# Experiences of women from ethnic minorities and underserved, marginalised and disadvantaged groups in communicating with health professionals during antenatal care: An overview of qualitative systematic reviews

## TL;DR

This study summarizes how women from ethnic minority and disadvantaged groups experience communication with healthcare professionals during pregnancy care in high-income countries.

## Contribution

The study provides a thematic synthesis of qualitative reviews highlighting communication barriers and positive experiences in antenatal care for marginalized women.

## Key findings

- Women faced challenges like language barriers, cultural differences, and discrimination in maternity care.
- Positive experiences included respectful communication, interpreters, and culturally sensitive care.
- Limited access to services was influenced by costs, transportation, and negative attitudes from staff.

## Abstract

Maternal mortality rates show disproportional disparities among disadvantaged groups.

To conduct an overview of qualitative systematic reviews to summarise the antenatal care experience of ethnic minority and underserved, marginalised and disadvantaged women in high-income countries.

Seven electronic databases were searched to identify reviews published between 2011-2022.

Two reviewers independently screened search results and full texts of potentially eligible articles.

Data were extracted by two independent reviewers, critically appraised using the JBI tool and assessed for overlap. A thematic analysis was conducted.

Nineteen qualitative reviews were included. Most were conducted in the UK (n=12) and provided a thematic synthesis of findings. Studied populations included women from minority ethnic groups and those who were migrants, homeless, refugees, asylum seekers, disabled, obese, or had experienced genital mutilation or human trafficking. Common challenges included language and cultural differences, and lack of effective interactions with healthcare professionals. Many women experienced discrimination, isolation, limited awareness of available services and negative attitudes from maternity care staff. Limited access to maternity services was influenced by various factors, including costs and communication barriers. Positive experiences included interactions with culturally responsive healthcare professionals, support from social groups, and access to interpreters.

Our findings highlight the complex challenges some women face during maternity care. Future research should focus on more personalised care solutions, long-term evaluations of maternity services, training of healthcare professionals, and ways to improve the quality of information provided and the interaction with healthcare professionals.

This study looked at how women from ethnic minority, underserved, and disadvantaged groups experience communication with health professionals during pregnancy care in high-income countries. These groups include migrants, refugees, asylum seekers, homeless women, women with disabilities, survivors of human trafficking or female genital mutilation, and women with obesity.

Our research team assessed 19 published studies to understand both challenges and positive experiences. Most studies were conducted in the UK. Many women reported difficulties such as language barriers, cultural misunderstandings, and a lack of clear information. Negative attitudes or discrimination from maternity staff made some women feel judged, isolated, or unsafe. Practical issues, such as costs, transportation, and childcare, also limited access to services. In some cases, women felt that the care was rushed, impersonal, or insensitive to their cultural or individual needs.

At the same time, women reported positive experiences when healthcare professionals communicated respectfully, gave clear information, and acknowledged cultural and emotional needs. Access to interpreters, support from family or community groups, and continuity of care also helped improve experiences.

Overall, our findings show that communication is central to good pregnancy care. When women feel listened to, respected, and supported, they are more likely to engage with services and have better experiences. However, many disadvantaged women face significant challenges that increase their risk of poor outcomes.

Maternity services, therefore, need to be more inclusive, culturally sensitive, and personalised. This includes training healthcare professionals in respectful and cross-cultural communication, improving interpreter services, and ensuring better access to supportive networks. Addressing these issues can help reduce inequalities and improve pregnancy care for all women.