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. 2019 Dec 31;9(12):e029478. doi: 10.1136/bmjopen-2019-029478

Table 1.

Master table of included studies

Reference Study aim Region Methodology Theory or framework Setting Data analysis Sample and mode of recruitment
2 To provide insights into possible causes of poor maternity outcomes for new migrants in the West Midlands region of the UK and to develop recommendations that could help improve maternity services for these migrants. West Midlands Mixed methods: a semistructured questionnaire and in-depth interviews. Not specified. Not specified. Qualitative: systematic thematic approach. Quantitative: triangulation of the findings. A non-probability purposive sample was generated by selecting 82 women who had moved to the UK within the past 5 years and had subsequently utilised maternity services. Of these, 13 underwent in-depth interviews as well.
17 To apply the ‘three delays’ framework (developed for low-income African contexts) to a high-income Western scenario to identify delay-causing influences in the pathway to optimal facility treatment. Greater London Qualitative: individual and focus group interviews. ‘Three delays’ framework. Not specified. Constructivist hermeneutic naturalistic study. Purposive and snowball sampling was used to recruit 54 immigrant women originally from sub-Saharan regions in Africa (Somalia, Ghana, Nigeria, Senegal and Eritrea) living in London and to recruit 32 maternal providers.
40 To identify any social or ethnic differences in access to antenatal care and to quantify the effects of any such differences using data collected in a survey of women’s experiences of antenatal screening. England Quantitative: a cross-sectional survey using a postal questionnaire. Not specified. Not specified. Quantitative: cross-sectional analysis. A stratified clustered random sampling strategy was used. Hospitals in England were stratified according to ethnic mix. To ensure inclusion of an adequate number of women from black and minority ethnicity (BME) backgrounds, hospitals with ≥15% of women of BME origin were oversampled. Pregnant women aged ≥16 years and receiving care in 15 participating hospitals were sent a postal questionnaire at 27–31 weeks of gestation.
41 To establish efficacy of link-worker services (an intervention) introduced for non-English-speaking Asian women in multiracial health districts. Not specified Quantitative survey: 21-item questionnaire. Not specified. Qualitative: content analysis. Questionnaire to the Heads of Midwifery Services in 30 multiracial district health authorities. 20 responded. Sample is not immigrant women, however this is an evaluation of an intervention.
42 To compare the health behaviours both antenatally (smoking and alcohol consumption) and postnatally (initiation and duration of breast feeding) of mothers who have white British or Irish heritage with those of mothers from ethnic minority groups and to examine in mothers from ethnic minority groups whether indicators of acculturation (generational status, language spoken at home and length of residency in the UK) were associated with these health behaviours. England Quantitative: a prospective nationally representative cohort study. Not specified. Not specified.  Quantitative: cohort study. Stratified clustered sampling framework to over-represent mothers from ethnic minority groups and disadvantaged areas produced 6478 white British or Irish mothers and 2110 mothers from ethnic minority groups. Of those from ethnic minority groups, 681 (33%) were first generation and 55 (4%) second generation.
43 To determine the pregnancy outcomes of women of similar parity and ethnic background who received antenatal care (‘booked’) compared those who did not (‘unbooked’) over a period of 18 months. North Middlesex University Hospital, London Quantitative: a retrospective cohort study from September 2006 to March 2008 comparing the sociodemographics and the foetal and maternal outcomes of pregnancies of unbooked vs booked women. Not specified. Not specified. Quantitative: a retrospective cohort study. Women who received no antenatal care or who delivered within 3 days of their initial booking visit were categorised as ‘unbooked’. In each case, the woman who had delivered next on the labour ward register (matched for ethnicity and parity) and who had received antenatal care prior to the second trimester served as a comparison.
44 To identify predictors of late initiation of antenatal care within an ethnically diverse cohort. Newham, East London Quantitative: a cross-sectional analysis of routinely collected electronic patient records from Newham University Hospital NHS Trust (NUHT). Not specified. Not specified. Quantitative: cross-sectional analysis. All women who attended their antenatal booking appointment within NUHT between 1 January 2008 and 24 January 2011 were included in this study. The main outcome measure was late antenatal booking, defined as attendance at the antenatal booking appointment after 12 weeks (+6 days) gestation. The sample included women from Somalia, Eastern Europe, Africa, the Caribbean and South Asia.
