References

2020 Health. 2012. https://bit.ly/3QYrwMa (accessed 18 August 2022)

2010. https://bit.ly/3QLBXD5 (accessed 27 July 2021)

Adams K Should the NHS curb spending on translation services?. BMJ. 2007; 334:(398)

2022. https://bit.ly/3AaZhmK (accessed 20 April 2022)

Asif S, Baugh A, Jones N The obstetric care of asylum seekers and refugee women in the UK. Obstet Gynaecol. 2015; 17:(4)223-231 https://doi.org/10.1111/tog.12224

Balaam M, Kingdon C, Thomson G, Finlayson K, Downe S ‘We make them feel special’: the experiences of voluntary sector workers supporting asylum-seeking and refugee women during pregnancy and early motherhood. Midwifery. 2016; 34:133-140 https://doi.org/10.1016/j.midw.2015.12.003

BBC News. 2012. https://bbc.in/3ADRlf8 (accessed 19 August 2022)

Bennett S, Scammell J Midwives caring for asylum-seeking women: research findings. Pract Midwife. 2014; 17:(1)9-12

Bloor M, Frankland J, Thomas M, Robson KLondon: Sage; 2001

2015. https://bit.ly/3AgaiDl (accessed 18 August 2022)

Briscoe L, Lavender T Exploring maternity care for asylum seekers and refugees. Br J Midwifery. 2009; 17:(1)17-23 https://doi.org/10.12968/bjom.2009.17.1.37649

Carey M, Asbury JWalnut Creek, CA: Left Coast Press; 2012

Cross-Sudworth F, Williams A, Gardosi J Community midwifery care and social care pathways. Evidence Based Midwifery. 2015; 13:(1)15-21

2015. https://bit.ly/3PHWVBB (accessed 8 August 2022)

2016. https://bit.ly/3pDh2pZ (accessed 8 August 2022)

Fair F, Raben L, Watson H Migrant women's experiences of pregnancy, childbirth and maternity care in European countries. PLoS One. 2020; 15:(2)1-26 https://doi.org/10.1371/journal.pone.0228378

2013. https://bit.ly/3pDawzr (accessed 27 April 2021)

2016. https://bit.ly/3ckGJZf (accessed 18 August 2021)

Ford T, Kruglanski A Effects of epistemic motivations on the use of accessible constructs in social judgement. Personality Soc Psychol Bulletin. 1995; 21:(9)950-962

Frank G, Fox D, Njue C, Dawson A The maternity experiences of women seeking asylum in high-income countries: a meta-ethnography. Women Birth. 2021; 30390:(20)1-8 https://doi.org/10.1016/j.wombi.2020.12.012

Gaudion A, Allotey PUxbridge: Centre for Public Health Research, Brunel University; 2008

Greenwood N, Ellmers T, Holley J The influence of ethnic group composition on focus group discussions. BMC Med Res Methodol. 2014; 14 https://doi.org/10.1186/1471-2288-14-107

Gov.uk. 2018. https://bit.ly/3pWqxAV (accessed 14 June 2021)

Haith-Cooper M, Bradshaw G Meeting the health and social needs of pregnant asylum seekers, midwifery students’ perspectives part 1; dominant discourses and midwifery students. Nurse Educ Today. 2013a; 33:(9)1008-1013 https://doi.org/10.1016/j.nedt.2012.05.005

Haith-Cooper M, Bradshaw G Meeting the health and social care needs fo pregnant asylum seekers; midwifery students’ perspectives part 3; ‘the pregnant woman within the global context’: an inclusive model for midwifery education to address the needs of asylum-seeking women in the UK. Nurse Educ Today. 2013b; 33:(9)1045-1050 https://doi.org/10.1016/j.nedt.2012.04.016

Haith-Cooper M, McCarthy R Striving for excellence in maternity care: the maternity stream of the City of Sanctuary. Br J Midwifery. 2015; 23:(9)648-652 https://doi.org/10.12968/bjom.2015.23.9.648

Harper Bulman K, McCourt C Somali refugee women's experiences of maternity care in west London: a case study. Critical Public Health. 2010; 12:(4)365-380 https://doi.org/10.1080/0958159021000029568

Henderson J, Gao H, Redshaw M Experiencing maternity care: the care received and perceptions of women from different ethnic groups. BMC Pregnancy Childbirth. 2013; 13:(196) https://doi.org/10.1186/1471-2393-13-196

Higginbottom G, Evans C, Morgan M, Bharj K, Eldridge J, Hussain B Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review. BMJ Open. 2015; 9:(12)1-23 http://dx.doi.org/10.1136/bmjopen-2019-029478

Higginbottom G, Evans C, Morgan M, Bharj K, Eldridge J, Hussain B Expereicnes of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review. Obstet Gynaecol. 2019; 9:(12)

2022. https://bit.ly/3QQ9Cfa (accessed 8 August 2022)

Home Office. 2021. https://bit.ly/3pIJlDe (accessed 8 May 2022)

