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Ethnic health inequalities in the UK's maternity services: a systematic literature review

02 February 2021
14 min read
Volume 29 · Issue 2

Abstract

Background

Black, Asian, and minority ethnic (BAME) women have significantly higher morbidity and mortality rates in the UK as well as poorer experiences of care. To date, a systematic literature review has not been undertaken in the UK to explore ethnicity based health inequalities.

Aim

To explore the maternal health inequalities encountered by BAME women in the UK in relation to their experiences and use of services.

Method

A systematic literature search was conducted via five databases (PubMed, MEDLINE, CINAHL, MIDIRS and BNI). Inclusion-exclusion criterion and a keyword strategy were implemented to screen for literature published between 2013–2018.

Findings

A total of eight studies with various ethnicities and geographical locations were included. Five themes emerged following thematic analysis: communication, midwife-woman relationship, healthcare services and systems, culture and social needs.

Conclusion

The review identified consistency within and across the five themes. Maternity services and systems is a predominant theme that has a residual effect on the remaining four themes.

Maternal and infant mortality and morbidity have progressively declined in the last decade throughout the world (Moller et al, 2019), and there have been many improvements in the quality of maternity care in the UK. However, disparities remain between ethnic groups (Ameh and van Den Broek, 2011; National Audit Office, 2013; Matthews, 2015). Black, Asian and minority ethnic (BAME) women face limitations in access to maternity services in the UK and experience poorer health outcomes compared to white British women (Garcia et al, 2015). The most recent confidential enquiry into maternal mortality reported that black women are five times more likely; mixed-ethnicity women are three times more likely; Asian women are twice as likely to die in pregnancy then white women (Knight et al, 2019). Moreover, black women are up to twice as likely to have a stillbirth at all gestational ages (Muglu et al, 2019).

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