45 To compare the maternal and birth outcomes of Polish and Scottish women having babies in Scotland and to describe any differences in clinical profiles and service use associated with migration from Poland. All over Scotland Quantitative: a population-based epidemiological study of linked maternal country of birth, maternity and birth outcomes. Scottish maternity and neonatal records linked to birth registrations were analysed for differences in modes of delivery and pregnancy outcomes between Polish migrants and Scots. These outcomes were also compared with Polish Health Fund and survey data. Not specified. Not specified. Quantitative: statistical analysis. The study analysed 119 698 Scottish and 3105 Polish births to primiparous women in Scotland in 2004–2009 using routinely collected administrative data on maternal country of birth and birth outcome.
46 To determine the nature of the barriers confronting women when they used antenatal and postnatal services. Pollokshields, Glasgow Qualitative: semistructured questionnaire. Not specified. Not specified. Qualitative: thematic analysis. Twenty women were interviewed in depth by a Centre’s Health Development Worker. Of these, 17 were born outside the UK.
47 To determine the current clinical practice of maternity care in England, including the service provision and organisations that underpin care, from the perspective of women needing the care; to identify the key areas of concern for women receiving maternity care in England; and to determine whether and in what ways women’s experiences and perceptions of care have changed over the last 10 years. England: not specified Quantitative: survey. Not specified. Survey: not specified. Quantitative: cross-sectional design. Random samples of women selected for the pilot and main studies were identified by staff at the ONS using live birth registrations for births within two specific weeks: 2–8 January (pilot) and 4–10 March 2006 (main study). The same method of sampling was used as had been employed in 1995 to enable direct comparisons. Random samples of 400 women for the pilot survey and 4800 women for the main survey who were aged 16 years and over and who had delivered their baby in a 1-week period in England were selected. The sampling was stratified on the basis of births in different geographical areas (Government Office Regions). No subgroups were oversampled. The usable response rate was 60% for the pilot survey and 63% for the main survey. The samples included 229 women of BME born outside the UK.
48 To explore the healthcare experience of vulnerable pregnant migrant women. London Mixed methods: participants were contacted by phone (using a three-way interpreter call if appropriate) and interviewed using a pro forma questionnaire designed to determine their access to antenatal care; barriers to that access; and their experiences during pregnancy, labour and the immediate postnatal period. Further data was extracted from their records at the Doctors of the World (DOTW) clinic to see how they had accessed the clinic. Not specified. Phone survey. Qualitative: thematic analysis. Quantitative: not clear. Pregnant women who presented to the drop-in clinic of the DOTW in London were approached between January 2013 and June 2014.
49 To develop a reliable and valid questionnaire to evaluate satisfaction with maternity care in Sylheti-speaking Bangladeshi women. London Mixed methods: two-stage psychometric study. First, a Sylheti-language questionnaire regarding Bangladeshi women’s experiences of maternity services was translated and culturally adapted from an English-language questionnaire using focus groups, in-depth interviews and iterative methods. Second, quantitative psychometric methods were used to field test and evaluate the acceptability, reliability and validity of this questionnaire. Not specified. Not specified. Qualitative: thematic analysis. Quantitative: validity of an instrument. Located at four hospitals providing maternity services in London, UK. Study participants included 242 women from the London Bangladeshi communities who were in the antenatal (at least 4 months pregnant) or postnatal phase (up to 6 months after delivery). The women spoke Sylheti, a language with no accepted written form. In stage one purposive samples of 40 women in the antenatal or postnatal phase participated, along with one convenience sample of six women in the antenatal phase and three consecutive samples of 60 women in the postnatal phase. In stage two, 135 women (main sample) completed the questionnaire 2 months after delivery (82% response rate), and 50 women (retest sample) from the main sample completed a second questionnaire 2 weeks later (96% response rate).
