Vulnerable migrant women and charging for maternity care in the UK: advocating change

2013 ◽  
Author(s):  
Rosalind Bragg
Keyword(s):  
Maternity Care ◽  
Migrant Women ◽  
The Uk

NHS charging for maternity care in England: Its impact on migrant women

2020 ◽  
pp. 026101832095016
Author(s):  
Rayah Feldman
Keyword(s):  
Maternity Care ◽  
Negative Impact ◽  
Migrant Women ◽  
Undocumented Migrant ◽  
Physical And Mental Health ◽  
Home Office ◽  
Debt Collectors ◽  
Scant Attention ◽  
The Uk ◽  
The Right

NHS charging for ‘overseas visitors’ is recognised as deterring migrants from accessing necessary health care. Even though maternity care does not have to be paid in advance, fear of four-figure bills and Home Office sanctions against people with unpaid debts has significant adverse effects on women affected. Undocumented migrant women, without the right to work or benefits, are among the most excluded and vulnerable people living in the UK today, risking destitution especially in pregnancy. Despite government guidance, hospital charging procedures pay scant attention to the welfare of vulnerable migrants, with women who are unable to pay harassed by debt collectors. Charging such women deters them from accessing maternity care and has a negative impact on their physical and mental health. The article, based on a study of women who were charged, argues that charging for maternity care undermines NHS principles and inherently discriminates against women.

scholarly journals An exploration of migrant women’s perceptions of public health messages to reduce stillbirth in the UK: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomasina Stacey ◽  
Melanie Haith-Cooper ◽  
Nisa Almas ◽  
Charlotte Kenyon
Keyword(s):  
Public Health ◽  
Perinatal Mortality ◽  
Health Professionals ◽  
Health Messages ◽  
Migrant Women ◽  
Global Public Health ◽  
Wide Range ◽  
Public Health Messages ◽  
Associated Risk Factors ◽  
The Uk

Abstract Background Stillbirth is a global public health priority. Within the United Kingdom, perinatal mortality disproportionately impacts Black, Asian and minority ethnic women, and in particular migrant women. Although the explanation for this remains unclear, it is thought to be multidimensional. Improving perinatal mortality is reliant upon raising awareness of stillbirth and its associated risk factors, as well as improving maternity services. The aim of this study was to explore migrant women’s awareness of health messages to reduce stillbirth risk, and how key public health messages can be made more accessible. Method Two semi-structured focus groups and 13 one to one interviews were completed with a purposive sample of 30 migrant women from 18 countries and across 4 NHS Trusts. Results Participants provided an account of their general awareness of stillbirth and recollection of the advice they had been given to reduce the risk of stillbirth both before and during pregnancy. They also suggested approaches to how key messages might be more effectively communicated to migrant women. Conclusions Our study highlights the complexity of discussing stillbirth during pregnancy. The women in this study were found to receive a wide range of advice from family and friends as well as health professionals about how to keep their baby safe in pregnancy, they recommended the development of a range of resources to provide clear and consistent messages. Health professionals, in particular midwives who have developed a trusting relationship with the women will be key to ensuring that public health messages relating to stillbirth reduction are accessible to culturally and linguistically diverse communities.

Psychiatric causes of maternal deaths: Lessons from the Confidential Enquiries into Maternal Deaths

2014 ◽  
Author(s):  
Margaret R. Oates
Keyword(s):  
Maternal Death ◽  
Cardiac Disease ◽  
Maternity Care ◽  
Marked Reduction ◽  
Blood Transfusions ◽  
Maternal Deaths ◽  
Illegal Abortion ◽  
The Uk ◽  
The 19Th Century ◽  
In Pregnancy

The UK Confidential Enquiries into Maternal Deaths, published triennially, are over 50 years old. Its forebears are even older; enquiries into maternal deaths began early in the 19th century in Scotland. In the 20th century the numbers of women dying from childbirth has steadily declined, influenced by many factors, including improved public health and maternity care, smaller family size, blood transfusions, and antibiotics, to name but a few. The introduction of the Abortion Act in 1967 was followed by a marked reduction of deaths in pregnancy from the consequences of illegal abortion. The rate and causes of maternal death have always been influenced by changes in reproductive epidemiology and technology, and continue to be so. Maternal deaths in pregnancy and in the 6 weeks following delivery are required to be reported to the Coroner, if directly related to childbirth. However, there are other causes of maternal death due to conditions exacerbated by pregnancy: for example, diabetes, cardiac disease, epilepsy. These are referred to as indirect deaths. Women who die from conditions unrelated to pregnancy or childbirth are counted and described as coincidental deaths. Over the years as the direct causes of maternal death have fallen, the indirect causes of maternal death have achieved more prominence and case ascertainment has improved. Improvements in medical care and in particular intensive care have resulted in some women developing their fatal condition within 6 weeks of childbirth, only to die beyond it. For this reason, the UK Enquiry extended their period of surveillance beyond 6 weeks to include late maternal deaths, both a small number of late direct deaths and a larger number of late indirect deaths. Suicide in pregnancy and following delivery has always been included in the Enquiries. However, prior to 1994 the cases were not separately analysed and were included in the group of late Coincidental Deaths (i.e. not thought to be related to pregnancy or childbirth). The 1994–1996 Enquiry, under the Directorship and Editorship of Dr Gwyneth Lewis and Professor James O’Drife, heralded a change in presentation of the Enquiry.

