City Research Online

Abstract

Background: In UK maternity care, racialised women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS); home births and midwife-led units, both free-standing and alongside hospitals, are available as a choice for low-risk women in the UK. MLBS deliver optimal outcomes for low-risk women with uncomplicated pregnancies, including for racialised women, and can offer culturally specific care, possibly mitigating existing social inequalities. Evidence suggests that racialised women access MLBS less than White women.

Aim: Map existing literature on facilitators and barriers to access to MLBS for racialised women and identify emerging themes.

Method: A scoping review of UK literature over the last 10 years using OVID, Ebsco Host and grey literature. Search, selection, and data extraction were performed using PRISMA and JBI guidelines. Data were analysed using inductive thematic analysis.

Results: Fourteen articles met the inclusion criteria, only one addressing the research question directly and others containing some relevant material. Six themes were identified: admission criteria, information giving, the role of antenatal groups, bias and assumptions, beliefs about birth, and MLBS as empowering.

Conclusion: There is a lack of research on racialised women’s access to MLBS. Community outreach, midwifery services embedded in the community, defaulting to MLBS for women categorised as low risk, continuity of carer and interventions achieving a reduction in care-giver bias may improve access and outcomes.

Publication Type:	Article
Additional Information:	"This is the peer reviewed version of the following article: Melamed, A., Rocca-Ihenacho, L. , Horn, A. , McCourt, C. , Rivers, F. & Daniele, M. (2024). Facilitators and barriers to access to midwife-led birth settings for racialised women in the UK: A scoping review. Birth, doi: 10.1111/birt.12897 which will be published in final form at onlinelibrary.wiley.com/journal/1523536x. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited."
Publisher Keywords:	Midwifery-unit, birth centre, home birth, racism, Black women, BAME, Ethnic minority
Subjects:	H Social Sciences > HT Communities. Classes. Races R Medicine > RG Gynecology and obstetrics R Medicine > RT Nursing
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:	Symplectic Administrator

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