50 A Sure Start local programme had funded a Bangladeshi support worker to provide bilingual breastfeeding support to childbearing Bangladeshi women, many of whom were not fluent in English. This study aimed to conduct a short evaluation of the impact of this work on the uptake and duration of breastfeeding among these women. Tower Hamlets Mixed methods: the survey questionnaire included some open and closed questions about the women’s intention to feed; their current feeding methods; the breastfeeding support and information they received antenatally, during the hospital stay and postnatally; overall views on the information and support received; and some demographic details. Eleven interviews were conducted by telephone in Sylheti (a dialect that has no written format), three in English and one in Urdu (using a female family member to translate). Interviews took between 15 and 30 min to complete. Not specified. Not specified (survey conducted by telephone). Qualitative: content analysis of a questionnaire (open and closed questions). The two midwives and the support worker had provided breastfeeding support to 194 women during a 1-year period (September 2001 to August 2002). Of these, 80 women received help from the support worker alone. The majority of these 80 women were Bangladeshi. For the evaluation, 15 women were randomly selected from these 80 women.
51 To explore the perspectives of first-generaltion and second-generation women of Pakistani origin on maternity care and to make recommendations for culturally appropriate support and care from maternity services. West Midlands Mixed methods: a retrospective Q methodology study of Pakistani women following childbirth. Retrospective Q method study. Not specified. Qualitative: Q methodology. A purposive sampling strategy was used. Postnatal first- and second-generation Pakistani women were self-identified by their responses to information leaflets disseminated at local Children’s Centres across an inner city in the West Midlands.
52 To evaluate a pilot mental health service for asylum-seeking mothers and babies. UK (not clear) Mixed methods: evaluation within a participatory action research framework. Participatory action research framework. Not specified. Qualitative: thematic analysis. Quantitative: the CARE-Index. An active outreach recruitment strategy was adopted by psychologists, who embedded themselves in a drop-in community group, the Merseyside Refugee & Asylum Seekers & Asylum Seekers Pre-& Postnatal Support Group. Participants were West African women who were asylum-seekers or refugee and who were either pregnant or had a young baby. They originated from The Gambia, Sierra Leone, Ivory Coast and Nigeria. All spoke English. Their ages ranged from 17 to 32 years, and all babies were under 6 months of age at the point of initial contact, with three babies not yet born. Attendance at the 21 therapeutic group sessions ranged between 4 and 12 mothers (with their babies). Seven mothers attended a significant proportion or all group sessions. An additional six mothers attended 1–4 group sessions.
53 To provide locally applicable data on the needs of Black and minority ethnic women in relation to their uptake of maternity and neonatal care provision by primary healthcare teams in Leeds. Leeds Mixed methods: questionnaires and focus groups. Interpreters were used when necessary for data collection. A questionnaire was translated into Urdu for some women. Not specified. Local community centres and in the participants’ homes. Qualitative: content analysis. Quantitative: survey (not clear). A total of 97 questionnaires were completed, of which 50 were completed through informal links at community centres, schools and in women homes. The remaining 47 were completed while the researcher attended various antenatal clinics in the community.
54 To explore perinatal clinical indicators and experiences of postnatal care among European and Middle Eastern migrant women and to compare them with those of British women at a tertiary hospital in the North East of Scotland. North East of Scotland Mixed methods. Phase 1 of the research was a secondary analysis of routine data for 15 030 consecutive deliveries at Aberdeen Maternity Hospital.
Phase two was a retrospective study of 26 European, Middle Eastern and British mothers in this hospital. After the women had given birth, verbal data was collected using face-to-face semistructured interviews.
