Ethnic minority women’s interactions with antenatal care providers in Europe

Background
Ethnic minority women are at greater risk of maternal morbidity and mortality. Antenatal care reduces risks of adverse maternal and neonatal outcomes and supports a positive transition to motherhood. Important components of quality antenatal care are interactions between women and care providers which are supportive and empowering.

Methods
We conducted a systematic review to identify and synthesise qualitative evidence on ethnic minority women's experiences of accessing antenatal care in European countries. Following a comprehensive search of 8 databases and two-step screening process, we included 27 studies from various European countries. Study findings were coded and synthesised using a ‘best-fit' framework approach.

Findings
Overall women expressed satisfaction with their antenatal care, frequently framed in relation to experiences of maternity care in countries of origin. Women highly valued interactions with antenatal care providers which were supportive and trust-inducing, and when there was continuity of carer to facilitate this. However, studies frequently showed a dichotomy between reported satisfaction with antenatal care and experiences of interactions with care providers which could be discriminatory, stigmatising and disempowering. Some women blamed themselves for negative interactions. Language barriers were frequently identified by women as a factor which hindered their communication with antenatal care providers and the subsequent quality of care received, when suitable interpreters were not available. Negative interactions with antenatal care providers could result in a withdrawal from ongoing antenatal care for some women.

Conclusions
This review highlights the importance of quality interactions between ethnic minority women and antenatal care providers. Policy implications: Antenatal care should be provided in such a way as to facilitate trust, support and effective communication between women and care providers.