended questions and probes. A purposive non-probability sampling technique was used to select 13 pregnant women who had completed 30 weeks of gestation. The women were selected from 9 antenatal healthcare facilities among them: 7 primary health centers, one polyclinic and one, tertiary hospital. Antenatal education focused on four thematic areas of safe pregnancy; safe labor and birth; postpartum care; and new-born care. Regarding antenatal education for safe pregnancy, the findings indicate that most healthcare workers provided pregnant women adequate information to promote healthy dietary habits; cope with pregnancy symptoms; recognize and manage medical conditions, and to adhere to dietary supplements and medication. In addition, the findings revealed that the healthcare team did not provide the required antenatal education to meet the pregnant women's needs to ensure they had safe labor and birth, postpartum care, and new-born care. This study is the first of its kind in Oman to provide baseline data regarding the current antenatal education services from the perspective of pregnant women. These findings will help in developing strategies to improve maternal and neonatal outcomes in the country.

Dietary Diversity and Haemoglobin Level Associated With Under Nutrition Among Pregnant Women at Sidama Hawassa, Ethiopia: Facility Based Cross-Sectional Study.

Under nutrition among pregnant women is common public health problem in developing countries including Ethiopia. It leads to poor maternal and neonatal outcomes. Despite its consequences there is shortage of research evidence to support intervention in this regard in the southern part of the country. Therefore, the aim of the study was to assess the determinates of under nutrition among pregnant women visiting antenatal care clinics at selected health facilities in Hawassa town. Health facility based cross-sectional study was employed among 454 systematically selected study participants. Data were collected by using structured and pre-tested questionnaires with face to face interview. Data were entered into Epi info and then exported to SPSS version 26 statistical software for analysis. Data were analyzed with descriptive statistics; bivariate and multivariate binary logistic regression. The over all of prevalence of under nutrition among pregnant women was 27.6% [95% CI (22.6, 30.8)]. In multivariate logistic regression model, lowest wealth quintile [AOR = 3.3, 95% CI (1.7, 7.0)], women with dietary diversity [AOR = 2.0, 95% CI (1.3, 4.0)], presence of anemia [AOR = 10.7, 95% CI (5.8,19.8)], lower pregnant women education level [AOR = 3.3, 95% CI (1.4, 7.9)], lower partner education level [AOR = 3.1, 95% CI (1.1, 8.5)], not ate flush/meat food [AOR = 2.8, 95% CI (1.7, 4.8)], and not ate other fruits [AOR = 1.8, 95% CI (1.1, 2.8)] had significant association with under nutrition. In this health facility based study, the burden of under nutrition was high. Lowest wealth quintiles, low dietary diversity scores, being anemic and low education of the pregnant women and her partner were associated with under nutrition. Therefore, counseling for dietary diversity during antenatal care, health promotion and education for pregnant women and empowering women on income generation activities are a key intervention to tackle under nutrition.

Do antenatal childbirth education classes improve birth satisfaction?

Do antenatal childbirth education classes improve birth satisfaction?

Evaluation of patient satisfaction with provided spinal anesthesia for Cesarean delivery: A survey in Leskovac General Hospital, Serbia

Introduction/Objective. ?o ensure that all patients receive the best possible anesthetic care, it is essential to continuously evaluate our practices and strive for improvement. The objective of this study was to internally assess the anesthesia services provided during the peripartum period. Methods. The Anesthesiology Department of Leskovac General Hospital, Serbia (LGH) aimed to evaluate patient satisfaction with spinal anesthesia (SA) for Cesarean delivery (CD) using a questionnaire consisting of four open-ended questions. Following Institutional Review Board approval, an institutional-based survey was conducted from August 2021 to July 2022. During the study period, 624 (40.6%) of the total 1535 deliveries in LGH were CDs, with 311 (49.8%) of them performed under SA. Of the patients who underwent CD under SA, 87 agreed to anonymously complete the questionnaire. Results. Although patients had sufficient space to provide detailed responses, the majority of participants opted for brief answers, often limited to ?yes? or ?no?. Of the surveyed participants, 78% were informed about SA for CD before delivery, and 96.6% expressed satisfaction with the information provided during the preoperative anesthesiologist?s visit. Additionally, the majority of participants (94.3%) reported satisfaction with the postoperative analgesia they received. Conclusion. Our patients expressed high levels of satisfaction with the preoperative anesthesiologist?s visit and the SA provided for CD. However, there is a need to improve antenatal education for expectant mothers in the field of anesthesia. Conducting a new and more detailed survey would be necessary to further explore the influence of patient education and socio-economic status on patient satisfaction.

