Exploring ethnic minority women's experiences of maternity care during the SARS-CoV-2 pandemic: a qualitative study.
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ABSTRACT: Objective
To explore the experiences of pregnancy, childbirth, antenatal and postnatal care in women belonging to ethnic minorities and to identify any specific challenges that these women faced during the SARS-CoV-2 pandemic.Design
This was a qualitative study using semistructured interviews of pregnant women or those who were 6 weeks postnatal from Black, Asian and minority ethnic backgrounds. The study included 16 women in a predominantly urban Scottish health board area.Results
The finding are presented in four themes: 'communication', 'interactions with healthcare professionals', 'racism' and 'the pandemic effect'. Each theme had relevant subthemes. 'Communication' encompassed respect, accent bias, language barrier and cultural dissonance; 'interactions with healthcare professionals': continuity of care, empathy, informed decision making and dissonance with other healthcare systems; 'racism' was deemed to be institutional, interpersonal or internalised; and 'the pandemic effect' consisted of isolation, psychological impact and barriers to access of care.Conclusions
This study provides insight into the specific challenges faced by ethnic minority women in pregnancy, which intersect with the unique problems posed by the ongoing SARS-CoV-2 pandemic to potentially widen existing ethnic disparities in maternal outcomes and experiences of maternity care.
SUBMITTER: John JR
PROVIDER: S-EPMC8423508 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundSubstantial changes occurred in Australian healthcare provision during the COVID-19 pandemic to reduce the risk of infection transmission. Little is known about the impact of these changes on childbearing women.AimTo explore and describe childbearing women's experiences of receiving maternity care during the COVID-19 pandemic in Australia.MethodsA qualitative exploratory design using semi-structured interviews was used. Women were recruited through social media and self-nominated to participate in an interview. Maximum variation sampling was used. Twenty-seven interviews were conducted with women from across Australia. Data was analysed thematically.FindingsThree primary themes and nine sub-themes emerged: 'navigating a changing health system' (coping with constant change, altered access to care, dealing with physical distancing restrictions, and missing care), 'desiring choice and control' (experiencing poor communication, making hard decisions, and considering alternate models of care), and 'experiencing infection prevention measures' (minimising the risk of exposure and changing care plans to minimise infection risk).DiscussionThe substantial changes in care delivery for pregnant and postpartum women during the pandemic appear to have reduced woman-centred care. In most cases, care was perceived as impersonal and incomplete, resulting in a very different experience than expected; consequences included missing care. The presence of a known care provider improved women's sense of communication, choice, and control.ConclusionThis study provides unique insight into the experiences of childbearing women across Australia. The importance of respectful woman-centred care cannot be forgotten during a pandemic. The findings may inform future service planning during pandemics and disaster situations.
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Project description:IntroductionRacial and ethnic disparities in rates of maternal morbidity and mortality in the United States are striking and persistent. Despite evidence that variation in the quality of care contributes substantially to these disparities, we do not sufficiently understand how experiences of perinatal care differ by race and ethnicity among women with severe maternal morbidity.MethodsWe conducted focus groups with women who experienced a severe maternal morbidity event in a New York City hospital during their most recent pregnancy (n = 20). We organized three focus groups by self-identified race/ethnicity ([1] Black, [2] Latina, and [3] White or Asian) to detect any within- and between-group differences. Discussions were audiotaped and transcribed. The research team coded the transcripts and used content analysis to identify key themes and to compare findings across racial and ethnic groups.ResultsParticipants reported distressing experiences and lasting emotional consequences after having a severe childbirth complication. Many women appreciated the life-saving care they received. However, poor continuity of care, communication gaps, and a perceived lack of attentiveness to participants' physical and emotional needs led to substantial concern and disappointment in care. Black and Latina women in particular emphasized these themes.ConclusionsThis study highlights missed opportunities for improved clinician communication and continuity of care to address emotional trauma when severe obstetric complications occur, particularly for Black and Latina women. Enhancing communication to ensure that women feel heard and informed throughout the birth process and addressing implicit bias, as a part of the more systemic issue of institutionalized racism, could both decrease disparities in obstetric care quality and improve the patient experience for women of all races and ethnicities.
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