Barriers to antenatal care pose risks to women from ethnic minorities

Barriers, including immigration status, bureaucracy, and racial bias, are putting pregnant women from minority ethnic backgrounds at increased risk of delayed access to antenatal care, according to research funded by Wellbeing of Women and the Burdett Trust for Nursing.

Previous studies have shown that Black women are four times more likely to die during pregnancy and childbirth compared to white women. For those who are Asian, the risk is two times greater. Although there are many possible reasons for this, low engagement with antenatal care plays a part.

The study, which has been published in BMC Health Services Research, analysed the antenatal care experiences of women from minority ethnic communities in 11 European countries.

Understanding the barriers to antenatal care

Researchers from the Maternal and Child Health Research Centre at the University of Bedfordshire highlighted several interconnected factors influencing access to antenatal care for ethnic minority women, from location and finances through to content and location of appointments.

Negative experiences of stigmatising, discriminatory attitudes from healthcare providers, language barriers and a failure to meet women’s basic information needs acted as explicit barriers to access.

Key factors improving access to antenatal care included building trusted relationships between women and their healthcare professionals, effective communication, and geographically close appointments.

The complex setup and bureaucracy of maternity services was also highlighted as a risk factor, particularly for those who don’t speak the local language, are worried about their migration status or are concerned about costs associated with healthcare.

Dr Shuby Puthussery, Director of Maternal and Child Health Research Centre at the University of Bedfordshire and lead researcher for this study, said: “Antenatal care is vital in helping to keep women and their unborn babies safe during pregnancy and the earlier women can access it the better. Unfortunately, we know it’s not always easy for women from Black, Asian and minority ethnic communities to access the health care they need to maximise their own and their babies’ health and wellbeing.

“Increasing the early uptake of antenatal care for women from underserved communities is vital. The only way to tackle this is to understand the barriers these women typically face so that effective solutions can be put in place.”

The World Health Organization recommends women attend at least eight antenatal classes as a preventative measure against adverse outcomes. However, Black and Asian women are less likely to start antenatal care early or receive the full course of appointments.

The research team has published six recommendations to improve access to antenatal care in high-income countries like the UK. These include:

• antenatal health care professionals receiving training in culturally safe care
• maternity services working with local third sector organisations
• promoting early initiation of antenatal care services
• basing services locally
• the use of interpreters and availability of accessible information on legal rights and entitlement to maternity care.

The study, Ethnic minority women’s experiences of accessing antenatal care in high income European countries: a systematic review, analysed 30 previous studies relating to the experiences of women from underserved communities in accessing antenatal care in 11 high-income European countries between January 2010 and May 2021.

Dr Puthussery’s research is one of a several studies we are funding to improve pregnancy outcomes for women and their babies. Read more about our research projects.

Support our vital work and help save and change the lives of women, girls and babies.