Dataset Information

Recency of migration, region of origin and women's experience of maternity care in England: Evidence from a large cross-sectional survey.

ABSTRACT:

Background

In the UK, changes to legislation in 2003 regarding the free movement of people in the European Union resulted in an increase in immigration from countries that joined the EU since 2004, the Accession countries.

Objective

To describe and compare the maternity experiences of recent migrant mothers to those who had been resident in the UK for longer, and to UK-born women, while taking into account their region of origin.

Design

Cross-sectional national survey.

Setting

England, 2009.

Participants

Random sample of postpartum women.

Measurements

Questionnaires asked about demographic characteristics, care during pregnancy, labour, birth and postnatally, about country of origin and, if not born in the UK, when they came to the UK. Country of origin was grouped into UK, Accession countries, and rest of the world. Recency of migration was grouped into recent arrivals (0-3 years), and earlier arrivals (4 or more years since arrival). Descriptive statistics and binary logistic regression were used to explore women's experiences of care. Stratified analyses were used to account for the strong correlation between recency of migration and region of origin.

Findings

Overall, 5332 women responded to the survey (a usable response rate of 54%). Seventy-nine percent of women were UK-born. Of the 21% born outside the UK, a third were born in Accession countries. All migrants reported a poorer experience of care than UK-born women. In particular, recent migrants from the Accession countries were significantly less likely to feel that they were spoken to so they could understand and treated with kindness and respect.

Conclusions

Given the rising population of non-UK-born women of childbearing age resident in the UK and the relatively high proportion from Accession countries, it is important that staff are able to communicate effectively, through interpreters if necessary.

Implications for practice

The differences in clinical practice between women's home countries and the UK should be discussed so that women's expectations of care are informed about the options available to them.

SUBMITTER: Henderson J

PROVIDER: S-EPMC6200018 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Recency of migration, region of origin and women's experience of maternity care in England: Evidence from a large cross-sectional survey.

Henderson Jane J Carson Claire C Jayaweera Hiranthi H Alderdice Fiona F Redshaw Maggie M

Midwifery 20180921

<h4>Background</h4>In the UK, changes to legislation in 2003 regarding the free movement of people in the European Union resulted in an increase in immigration from countries that joined the EU since 2004, the Accession countries.<h4>Objective</h4>To describe and compare the maternity experiences of recent migrant mothers to those who had been resident in the UK for longer, and to UK-born women, while taking into account their region of origin.<h4>Design</h4>Cross-sectional national survey.<h4>S ...[more]

PMID: 30273924

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Project description:BackgroundAs maternity services evolve and the population of women served also changes, there is a continuing need to effectively document the views of women with recent experience of care. A woman's maternity experience can have a positive or negative effect upon her emotional well-being and health, in the immediate and the long-term, which can also impact the infant and the wider family system. Measuring women's perceptions of maternity services is an important way of monitoring the quality of care provision, as well as providing key indicators to organisations of the services that they are providing. It follows that, without information identifying possible areas in need of improvement, it is not clear what changes should be made to improve the experiences of women during their journey through maternity services from pregnancy to the early weeks at home with a new baby . The objective is to describe the development process and psychometric properties of a measure of women's experience of maternity care covering the three distinctly different phases of maternity - pregnancy, labour and birth, and the early postnatal period.MethodsData from a national survey of women who had recently given birth (n = 504) were used. Exploratory and confirmatory factor analytic methods were employed. The measure was assessed for underlying latent factor structure, as well as for reliability, internal consistency, and validity (predictive, convergent and discriminant).ResultsThe models developed confirmed the use of three separate, but related scales about experience of maternity care during pregnancy, labour and birth and the postnatal period. Data reduction was effective, resulting in a measure with 36 items (12 per scale).ConclusionThe need for a psychometrically robust and qualitatively comprehensive measure of women's experience of maternity care has been addressed in the development and validation of this prototype measure. The whole measure can be used at one time point, or the three separate subscales used as individual measures of experience during particular phases of the maternity journey with identified factor structures in their own right.

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Project description:Minoritised 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. A 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. Overall, 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. An 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.

Project description:BACKGROUND:Evaluating women's satisfaction should reflect the entire maternity care experience (antenatal, intrapartum and postnatal). The Women's Experience Maternity Care Scale (WEMCS) questionnaire enables this assessment. The purpose of this study was to translate in French, adapt and explore the psychometric properties of the WEMCS and to determine the best cut-off on the optimal satisfaction for the three scales. METHODS:Backward, forward translation and cross-cultural adaptation were processed to validate the French version of WEMCS: Échelle de Satisfaction de l'Experience des soins en Maternité (ESEM). Psychometric tests assessed the questionnaire, which includes three scales, such as construct validity, internal consistency, Cronbach's alpha coefficients and ceiling and floor effects. A receiver operating characteristic (ROC) curve was used to determine the best cut-off values for optimal satisfaction. Reproducibility was verified by test-retest reliability. RESULTS:Primiparas with uncomplicated pregnancies were recruited antenatally at the University Hospital of Geneva. Of the 229 patients who agreed to participate, 202 women (88.2%) returned the test and retest questionnaires. Principal component analysis for the antenatal, intrapartum and postnatal scales suggested the unidimensional character of the three scales; Cronbach's alpha coefficients were high for the three scales with values of >?0.85. Construct validity based on the five-point Likert scale values showed a Spearman's rho correlation of r?=?0.56 for the antenatal scale (p?<?0.001) and r?=?0.62 for the intrapartum scale (p?<?0.001), as well as a strong correlation with the postnatal scale, with r?=?0.78 (p?<?0.001). Optimum cut-off scores for the ROC curve of the antenatal, intrapartum and postnatal scores were equal to or higher than 48, 50 and 70, respectively. The three scales showed good sensitivity and good specificity. The stability of the ESEM questionnaire was confirmed by intra-class correlation coefficients of >?0.80. However, the three scales revealed ceiling effects. CONCLUSION:The psychometric proprieties of the ESEM demonstrate it's ability to evaluate the quality of perinatal health care. The ESEM should be tested in the context of different models of women's care and with women with different degrees of pregnancy complications to explore the validity of this scale.

Dataset Information

Recency of migration, region of origin and women's experience of maternity care in England: Evidence from a large cross-sectional survey.

Background

Objective

Design

Setting

Participants

Measurements

Findings

Conclusions

Implications for practice

Publications

Recency of migration, region of origin and women's experience of maternity care in England: Evidence from a large cross-sectional survey.

Similar Datasets

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