'They're more like ordinary stroppy British women': attitudes and expectations of maternity care professionals to UK-born ethnic minority women.

OBJECTIVE: To explore the attitudes and expectations of maternity care professionals to UK-born ethnic minority mothers. METHODS: Qualitative in-depth interviews with 30 professionals from eight NHS maternity units in England that provide services for large proportions of women of black Caribbean, black African, Indian, Pakistani and Irish descent. RESULTS: All the professionals reported providing care to both UK-born and migrant mothers from ethnic minorities. Most of them felt that they could differentiate between UK-born and migrant mothers based mainly on language fluency and accent. 'Westernized dress' and 'freedom' were also cited as indicators. Overall, professionals found it easier to provide services to UK-born mothers and felt that their needs were more like those of white English mothers than those of migrant mothers. UK-born mothers were generally thought to be assertive and expressive, and in control of care-related decision-making whereas some South Asian Muslim women were thought to be constrained by family influences. Preconceived ideas about ethnic minority mothers' tolerance of pain in labour, use of pharmacological pain relief measures and mode of delivery were recurring themes. Women's education and social class were felt to be major influences on the uptake of maternity care, regardless of ethnicity. CONCLUSIONS: Professionals appeared to equate the needs of UK-born ethnic minority women with those of white English women. Overall, this has positive implications for care provision. Despite this, specific behavioural expectations and unconscious stereotypical views were evident and have the potential to affect clinical practice.

Childbirth care practices in public sector facilities in Jeddah, Saudi Arabia: a descriptive study.

OBJECTIVES: to explore reported hospital policies and practices during normal childbirth in maternity wards in Jeddah, Saudi Arabia, to assess and verify whether these practices are evidence-based. DESIGN: quantitative design, in the form of a descriptive questionnaire, based on a tool extracted from the literature. SETTING: nine government hospitals in Jeddah, Saudi Arabia. These hospitals have varied ownership, including Ministry of Health (MOH), military, teaching and other government hospitals. PARTICIPANTS: key individuals responsible for the day-to-day running of the maternity ward. MEASUREMENTS: nine interviews using descriptive structured questionnaire were conducted. Data were analysed using SPSS for Windows (version 16.0). FINDINGS: the surveyed hospitals were found to be well equipped to deal with obstetric emergencies, and many follow evidence-based procedures. On average, the caesarean section rate was found to be 22.4%, but with considerable variances between hospitals. Some unnecessary procedures that are known to be ineffective or harmful and that are not recommended for routine use, including pubic shaving, enemas, episiotomy, electronic fetal monitoring (EFM) and intravenous (IV) infusion, were found to be frequently practiced. Only 22% of the hospitals sampled reported allowing a companion to attend labour and childbirth. KEY CONCLUSIONS: many aspects of recommended EBP were used in the hospitals studied. However, the results of this study clearly indicate that there is wide variation between hospitals in Jeddah, Saudi Arabia in some obstetric practices. Furthermore, the findings suggest that some practices at these hospitals are not supported by evidence as being beneficial for mothers or infants and are positively discouraged under international guidelines. IMPLICATIONS FOR PRACTICE: this study has specific implications for obstetricians, midwives and nurses working in maternity units. It gives an overview of current hospital policies and practices during normal childbirth. It is likely to contribute to improving the health and well-being of women, and have implications for service provision. It could also help in the development of technical information for policy-makers, and health care professionals for normal childbirth care.

UK-born ethnic minority women and their experiences of feeding their newborn infant.

OBJECTIVE: to explore the factors that impact on UK-born ethnic minority women's experiences of and decisions around feeding their infant. DESIGN: in-depth semi-structured interviews. PARTICIPANTS: 34 UK-born women of Black African, Black Caribbean, Pakistani, Bangladeshi, Indian and Irish parentage and 30 health-care professionals. SETTING: women and health-care professionals were recruited primarily from hospitals serving large numbers of ethnic minority women in London and Birmingham. FINDINGS AND CONCLUSIONS: despite being aware of the benefits of exclusive breast feeding, many women chose to feed their infant with formula. The main barriers to breast feeding were the perceived difficulties of breast feeding, a family preference for formula feed, and embarrassment about breast feeding in front of others. Reports from women of South Asian parentage, particularly those who lived with an extended family, suggested that their intentions to breast feed were compromised by the context of their family life. The lack of privacy in these households and grandparental pressure appeared to be key issues. Unlike other participants, Irish women reported an intention to feed their infant with formula before giving birth. The key facilitators to breast feeding were the self-confidence and determination of women and the supportive role of health-care professionals. IMPLICATIONS FOR PRACTICE: these findings point to common but also culturally specific mechanisms that may hinder both the initiation and maintenance of breast feeding in UK-born ethnic minority women. They signal potential benefits from the inclusion of family members in breast-feeding support programmes.

'You need that loving tender care': maternity care experiences and expectations of ethnic minority women born in the United Kingdom.

OBJECTIVE: To explore the maternity care experiences and expectations of United Kingdom (UK)-born ethnic minority women. METHODS: Qualitative in-depth interviews with 34 UK-born mothers of Black Caribbean, Black African, Indian, Pakistani, Bangladeshi and Irish descent, recruited mainly from nine National Health Service (NHS) maternity units in England. RESULTS: Overall, women felt that their ethnic background did not matter at all with respect to the care they received. UK-born women's familiarity with the system and the absence of language barriers were felt to be influential in getting treated the same as White women. Women stressed the need for professionals to be 'sensitive' and 'delicate' in their interactions and wanted 'continuity of care'. In general, they were positive about the adequacy of the information given during their antenatal appointments, but some women found it difficult to get access to antenatal classes. Women valued good communication and consistent information, with their views acknowledged and their questions answered consistently. They also expressed the need for better physical environments in maternity units. CONCLUSIONS: Our findings contribute to the growing evidence about the need to improve maternity and postnatal care, and to develop more sensitive and women-centred care for all women irrespective of ethnic background.