Not clear. Phase 2: 24 interviews were conducted in the homes of participants and two interviews at the university department. Qualitative: thematic analysis. Quantitative: Phase 1 was a secondary analysis of routine data for 15 030 consecutive deliveries at Aberdeen Maternity Hospital. Phase 2 was a retrospective study of women. Phase 1: The 15 030 deliveries included all births at Aberdeen Maternity Hospital over the financial years 2004–2008 in which maternal nationalities were identified and gestation was ≥24 weeks. Both singleton and multiple births were included. The clinical data was harvested from the Patient Administration System and the PROTOS maternity information system. In the case of women with multiple order births during the study, all births were included. Phase 2 of the research was a retrospective study of a few of the mothers who had given birth at this hospital. Eight European and five Middle Eastern women were semimatched with 13 British women.
55 To assess the mechanisms of support available to EM (ethnic minority) communities from community and voluntary sector organisations in relation to maternal and infant nutrition (a mapping exercise); to explore the experiences of the targeted client groups in seeking and receiving such support; and to identify gaps and opportunities to enhance support mechanisms and engagement with diverse EM communities. Glasgow, Edinburgh, Aberdeen, Stirling, Fife, Dundee and Inverness. Mixed methods: an online questionnaire survey of organisations working with EM communities, focus groups and telephone interviews with EM women. Not specified. Not specified. Qualitative: thematic analysis. Quantitative: The study identified 65 community organisations that potentially provided food and health services across EM communities in Scotland. In total, 37 organisations replied to the survey. Of those organisations, 15 indicated that they are providing services in the area of maternal and infant nutrition. A further 12 indicated that despite working with EM communities, they do not provide services in maternal and infant nutrition or healthy eating in general. An additional ten organisations confirmed by telephone that they were or had been working with EM women, but were unable to undertake the survey. The majority of interviewees for the focus groups and interviews were selected in response to a request sent by Black and Ethnic Minorities Infrastructure in Scotland (BEMIS) to community organisations. Snowball sampling was used to provide further contacts. In total, four focus groups were conducted with Polish, Roma, Czech and African mothers. In addition, six telephone interviews were conducted with Polish mothers. We focused on Polish mothers because they were the largest new ethnic group in Scotland since 2004.
56 To understand the nature of need in super-diverse areas and to examine the emergent challenges for effective maternity service delivery in an era of superdiversity. West Midlands Mixed methods: the study used a semistructured questionnaire and held narrative interviews of newcomer women. The findings were then triangulated with interviews of professionals who regularly worked with such women. Not specified. Not specified. Qualitative: systematic thematic analysis. Quantitative: triangulation of findings. Sampling was not described clearly. However, the study used a semistructured questionnaire that was designed in collaboration with maternity professionals and community researchers to explore the views and maternity experiences of newcomer women. Experienced multilingual female community researchers completed 82 of these questionnaires with interviewees in a range of different languages. Narrative interviews were also held with 13 women to further explore issues. The findings were triangulated with 18 interviews of professionals who regularly worked with migrant women.
57 To study the maternity care experiences of Somali refugee women in an area of West London. This article focused particularly on findings relating to the language barrier, which to a large degree underpinned or at least aggravated other problems the women experienced. West London Qualitative: case study. Six semistructured interviews and two focus groups (with six participants each). Not specified. Not specified. Qualitative: thematic analysis. Snowball sampling: 12 Somali women were selected from a larger survey involving 1400 women.
58 To undertake a qualitative study of the maternity experiences of 33 asylum-seekers. London, Plymouth, Hastings, Brighton, Oxford, Manchester and King’s Lynn. Qualitative. Not specified. Home or a neutral location. Qualitative: content analysis. Convenience and snowball sampling of recent asylum-seekers. Based on semistructured interviews carried out in seven English cities.
59 To explore and synthesise the maternity care experiences of female asylum-seekers and refugees. UK Qualitative: multiple exploratory longitudinal case studies that used a series of interviews, photographs taken by the women, field notes and observational methods to contextualise data obtained during 2002 and 2003. Theory of interactions and transformational educational theory. Hospital settings or women’s homes. Qualitative: thematic analysis. Women were approached if the status of ‘asylum-seeker’ or ‘refugee’ was written in the hospital notes taken at their booking appointment. Fourteen women were approached, but nine women declined to participate. Five women consented, but one woman was dispersed before 20 weeks gestation and therefore was not included in the study. Of the remaining four participating women, three were asylum-seekers and one was a refugee. The sampling technique was not clearly reported.
