Professionals’ perspectives on barriers for timely antenatal care for ethnic minority women in the United Kingdom and The Netherlands

Abstract

Background Antenatal care (ANC) is important to promote health and well-being of women and babies. Women from ethnic minority backgrounds are likely to start ANC later and to attend fewer appointments than recommended compared to white women. These women and their babies are more likely to experience negative health outcomes. This study explored the perspectives of maternity care professionals on barriers for timely ANC initiation for ethnic minority women in the UK (UK) and The Netherlands. Methods We conducted qualitative semi structured in-depth interviews with 19 healthcare professionals (eight and eleven from the UK and The Netherlands respectively) including nurses, midwives, general practitioners and obstetricians. All interviews were conducted virtually on Teams or Zoom and were recorded, transcribed and analysed using a thematic approach using ATLAS.ti version 9 software. Results Maternity care professionals in the UK and The Netherlands perceived more or less similar barriers for ethnic minority women for timely ANC initiation. As reflected in the accounts, these barriers operated at individual and health system levels, and included negative interactions with antenatal care providers, women’s and community’s lack of trust in the health system, differences in spoken language between women and professionals, cultural differences, role of family and wider networks, and difficulties in reaching care. Perceived measures to facilitate access included skill development of healthcare professionals; educating women and building awareness in the community about how to navigate the healthcare system; integration of preventative psychosocial care into maternity services and continuity of care. Conclusions Similarity in perceived barriers and mitigation measures indicated the potential for developing and implementing targeted cross-country interventions to facilitate timely ANC initiation for ethnic minority women in high-income European countries. Key messages • Maternity care professionals in the UK and The Netherlands perceived similar barriers for ethnic minority women for timely ANC initiation. • There is potential for developing targeted cross-country programmes and services to support mothers from ethnic minority backgrounds to start antenatal care on time.