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Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review

Alix Bukkfalvi-Cadotte, Gargi Naha Orcid Logo, Ashra Khanom Orcid Logo, Amy Brown Orcid Logo, Helen Snooks Orcid Logo

BMC Pregnancy and Childbirth, Volume: 24

Swansea University Authors: Alix Bukkfalvi-Cadotte, Gargi Naha Orcid Logo, Ashra Khanom Orcid Logo, Amy Brown Orcid Logo, Helen Snooks Orcid Logo

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DOI (Published version): 10.1186/s12884-024-06893-2

Abstract

Background: Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care,...

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Published in: BMC Pregnancy and Childbirth
ISSN: 1471-2393
Published: Springer Science and Business Media LLC 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68221
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A scoping review</title><swanseaauthors><author><sid>6dab4f2309d3612d195c9177e788b910</sid><firstname>Alix</firstname><surname>Bukkfalvi-Cadotte</surname><name>Alix Bukkfalvi-Cadotte</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>3da7223a6ff1f9179f187a63187b5fbd</sid><ORCID>0000-0003-4293-5894</ORCID><firstname>Gargi</firstname><surname>Naha</surname><name>Gargi Naha</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>1f0f14742e3a36e8fd6d29f59374a009</sid><ORCID>0000-0002-5735-6601</ORCID><firstname>Ashra</firstname><surname>Khanom</surname><name>Ashra Khanom</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>37aea6965461cb0510473d109411a0c3</sid><ORCID>0000-0002-0438-0157</ORCID><firstname>Amy</firstname><surname>Brown</surname><name>Amy Brown</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ab23c5e0111b88427a155a1f495861d9</sid><ORCID>0000-0003-0173-8843</ORCID><firstname>Helen</firstname><surname>Snooks</surname><name>Helen Snooks</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-11-08</date><deptcode>MEDS</deptcode><abstract>Background: Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups. Methods: We conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections. Results: Twenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10&#x2013;0.60) to 0.96 (CI: 0.70&#x2013;1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15&#x2013;0.39) and 0.78 (CI: 0.47&#x2013;1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies. Conclusions: The studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all.</abstract><type>Journal Article</type><journal>BMC Pregnancy and Childbirth</journal><volume>24</volume><journalNumber/><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1471-2393</issnElectronic><keywords>Refugee, Asylum, Migrant, Intrapartum, Childbirth, Intervention</keywords><publishedDay>12</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-11-12</publishedDate><doi>10.1186/s12884-024-06893-2</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>External research funder(s) paid the OA fee (includes OA grants disbursed by the Library)</apcterm><funders>This is part of a doctoral research project which funded by an Economic and Social Research Council (ESRC) Wales DTP studentship (project reference: 2753746 related to ES/P00069X/1).</funders><projectreference/><lastEdited>2024-12-05T14:43:12.4010719</lastEdited><Created>2024-11-08T10:58:53.7090670</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Biomedical Science</level></path><authors><author><firstname>Alix</firstname><surname>Bukkfalvi-Cadotte</surname><order>1</order></author><author><firstname>Gargi</firstname><surname>Naha</surname><orcid>0000-0003-4293-5894</orcid><order>2</order></author><author><firstname>Ashra</firstname><surname>Khanom</surname><orcid>0000-0002-5735-6601</orcid><order>3</order></author><author><firstname>Amy</firstname><surname>Brown</surname><orcid>0000-0002-0438-0157</orcid><order>4</order></author><author><firstname>Helen</firstname><surname>Snooks</surname><orcid>0000-0003-0173-8843</orcid><order>5</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2024-12-05T14:43:12.4010719 v2 68221 2024-11-08 Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review 6dab4f2309d3612d195c9177e788b910 Alix Bukkfalvi-Cadotte Alix Bukkfalvi-Cadotte true false 3da7223a6ff1f9179f187a63187b5fbd 0000-0003-4293-5894 Gargi Naha Gargi Naha true false 1f0f14742e3a36e8fd6d29f59374a009 0000-0002-5735-6601 Ashra Khanom Ashra Khanom true false 37aea6965461cb0510473d109411a0c3 0000-0002-0438-0157 Amy Brown Amy Brown true false ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 2024-11-08 MEDS Background: Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups. Methods: We conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections. Results: Twenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10–0.60) to 0.96 (CI: 0.70–1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15–0.39) and 0.78 (CI: 0.47–1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies. Conclusions: The studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all. Journal Article BMC Pregnancy and Childbirth 24 Springer Science and Business Media LLC 1471-2393 Refugee, Asylum, Migrant, Intrapartum, Childbirth, Intervention 12 11 2024 2024-11-12 10.1186/s12884-024-06893-2 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) This is part of a doctoral research project which funded by an Economic and Social Research Council (ESRC) Wales DTP studentship (project reference: 2753746 related to ES/P00069X/1). 2024-12-05T14:43:12.4010719 2024-11-08T10:58:53.7090670 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Alix Bukkfalvi-Cadotte 1 Gargi Naha 0000-0003-4293-5894 2 Ashra Khanom 0000-0002-5735-6601 3 Amy Brown 0000-0002-0438-0157 4 Helen Snooks 0000-0003-0173-8843 5
title Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
spellingShingle Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
Alix Bukkfalvi-Cadotte
Gargi Naha
Ashra Khanom
Amy Brown
Helen Snooks
title_short Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
title_full Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
title_fullStr Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
title_full_unstemmed Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
title_sort Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
author_id_str_mv 6dab4f2309d3612d195c9177e788b910
3da7223a6ff1f9179f187a63187b5fbd
1f0f14742e3a36e8fd6d29f59374a009
37aea6965461cb0510473d109411a0c3
ab23c5e0111b88427a155a1f495861d9
author_id_fullname_str_mv 6dab4f2309d3612d195c9177e788b910_***_Alix Bukkfalvi-Cadotte
3da7223a6ff1f9179f187a63187b5fbd_***_Gargi Naha
1f0f14742e3a36e8fd6d29f59374a009_***_Ashra Khanom
37aea6965461cb0510473d109411a0c3_***_Amy Brown
ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
author Alix Bukkfalvi-Cadotte
Gargi Naha
Ashra Khanom
Amy Brown
Helen Snooks
author2 Alix Bukkfalvi-Cadotte
Gargi Naha
Ashra Khanom
Amy Brown
Helen Snooks
format Journal article
container_title BMC Pregnancy and Childbirth
container_volume 24
publishDate 2024
institution Swansea University
issn 1471-2393
doi_str_mv 10.1186/s12884-024-06893-2
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 0
active_str 0
description Background: Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups. Methods: We conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections. Results: Twenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10–0.60) to 0.96 (CI: 0.70–1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15–0.39) and 0.78 (CI: 0.47–1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies. Conclusions: The studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all.
published_date 2024-11-12T20:35:57Z
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score 11.04748

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