The midwife–woman relationship in a South Wales community: Experiences of midwives and migrant Pakistani women in early pregnancy
2018
Background: In 2015, 27.5% of births in England and Wales were to mothers born
outside of the UK. Compared to their White British peers, minority ethnic and migrant
women are at a significantly higher risk of maternal and perinatal mortality, along with
lower maternity care satisfaction. Existing literature highlights the importance of
midwife–woman relationships in care satisfaction and pregnancy outcomes; however,
little research has explored midwife–woman relationships for migrant and minority
ethnic women in the UK.
Methods: A focused ethnography was conducted in South Wales, UK, including semi-structured
interviews with 9 migrant Pakistani participants and 11 practising midwives,
fieldwork in the local migrant Pakistani community and local maternity services,
observations of antenatal appointments, and reviews of relevant media. Thematic data
analysis was undertaken concurrently with data collection.
Findings: The midwife–woman relationship was important for participants’ experiences
of care. Numerous social and ecological factors influenced this relationship, including
family relationships, culture and religion, differing health-care
systems,
authoritative knowledge and communication of information. Marked differences were
seen between midwives and women in the perceived importance of these factors.
Conclusions: Findings provide new theoretical insights into the complex factors contributing
to the health-care
expectations of pregnant migrant Pakistani women in the
UK. These findings may be used to create meaningful dialogue between women and
midwives, encourage women’s involvement in decisions about their health care and
facilitate future midwifery education and research. Conclusions are relevant to a broad
international audience, as achieving better outcomes for migrant and ethnic minority
communities is of global concern.
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