Ethnographer location and the politics of translation: researching one’s own group in a host country

2012 ◽  
Vol 12 (2) ◽  
pp. 131-146 ◽  
Author(s):  
Young Jeong Kim
Keyword(s):  
Host Country ◽  
Research Process ◽  
Power Relationships ◽  
Migrant Women ◽  
Research Experience ◽  
Methodological Issues ◽  
South Korean ◽  
Hierarchical Relationship ◽  
The Uk ◽  
The Relationship

As public and academic attention to migration increases, methodological issues related to such research become increasingly important. Although previous efforts of scholars have provided excellent guidance concerning reflexivity and power relationships in research, these discussions have tended to assume a conventional hierarchy positioning and have been limited to the relationship between the researcher and the researched only. Yet, given the shift in the research environment stemming from the increasing mobility of scholars and the increasing interchange of knowledge, as well as emerging auto-ethnographic/auto-biographic research, it is now necessary to challenge these traditional assumptions. This article raises questions concerning the hierarchical relationship between researcher and researched and certain conceptions of the field of ethnography based on my own research experience regarding South Korean migrant women in the UK. Accordingly, with particular emphasis on the researcher’s role as a translator, this article suggests extending our consideration of such relationships to the readership, which constitutes an important, but under-considered, factor in the research process.

scholarly journals Exploring the views of undocumented migrant women on access to maternity services in the UK

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Hargreaves ◽  
L B Nellums ◽  
J Powis ◽  
L Jones ◽  
A Miller ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Policies ◽  
Migrant Women ◽  
Undocumented Migrant ◽  
Maternity Services ◽  
Access To Health ◽  
The Uk ◽  
Detrimental Impact

Abstract Background Migrant women face inequalities in access to health-care services and are known to experience poorer maternal and child outcomes than women born in the UK. The development of more restrictive health policies in the UK and Europe, including being denied or charged for healthcare at maternity services, may be exacerbating these outcomes, particularly among undocumented migrant women without permission to reside. We investigated undocumented migrant women's experiences of accessing maternity services in the UK and their impact on health outcomes. Methods We did semi-structured in-depth qualitative interviews with a purposive sample of migrant women (born outside the UK) who were aged 18 and over, and had experiences of pregnancy in the UK whilst undocumented. Participants were recruited through the Doctors of the World UK clinic. Interviews were transcribed and analysed using thematic analysis. Results We did interviews with 20 undocumented women (age range 31-40 years; mainly from Africa and Asia). Among participants, of whom 13 were pregnant at the time of interview, 10 (50%) first accessed antenatal care late (after the national target of 13 weeks). Women described an ongoing cycle of precariousness, defined by their legal status, social isolation, and poor economic status. Women reported receiving bills of up to £11,500 for maternity services (range £3,072 to £11.500). The impact of their experiences meant that they were deterred from seeking timely health care and were reluctant to present to health services, with women reporting fear and loss of trust in the health system. Conclusions These women's narratives illustrated the potential deterrent and detrimental impact of increasingly restrictive health policies on women's access to care and their health. UK and European health policies must be equitable, non-discriminatory, and better align with our commitments to promote universal health coverage among all individual residing in the region. Key messages Increasingly restrictive health policies may have a deterrent and detrimental impact on migrant women’s access to health care. Undocumented migrant women in the UK reported fear and loss of trust in the health system.

scholarly journals Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e029478 ◽  
Author(s):  
Gina Marie Awoko Higginbottom ◽  
Catrin Evans ◽  
Myfanwy Morgan ◽  
Kuldip Kaur Bharj ◽  
Jeanette Eldridge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Professionals ◽  
Maternity Care ◽  
Immigrant Women ◽  
Grey Literature ◽  
Further Education ◽  
Social Needs ◽  
Narrative Synthesis ◽  
Foreign Born ◽  
The Uk

One in four births in the UK is to foreign-born women. In 2016, the figure was 28.2%, the highest figure on record, with maternal and perinatal mortality also disproportionately higher for some immigrant women. Our objective was to examine issues of access and experience of maternity care by immigrant women based on a systematic review and narrative synthesis of empirical research.Review methodsA research librarian designed the search strategies (retrieving literature published from 1990 to end June 2017). We retrieved 45 954 citations and used a screening tool to identify relevance. We searched for grey literature reported in databases/websites. We contacted stakeholders with expertise to identify additional research.ResultsWe identified 40 studies for inclusion: 22 qualitative, 8 quantitative and 10 mixed methods. Immigrant women, particularly asylum-seekers, often booked and accessed antenatal care later than the recommended first 10 weeks. Primary factors included limited English language proficiency, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Maternity care experiences were both positive and negative. Women with positive perceptions described healthcare professionals as caring, confidential and openly communicative in meeting their medical, emotional, psychological and social needs. Those with negative views perceived health professionals as rude, discriminatory and insensitive to their cultural and social needs. These women therefore avoided continuously utilising maternity care.We found few interventions focused on improving maternity care, and the effectiveness of existing interventions have not been scientifically evaluated.ConclusionsThe experiences of immigrant women in accessing and using maternity care services were both positive and negative. Further education and training of health professionals in meeting the challenges of a super-diverse population may enhance quality of care, and the perceptions and experiences of maternity care by immigrant women.

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