60 To identify key features of communication across antenatal care and whether they are evaluated positively or negatively by service users. Central London Qualitative: used six focus groups of 15 participants each and conducted 15 semistructured interviews. Non-English-speaking focus groups and interviews were conducted in standard Bengali, Sylheti or Somali. Not specified. Focus groups: hospitals and university meeting rooms. Semistructured interviews: various locations to suit the needs of the women. Qualitative: thematic analysis. The sampling technique was not clearly reported, but they recruited 30 pregnant women from diverse social and ethnic backgrounds affiliated with one NHS Trust (ie, hospital) in central London. Participants were recruited within this hospital, in eight community antenatal clinics situated in socially and ethnically diverse areas, via a community parenting group for Somali women, and via a Bengali Women’s Health Project. Within the hospital, participants were recruited from the antenatal waiting room (which services low-risk and high-risk pregnancies), the ultrasound clinic and the glucose tolerance testing clinic.
62 To address the research question that postulates that immigrant women experience sensitive care through the use of an ethnically congruent interpreter and that such women prefer to meet health providers of the same ethnic and gender profile when in a multiethnic obstetrics care setting. Greater London Qualitative: in-depth individual and focus group interviews. Open-ended questions were presented by an obstetrician and an anthropologist. Framework of naturalistic enquiry. Not specified. Qualitative: naturalistic inquiry. Participants were recruited throughout Greater London between 2005 and 2006. Snowball sampling was used to recruit 36 immigrant Somali women, and another three were selected by a by purposive technique for a total of 39. A purposive technique was used to select further 11 Ghanaian women who had delivered at least one child within the British healthcare system and who were living within the study area at the time of data collection.
61 To study the relationships between Somali women and their Western obstetric care providers. The attitudes, perceptions, beliefs and experiences of both groups were explored in relation to caesarean sections, particularly to identify factors that might lead to adverse obstetric outcomes. Greater London Qualitative: in-depth individual and focus group interviews. Framework of naturalistic enquiry, emic/etic model. Not specified. Qualitative: emic/etic analysis. Selected 39 Somali women by snowball sampling, 36 from the community and three purposively from a hospital.
63 To investigate women’s experiences of dispersal in pregnancy and to explore the effects of dispersal on the health and maternity care of women asylum-seekers who were dispersed during pregnancy in the light of National Institute for Health and Care Excellence guidelines on antenatal, intrapartum and postnatal care. London, South of England, Midlands and East of England, North West, North East and Wales. Qualitative: interviews were conducted with 19 women who had been dispersed during their pregnancies and with one woman kept in an Initial Accommodation Centre under a new Home Office pregnancy and dispersal guidance issued in 2012. Not specified. Not specified. Qualitative (not clear). The sampling technique was not mentioned clearly. The women interviewed came from 14 different countries and had been dispersed or relocated to or within six regions of the UK. At the time of dispersal, 14 had been awaiting a decision on their asylum claim and six had been refused asylum.
64 To understand the multiple influences on behaviour and hence the risks to metabolic health of South Asian mothers and their unborn children, to theorise how these influences interact and build over time, and to inform the design of culturally congruent, multilevel interventions. London boroughs, Tower Hamlets and Newham. Qualitative: group story-sharing sessions and individual biographical life-narrative interviews. Multilevel ecological models. All but four interviews were in the participants’ homes. Qualitative: phenomenology. The study recruited from diabetes and antenatal services in two deprived London boroughs 45 women of Bangladeshi, Indian, Sri Lankan or Pakistani origin aged 21–45 years with histories of diabetes in pregnancy. Overall, 17 women shared their experiences of diabetes, pregnancy and health services in group discussions, and 28 women gave individual narrative interviews (facilitated by multilingual researchers). All were audiotaped, translated and transcribed.
