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Black, Asian and minority ethnic women's experiences of maternity services in the UK : A qualitative evidence synthesis
Abstract
Aims: Black, Asian and minority ethnic women are at higher risk of dying during pregnancy, childbirth and postnatally and of experiencing premature birth, stillbirth or neonatal death compared with their White counterparts. Discrimination against women from ethnic minorities is known to negatively impact women's ability to speak up, be heard and their experiences of care. This evidence synthesis analysed Black, Asian and minority ethnic women's experiences of UK maternity services in light of these outcomes. Design: We conducted a systematic review and qualitative evidence synthesis using the method of Thomas and Harden. Data Sources: A comprehensive search in AMED, Cinahl, Embase, Medline, PubMed and PsycINFO, alongside research reports from UK maternity charities, was undertaken from 2000 until May 2021. Eligible studies included qualitative research about antenatal, intrapartum and postnatal care, with ethnic minority women in maternity settings of the UK NHS. Review Methods: Study quality was graded using the Critical Appraisal Skills Programme tool. Results: Twenty‐four studies met the inclusion criteria. Our synthesis highlights how discriminatory practices and communication failures in UK NHS maternity services are failing ethnic minority women. Conclusion: This synthesis finds evidence of mistreatment and poor care for ethnic minority women in the UK maternity system that may contribute to the poor outcomes reported by MBRRACE. Woman‐centred midwifery care is reported as positive for all women but is often experienced as an exception by ethnic minority women in the technocratic birthing system. Impact: Ethnic minority women report positive experiences when in receipt of woman‐centred midwifery care. Woman‐centred midwifery care is often the exception in the overstretched technocratic UK birthing system. Mistreatment and poor care reported by many ethnic minority women in the UK could inform the inequalities of outcomes identified in the MBRRACE report.
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“In the context of the current study, this fi nding is surprising, given the vast body of evidence exploring this notion [17,19-21,23,44-50].”
From The birth trauma earthquake: A qualitative investigation of first-time mothers who perceived their birth as traumatic (2026) · cites this paper as [23]
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“as well as having direct influence upon the type of care they receive and the discouragement of concern-raising [23].”
From The birth trauma earthquake: A qualitative investigation of first-time mothers who perceived their birth as traumatic (2026) · cites this paper as [23]
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The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, J., & Harden, A. (2008) · BMC Medical Research Methodology · doi:10.1186/1471-2288-8-45 · Cited by 9,312
Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., Koffel, J. B., PRISMA-S Group, Blunt, H., Brigham, T., et al. (2021) · Systematic Reviews · doi:10.1186/s13643-020-01542-z · Cited by 3,714
Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., & Koffel, J. (2019) · doi:10.31219/osf.io/sfc38 · Cited by 3,696
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“Core concepts identified as necessary for a positive birth experience among all birthing women include respectful care, trusting relationships, control and participation in decision- making (Downe et al., 2018; Karlsdottir et al., 2018; Renfrew et al., 2014).”
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Bailey, E. C., Barry, Z., Buabeng, R., Fellows, R. E., Khazaezadeh, N., Rajasingam, D., Silverio, S. A., & Sheen, K. S. (2026) · Women and Birth · doi:10.1016/j.wombi.2026.102171
Metadata
- Authors
- MacLellan, J., Collins, S., Myatt, M., Pope, C., Knighton, W., & Rai, T.
- Affiliations
- Nuffield Department of Primary Care Health Sciences University of Oxford, Radcliffe Observatory Quarter Oxford UK
- Nuffield Department of Women's & Reproductive Health University of Oxford, Level 3, Women's Centre, John Radcliffe Hospital Oxford UK
- University Hospitals Sussex NHS Foundation Trust Worthing UK
- Riseproject.co. Oxford UK
- ORCID
- MacLellan, Jennifer
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2022-03-24
- Volume
- 78
- Issue
- 7
- Pages
- 2175-2190
- ISSN
- 0309-2402
- 1365-2648
- PMC
- PMC9314829
- Cited by
- 86
- References
- 7
- Language
- en
- Funders
- Burdett Trust for Nursing (SB\ZA\101010662\633464)
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