Professionals’ Perspectives on Barriers for Timely Antenatal Care for Migrant and Ethnic Minority Women in the UK and the Netherlands
Antenatal care (ANC) is provided to women during pregnancy by healthcare professionals and is important to promote health and well-being of women and babies. Women from ethnic minority and migrant backgrounds are likely to start ANC later and to attend fewer appointments than recommended compared to white women in high-income European countries. These women and their babies are more likely to experience negative health outcomes. This study explored the perspectives of maternity care professionals on barriers for timely ANC initiation for ethnic minority and migrant women in the United Kingdom (UK) and The Netherlands.
Methods
We conducted qualitative semi structured in-depth interviews with 19 maternity care professionals (eight and eleven from the UK and The Netherlands respectively) including nurses, midwives, general practitioners, obstetricians and NGO representatives. All interviews were conducted virtually on Teams or Zoom and were recorded, transcribed and analysed using a thematic approach.
Results
Professionals in the UK and The Netherlands perceived more or less similar barriers for ethnic minority and migrant women for timely ANC initiation. As reflected in the accounts, these barriers operated at individual, health system and wider societal levels, and included negative interactions with antenatal care providers, women’s and community’s lack of trust in the health system, differences in spoken language between women and professionals, cultural differences, role of family and wider networks, and difficulties in reaching care. Perceived measures to facilitate access included skill development of healthcare professionals; educating women and building awareness in the community about how to navigate the healthcare system; integration of preventative psychosocial care into maternity services and continuity of care.
Conclusion
Similarity in perceived barriers and mitigation measures indicated the potential for developing and implementing targeted cross-country strategies and programs to facilitate timely healthcare acess for ethnic minority and migrant women in high-income European countries.