65 To gain an understanding of infant feeding practices among a group of UK-based refugee mothers. Liverpool and Manchester Qualitative: two focus group discussions and 15 semistructured interviews. Not specified. HCPs: private offices or clinics Refugee women: private rooms or discrete areas at the support venue (community centre or church hall). Qualitative: thematic analysis. The study purposively selected 30 refugee mothers from 19 countries who now resided in Liverpool or Manchester and were at least 6 months pregnant or had a child who had been born in the UK in the last 4 years. Of these 30, 19 were HIV negative and 11 were HIV positive.
66 To explore how Somali women with FGM experienced and perceived antenatal and intrapartum care in England. Birmingham Qualitative: a descriptive, exploratory study using face-to-face semistructured interviews that were audio-recorded. Not specified. Private room. Qualitative: thematic analysis. The study used convenience and snowball sampling of ten Somali women in Birmingham who had received antenatal care in England in the past 5 years.
67 To explore the maternity care experiences of pregnant asylum-seeking women in West Yorkshire to inform service development. West Yorkshire Qualitative: interpretative approach within the tradition of hermeneutic phenomenology. Not specified. Not specified. Qualitative: interpretive approach with hermeneutic phenomenology analysis. Purposive sampling was performed through the voluntary sector and a children’s centre. In addition, word-of mouth led to an element of snowball sampling. Six women were recruited.
68 To explore differences in infant thermal care beliefs between mothers of South Asian and white British origin in Bradford, UK. Bradford District, West Yorkshire Mixed methods: mothers were interviewed using a questionnaire with structured and unstructured questions. Not specified. The women chose the location of the interview. Qualitative: thematic analysis.  A total of 102 mothers (51 South Asian and 51 white British) were recruited in Bradford District, West Yorkshire, UK. The inclusion criteria specified infants aged 13 months or less with a parent of South Asian or white British cultural origin who lived in the Bradford District. South Asia was defined as including the countries of Pakistan, India, Afghanistan, Sri Lanka and Nepal. Recruitment was aided by local community organisations, children’s centres and community contacts. Urdu-speaking and Punjabi-speaking interpreters were requested and provided for 69 per cent of the first-generation South Asian mothers (n=26) in the sample.
69 To study the effectiveness of three linkworker and advocacy schemes that were designed to empower minority ethnic community users of maternity services. Birmingham Qualitative: focus group discussions, semistructured interviews and non-directive interviews. Not specified. Antenatal clinics in hospitals and health centres, community group settings and participants’ homes. Qualitative: not clear, thematic analysis? Individual interviews were conducted with 66 Asian women who had received support from link-worker and advocacy services during their pregnancy and postnatally. Of these, 28 were from Birmingham, 13 from Leeds and 25 from Wandsworth-London. A semistructured interview guide was translated into five Asian languages: Hindi, Punjabi, Gujarati, Urdu and Tamil. The study also included ten focus groups made up of 60 women who had not used linkworker or advocacy services. All participants were recruited with the help of various minority ethnic women’s groups and community organisations. Interpreters assisted 11 personal interviews with non-users from Vietnamese and Chinese backgrounds.
70 To study the maternity services experiences of Muslim parents in England. UK: not specified Qualitative: focus groups with Muslim mothers to explore their experiences of and views about maternity services; questionnaires with Muslim fathers; and interviews with health professionals Not specified. Not specified. Qualitative: content analysis. A mixed sample of 43 immigrants and non-immigrants were recruited via their project advisory groups. The focus groups were conducted in various locations around the UK, with two focus group discussions in a language other than English. A total of eight health professionals were interviewed: six midwives (two of whom worked for Sure Start programmes), a health visitor and a consultant obstetrician.
71 To explore the perceptions of pregnant asylum-seekers in relation to the provision of their maternity care while in emergency accommodation in the UK. South East of England Qualitative: an exploratory approach using unstructured interviews with five healthcare professionals and semistructured interviews with ten pregnant asylum-seekers. Not specified. Participants’ emergency accommodations. Qualitative: thematic analysis. Purposive sampling of those providing maternity care for asylum-seekers produced a sample comprising two midwives (M1 and M2), one GP (GP), one hospital consultant (C) and one nurse (N), all based in south coast health centres and hospitals. A total of 15 pregnant asylum-seekers were approached to participate in the study. These women entered the UK through a south coast port over a 3-month period. Their countries of origin were Algeria, Congo, Angola, Nigeria, Somalia and Iraq, and they spoke French, Portuguese, Yoruba, Arabic and Kurdish. Translated information letters and consent forms were distributed to pregnant asylum-seekers via the Refugee Help Line, which also returned signed consent forms. This constitutes non-probability, purposive sampling.