Predilection for Birth Companionship among Antenatal Women of North India: Experience of a Tertiary Care Center

Background: In the accomplishment of respectful maternal care, the birth companion of choice is a well-known cost-effective, beneficial intervention with evidence of improved labor and delivery outcomes. However, there is paucity regarding the status of women’s desire for birth companionship. The following study was directed to assess the prevalence of predilection for birth companionship and factors influencing it among antenatal women in Karnal city of North India. Methodology: This was a cross-sectional study conducted in a tertiary care center over 3 months in Karnal city of North India. A total of 423 antenatal women were accessed by systematic random sampling using a face-to-face interviewer-administered questionnaire. The data were entered into Epi data version 4.6 and transformed to SPSS version 25. Binary logistic regression analysis was performed, and variables with a P ≤ 0.2 on bivariable analysis were taken for multivariable analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to detect the association, and a P &lt; 0.05 in the multivariable analysis was used to declare statistical significance. Results: The prevalence of desire for birth companionship was 59.1%. Women with planned pregnancy (AOR = 2.9; [95% CI 1.67–5.04]), first or second gravida (AOR = 3.375 [1.670–6.818]) and between 18 and 25 years of age (AOR = 6.087 [2.28–16.22]) had a significant desire for birth companionship. Conclusions: The desire for birth companionship among pregnant women was high in this study. Improving women’s decision-making power, emphasis on planned pregnancy and antenatal education classes were the areas of improvement to increase the desire of women for a labor companion.

Minoritised ethnic women’s experiences of inequities and discrimination in maternity services in North-West England: a mixed-methods study

BackgroundMinoritised ethnic perinatal women can experience judgemental and stigmatising care due to systemic racism. Discriminatory care contributes to increased risks of poor maternal and infant outcomes, including higher rates of mental ill-health. This study aimed to explore minoritised ethnic women’s experiences of maternity services, including maternity care and mental health support, within a North-West England locality. Here we use an equity lens to report the findings that describe if and how women’s personal, cultural, and spiritual needs were met, their experiences of discriminatory and prejudicial care, and to identify recommendations for service provision.MethodsA mixed-methods study was undertaken comprising an online survey, interviews, and community consultations. Questions explored access to and experiences of antenatal care and education; information, communication, and choice; experiences of (dis)respect and judgement; mental health needs and support; cultural/religious needs and support; and overall experiences of maternity care. Eligibility criteria were: women, 18+ years, from self-reported minoritised ethnic backgrounds, who had given birth in the previous 2 years and received maternity care in the locality. Surveys were available in seven languages and distributed via social media, mother-baby groups, and community locations. English-speaking survey participants were invited to take part in a follow-up interview. Community staff were approached to collect data on behalf of the study team. Quantitative data were analysed descriptively (n, %) and merged with qualitative data into descriptive themes.ResultsOverall, 104 women provided data; most self-identified as Asian (65.0%) or Black (10.7%) and were aged between 30–34 (32.0%) or 25–29 years (23.3%). Four descriptive themes are reported: ‘accessing care’ details variations and barriers in accessing maternity care; ‘communication needs, and resources’ describes views on adaptions and resources for specific communication needs; ‘meeting religious and cultural needs’ outlines how various religious and cultural needs were met by maternity providers; ‘discriminatory or stigmatising care’ reports on experiences of pejorative and inequitable care.ConclusionsAn equity lens helped identify areas of discriminatory and inequitable care. Key recommendations include cultural safety training for staff; service-user engagement and co-production of research and resources, and appropriate facilities and recording systems to facilitate individualised, needs-based maternity care.