Horn A Racism matters: ‘when people show you who they are, believe them’: why black women mistrust maternity services. Pract Midwife. 2020; 23:(8)

2020. https://bit.ly/3Cmt52w (accessed 19 August 2022)

Kirkwood S, Mckinlay A, Mcvittie C The mutually constitutive relationship between place and identity: the role of place-identity in discourse on asylum seekers and refugees. J Community Appl Soc Psychol. 2013; 23:(6)453-465 https://doi.org/10.1002/casp.2141

Kitzinger J The methodology of focus groups: the importance of interaction between research participants. Sociol Health Illn. 1994; 16:(1)103-121 https://doi.org/10.1111/1467-9566.ep11347023

2014. https://bit.ly/3KtnlpT (accessed 24 March 2021)

Knight M, Bunch K, Tuffnell DOxford: National Perinatal Epidemiology Unit, University of Oxford; 2019

Kruglanski A, Pierro A, Mennetti L, De Grada E Groups as epistemic providers: need for closure and the unfolding of group-centrism. Psychol Rev. 2006; 113:(1)84-100

Kurth E, Jaeger F, Zemp E, Tschudin S, Bischoff A Reproductive health care for asylum-seeking women - a challenge for health professionals. BMC Public Health. 2010; 10:(659)1-11 https://doi.org/10.1186/1471-2458-10-659

Lephard E, Haith-Cooper M Pregnant and seeking asylum: exploring women's experiences ‘from booking to baby’. Br J Midwifery. 2016; 24:(2)130-136 https://doi.org/10.12968/bjom.2016.24.2.130

Loder E, Groves TS, Schroter S, Merino J, Weber W Qualitative research and the BMJ: a response to Greenhalgh and colleagues’ appeal for more. BMJ. 2016; 352:641-642 https://doi.org/10.1136/bmj.i641

Long H, French D, Brooks J Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis. Res Methods Med Health Sci. 2020; 1:(1)31-42 https://doi.org/10.1177%2F2632084320947559

Machin D, Mayr AThousand Oaks, CA: SAGE Publications Ltd; 2012

Maslach C, Jackson S The measurement of experienced burnout. J Occup Behav. 1981; 2:(2)99-113 https://doi.org/10.1002/job.4030020205

McKnight P, Goodwin L, Kenyon S A systematic review of asylum-seeking women's views and experiences of UK maternity care. Midwifery. 2019; 77:16-23 https://doi.org/10.1016/j.midw.2019.06.007

Muoni T Decision-making, intuition, and the midwife: understanding heuristics. Br J Midwifery. 2012; 20:(1)52-56 https://doi.org/10.12968/bjom.2012.20.1.52

NHS England. 2020. https://bit.ly/3CtTZWa (accessed 24 March 2021)

O'Regan V, Riordan E Comparing the representation of refugees, asylum seekers and migrants in the Irish and UK press. J Lang Politics. 2018; 17:(6)744-768 http://dx.doi.org/10.1075/jlp.17043.ore

Owens D, Fett S Black maternal and infant health: historical legacies of slavery. Am J Public Health. 2019; 109:(10)1342-1345 https://doi.org/10.2105%2FAJPH.2019.305243

Pangas J, Ogunsiji O, Emir R Refugee women's experiences negotiating motherhood and maternity care in a new country: a meta-ethnographic review. Int J Nurs Studies. 2018; 90:31-45 https://doi.org/10.1016/j.ijnurstu.2018.10.005

Pezaro S, Clyne W, Turner A, Fulton E, Gerada C ‘Midwives overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile stays on. Women Birth. 2016; 29:(3)59-66 http://dx.doi.org/10.1016/j.wombi.2015.10.006

Phillimore J Delivery maternity services in an era of superdiversity: the challenges of novelty and newness. Ethnic Racial Stud. 2015; 38:(4)568-582

Pruitt L Closed due to ‘flooding’? UK media representations of refugees and migrants in 2015-2016 - creating a crisis of borders. Br J Polit Int Relations. 2019; 21:(2)383-402 https://doi.org/10.1177%2F1369148119830592

Puthussery S Perinatal outcomes among migrant mothers in the United Kingdom: is it a matter of biology, behaviour, policy, social determinants or access to health care?. Best Pract Res Clin Obstet Gynaecol. 2016; 32:39-49 https://doi.org/10.1016/j.bpobgyn.2015.09.003

Reed A Amity Reed reviews the media response to Ockenden's ‘emerging findings’ report. Midwifery Matters. 2021; 168:(45)

Reid A Buses and breaking point: freedom of expression and the ‘Brexit’ campaign. Ethical Theory Moral Pract. 2019; 22:(3)623-637 https://doi.org/10.1007/s10677-019-09999-1

Refugee Action. 2019. https://bit.ly/3R4FT1G (accessed 18 August 2021)

2017. https://bit.ly/3wLI3vx (accessed 20 May 2021)

Royal College of Obstetricians and Gynaecologists. 2018. https://bit.ly/3Kfa18i (accessed 30 January 2022)

Royal College of Obstetricians and Gynaecologists. 2020a. https://bit.ly/3wozJBn (accessed 24 March 2021)