72 To explore the meanings attributed by migrant Arab Muslim women to their experiences of childbirth in the UK. In particular, to explore migrant Arab Muslim women’s experiences of maternity services in the UK; to examine the traditional childbearing beliefs and practices of Arab Muslim society; and to suggest ways to provide culturally sensitive care for this group of women. UK: not specified Qualitative: an interpretive ontological-phenomenological perspective informed by the philosophical tenets of Heidegger (1927/1962). Heideggerian hermeneutic phenomenology. All interviews were in the participants’ homes except for one, which took place in a restaurant after 22:00 hours. Qualitative: thematic analysis. Purposive sampling produced eight Arab Muslim women who had migrated to one multicultural city in the Midlands.
73 To examine the health-seeking behaviours of Korean migrant women living in the UK. London Qualitative: 21 semistructured interviews. Foucauldian approach. Not clear. Qualitative: not clear. Women were recruited from New Malden via Korean community contacts.
74 To explore the experiences of obstetric care in Scotland among women who have undergone FGM. Glasgow and Edinburgh Qualitative: personal experiences of FGM and interviews. Interpretivism paradigm and feminist perspective. The Dignity Alert & Research Forum office or in the participant’s home. Qualitative: thematic analysis. Convenience and purposive sampling resulted in a total number of seven women taking part in this study. All women were of African origin living in Scotland (three in Glasgow and four in Edinburgh). The inclusion criteria for the study were women who have undergone FGM and had experienced childbirth in Scotland. Three women were originally from Somalia, two from The Gambia, one from Ghana and one from Sudan. Six of them were Muslims and one was Christian. All women had undergone FGM in their countries of origin. Four women had been infibulated and the remaining three could not tell if they have had FGM type 2 or 3.
75 To gain a rich understanding of migrant Pakistani Muslim women’s experiences of postnatal depression within motherhood; to inform clinical practice; and to suggest ways of improving supportive services for this group. East London Qualitative: interpretative phenomenology. Interpretative phenomenological analysis (IPA) theory. Not specified. Qualitative: interpretative phenomenology. Purposive sampling resulted in the recruitment of four migrant Pakistani Muslim women from London aged from 27 to 39.
76 To explore relationships between first-generation migrant Pakistani women and midwives in the South Wales region, focusing on the factors that contribute to these relationships and the ways that these factors might affect the women’s experiences of care. South Wales Qualitative: a focused ethnography. Symbolic interactionism. Midwives: at lunch break or between clinics. Pakistani women: not clear. Qualitative: thematic analysis. Purposive sampling, through midwife gatekeepers, was selected for the initial recruitment of pregnant migrant Pakistani women: emails were sent to all midwives working with migrant women in South Wales. Snowballing was then used to recruit other midwives eligible for participation. Focused, non-participant observations of antenatal booking appointments took place in antenatal clinics across the local health board region over a period of 3–6 months. A total of seven midwives and 15 women were observed during these appointments, which lasted 20–60 min each.
77 To explore BME women’s experiences of contemporary maternity care in all over England. England Qualitative data collected from a large cross-sectional survey using three open-ended questions that encouraged participants to articulate their experience of maternity care in their own words. Not specified. Not specified. Qualitative: Thematic analysis. A random sample of 4800 women was selected using Office for National Statistics birth registration records. The overall response rate was 63% but was only 3% from BME groups. A total of 368 women self-identified as coming from BME groups. Of those, 219 (60%) responded with open text and 132 (60%) were born outside the UK.

PROTOS is a maternity care recording system.

HCP, healthcare professional.