Tackling racism in maternal health

Catalao, Raquel; Zephyrin, Laurie; Richardson, Lisa; Coghill, Yvonne; Smylie, Janet; Hatch, Stephani L

doi:10.1136/bmj-2023-076092

Cited by 16 publications

(3 citation statements)

References 33 publications

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“…Racial and ethnic disparities are prevalent in both (maternity) health care and CP referrals and require an intersectional approach to be fully understood [ 97 – 99 ]. Across the world, women of Indigenous and racialised groups experience poorer (reproductive) health [ 100 ] and have disproportionately more contact with CP services, with higher rates of child removal [ 99 , 101 , 102 ]. Calls to acknowledge the intergenerational trauma of child removal in indigenous communities in settler countries (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Building a trauma-informed workforce that is confident in safeguarding is essential to facilitate positive perinatal healthcare experiences. Looking at the wider healthcare system, the systemic impact of post-colonialism and racism, has been acknowledged as a priority to address existing reproductive health inequalities of Indigenous and racialised groups [ 100 , 104 , 108 ]. Our review has highlighted this should also be extended to safeguarding practice and processes of CP when accessing healthcare.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis

Backer,

Rayment-Jones,

Lever Taylor

et al. 2024

PLoS ONE

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Background The perinatal period is known as time of transition and anticipation. For women with social risk factors, child protection services may become involved during the perinatal period and this might complicate their interactions with healthcare providers. Aim To systematically review and synthesise the existing qualitative evidence of healthcare experiences of women and healthcare professionals during the perinatal period while facing child protection involvement. Methods A systematic search of databases (Web of Science, MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, MIDIRS, Social Policy and Practice and Global Health) was carried out in January 2023, and updated in February 2024. Quality of studies was assessed using the Critical Appraisal Skills Programme. A Critical Interpretative Synthesis was used alongside the PRISMA reporting guideline. Results A total of 41 studies were included in this qualitative evidence synthesis. We identified three types of healthcare interactions: Relational care, Surveillance and Avoidance. Healthcare interactions can fluctuate between these types, and elements of different types can coexist simultaneously, indicating the complexity and reciprocal nature of healthcare interactions during the perinatal period when child protection processes are at play. Conclusions Our findings provide a novel interpretation of the reciprocal interactions in healthcare encounters when child protection agencies are involved. Trust and transparency are key to facilitate relational care. Secure and appropriate information-sharing between agencies and professionals is required to strengthen healthcare systems. Healthcare professionals should have access to relevant training and supervision in order to confidently yet sensitively safeguard women and babies, while upholding principles of trauma-informed care. In addition, systemic racism in child protection processes exacerbate healthcare inequalities and has to be urgently addressed. Providing a clear framework of mutual expectations between families and healthcare professionals can increase engagement, trust and accountability and advance equity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis

Backer,

Rayment-Jones,

Lever Taylor

et al. 2024

PLoS ONE

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show abstract

“…2 In the way racism affects maternal health (doi:10.1136/bmj-2023-07609). 3 In the faltering struggle against non-communicable diseases, such as the rise of type II diabetes in young people (doi:10.1136/bmj.p2490). 4 In the alarming drop in childhood vaccination rates (doi:10.1136/bmj.p2426).…”

mentioning

confidence: 99%

Health’s doom loops and why they matter

Abbasi

2023

BMJ

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Is the period of austerity in the UK associated with increased rates of adverse birth outcomes?

Watson,

Walsh,

Scott

et al. 2024

European Journal of Public Health

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Hugely concerning changes to health outcomes have been observed in the UK since the early 2010s, including reductions in life expectancy and widening of inequalities. These have been attributed to UK Government ‘austerity’ policies which have profoundly affected poorer populations. Studies in mainland Europe have shown associations between austerity and increases in adverse birth outcomes such as low birthweight (LBW). The aim here was to establish whether the period of UK austerity was also associated with higher risks of such outcomes. We analysed all live births in Scotland between 1981 and 2019 (n = 2.3 million), examining outcomes of LBW, preterm birth (PB) and small-for-gestational-age (SGA). Descriptive trend analyses, segmented regression (to identify changes in trends) and logistic regression modelling (to compare risk of outcomes between time periods) were undertaken, stratified by infant sex and quintiles of socioeconomic deprivation. There were marked increases in LBW and PB rates in the austerity period, particularly in the most deprived areas. However, rates of SGA decreased, suggesting prematurity as the main driver of LBW rather than intrauterine growth restriction. The regression analyses confirmed these results: trends in LBW and PB changed within 1–3 years of the period in which austerity was first implemented, and that period was associated with higher risk of such outcomes in adjusted models. The results add to the European evidence base of worsening birth outcomes associated with austerity-related economic adversity. The newly elected UK government needs to understand the causes of these changes, and the future implications for child and adult health.

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Tackling racism in maternal health

Cited by 16 publications

References 33 publications

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis

Health’s doom loops and why they matter

Is the period of austerity in the UK associated with increased rates of adverse birth outcomes?

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