Royal College of Obstetricians and Gynaecologists. 2020b. https://bit.ly/3QY6RYw (accessed 18 August 2021)

Royal College of Midwives. 2016a. https://bit.ly/2I0xmw5 (accessed 15 May 2021)

Royal College of Midwives. 2016b. https://bit.ly/3KtnB8l (accessed 14 July 2021)

Royal College of Midwives. 2018. https://bit.ly/3KgeHKV (accessed 30 January 2022)

Royal College of Midwives. 2020a. https://bit.ly/3AFFsVY (accessed 18 August 2021)

Royal College of Midwives. 2020b. https://bit.ly/3wk5OKI (accessed 14 July 2021)

Royal College of Midwives. 2021. https://bit.ly/3wn3e6G (accessed 30 January 2022)

Salvo T “If I speak English, what am I? I am full man, me”: emotional impact and barriers for refugees and asylum seekers learning English. Transcult Psychiatry. 2017; 54:(5-6)733-755 https://doi.org/10.1177/1363461517746315

Stepanikova I Racial-ethnic biases, time pressure, and medical decisions. J Health Soc Behav. 2012; 53:(3)329-343 https://doi.org/10.1177/0022146512445807

Tobin C, Murphy-Lawless J Irish midwives’ experiences of providing maternity care to non-Irish women seeking asylum. Int J Womens Health. 2014; 31:(6)159-169 https://doi.org/10.2147%2FIJWH.S45579

Tong J, Zuo L Othering the European Union through constructing moral panics over ‘im/migrant(s)’ in the coverage of migration in three British newspapers, 2011-2016. Int Commun Gaz. 2019; 81:(5)445-469 https://doi.org/10.1177%2F1748048518802237

United Nations High Commissioner for Refugees. 2021. https://bit.ly/2BZkGmc (accessed 8 May 2022)

UK Home Office. 2020. https://bit.ly/3wrSaoT (accessed 14 July 2021)

Van de Vyver J, Houston D, Abrams D, Vasiljevic M How the July 7, 2005, London bombings affected liberals’ moral foundations and prejudice. Psychological Science. 2016; 27:(2)

Weller S, Crosby L, Turnbull E The negative health effects of hostile environment policies on migrants: a cross-sectional serice evaluation of humanitarian healthcare provision in the UK. Wellcome Open Research. 2019; 4:(109)

Briefing: what is the hostile environment, where does it come from, who does it affect?. 2018. https://bit.ly/3woZotJ (accessed 15 May 2021)

Pregnancy
compassion
Black, Asian, and minority ethnic
Health inequalities

Midwives’ experiences caring for asylum-seeking women in the UK: a systematic review

02 September 2022
Research
02 September 2022
Volume 30 · Issue 9

Abstract

Background/Aims

Asylum-seeking women face higher rates of maternal and neonatal mortality as a result of multiple barriers to accessing maternity care. Midwives are currently experiencing short staffing and high rates of burnout. Complex cases can add additional workload and stress. There is an evidence gap concerning midwives’ experiences of caring for asylum-seeking women in the UK. This study's aim was to examine the existing literature on this topic and consider the findings against the current realities of working within the NHS maternity system.

Methods

Literature was screened using the Critical Appraisal Skills Programme qualitative article checklist and the preferred reporting items for systematic reviews and meta-analyses flow diagram. Eight studies were included and analysed for thematic similarities.

Results

The results of the systematic review were categorised into three themes: racism and resentment, structural difficulties and systematic problems.

Conclusions

Midwives lacked the time to appropriately care for asylum-seeking women. A lack of time and resources may negatively impact midwives’ attitudes towards asylum-seeking women.

There is copious evidence regarding the experiences of asylum-seeking women accessing maternity care in the UK (Briscoe and Lavender, 2009; Feldman, 2013; Lephard and Haith-Cooper, 2016; McKnight et al, 2019), but this is not the case regarding the experiences of midwives themselves. In 2021, the UK received 485 480 asylum applications (Home Office, 2021). When compared to other European countries, this is a relatively low number; however, media and political discourse often present the volume of asylum seekers as a ‘crisis’ or ‘threat’ (Hill, 2022). This can negatively alter public perceptions towards asylum seekers and increase the discrimination they face.

In many ways, midwives are practicing in a time of crisis. It has been reported that for every 30 newly qualified midwives, 29 leave the profession (Royal College of Midwives (RCM), 2018). Management systems are alleged to be bullying and hierarchical (Royal College of Obstetricians and Gynaecologists (RCOG), 2018), and midwives are burnt out and unsatisfied with the quality of care they are able to deliver (RCM, 2021). In-keeping with welcome developments in policy to reduce racial inequalities in maternal outcomes (RCOG, 2020a; RCM, 2020a), this systematic review aimed to provide insight into the experiences of midwives when caring for asylum seekers.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month

Register
Or continue by

Signing in with your registered email address

Asylum seeker
Midwifery burnout
Racism
Resource limitation
Stereotyping