Midwives’ experiences caring for asylum-seeking women in the UK: a systematic review
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.
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.
The results of the systematic review were categorised into three themes: racism and resentment, structural difficulties and systematic problems.
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.
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