Reducing traumatic birth experiences for disadvantaged women through improved awareness, attitudes, behaviors and practices among maternity professionals: A study to assess the feasibility of developing and using a tailored educational programme

In 2012 the Health and Social Care Act placed a duty on theSecretary of State, NHS England and Clinical Commissioning Groups to addressinequalities in health. However, recent statistics reveal that teenage mothers,those from... [ view full abstract ]

In 2012 the Health and Social Care Act placed a duty on theSecretary of State, NHS England and Clinical Commissioning Groups to addressinequalities in health. However, recent statistics reveal that teenage mothers,those from socioeconomically disadvantaged areas and Black and Minority Ethnic(BME) communities are more likely to have mental health issues, have a highermortality rate and have a higher rate of long term conditions associated withlifestyle. The World Health Organization also identified that those fromdisadvantaged socioeconomic backgrounds were more likely to receive poor carepractices from maternity providers and to experience a traumatic birth. As a multi-racial, multi-culturalsociety, maternity professionals are increasingly required to provide maternityservices to women from diverse backgrounds and who have complex needs. NHSEngland recently committed to ensuring equality, diversity and culturallycompetent principles become central to NHS care. Yet, disparities ineducational resources to address these issues, alongside a lack of culturallycompetent staff, result in some NHS trusts feeling unequipped to deal withcomplex and diverse minority groups.

This research aims to addressthese issues by developing a feasible and acceptable educational programme formaternity professionals to reduce the number of socioeconomicallydisadvantaged/vulnerable women experiencing a traumatic birth. During thepresentation I will provide insights from a completed meta-synthesis of 17papers that explored theinteractions between vulnerable/disadvantaged women and their healthcare professionals in high-income countries. Four third-order interpretationswere developed: ‘depersonalization’, ‘no care in the care’,dehumanization’ and ‘them and us’. Empirical research that focuses onthe experiences of a traumatic/distressing birth among socio-economicallydisadvantaged women has also been undertaken. This consisted of tensemi-structured interviews, paying particular attention to their experiences ofmaternity health care professionals (HCPs). The plans for phase two of thestudy (PhD) include the use ofvignettes with HCPs to explore their experiences of delivering care todisadvantaged/vulnerable women and to explore their self-identified educationalneeds. This phase will also include engaging with critical theory, educationaltheories, emancipatory action research and patient/public involvement (i.e.women/health care staff/educational professionals). It is intended thatthe secondary (meta-synthesis) and empirical work will be reviewed through acritical lens, applying the methodology of participatory action research andusing Freierean critical pedagogy, in particular The seminal work of PauloFreire ‘Pedagogies of the oppressed’ which will serve as a blueprint toco-design the educational programme alongside an adapted participatory actionresearch method. Freire’s work resonates with the work of Miranda Fricker whosetheory of ‘Epistemic injustice’ discusses the notion of ‘testimonial injustice’& ‘hermeneutical injustice’ as a precursor to the dehumanization ofvulnerable groups. In this presentation I will highlight the relevance of theseimportant works in relation to the study and to illuminate vulnerable women’sexperiences of maternity care.