The Midwife-Client Relationship: A Focus on Migrant Pakistani Women Living in South Wales

Background In 2011, 25.5% of births in England and Wales were to mothers born outside of the UK. Recent reports show significantly higher maternal mortality rates in England for minority ethnic than white women. Ethnic... [ view full abstract ]

Background
In 2011, 25.5% of births in England and Wales were to mothers born outside of the UK. Recent reports show significantly higher maternal mortality rates in England for minority ethnic than white women. Ethnic minority mothers also report lower maternity care satisfaction than their white counterparts, and UK health professionals report more difficulty in providing services to migrant clients. Lower care satisfaction has been consistently linked to the quality of the midwife-client relationship however little research has been conducted on this relationship.

Aim and objectives
Explore relationships between midwives and migrant Pakistani clients in South Wales, in order to better understand the barriers/facilitators of a successful midwife-client relationship for migrant women in the UK.

Method
Focused Ethnography consisting of semi-structured interviews and non-participant observations. Interviews were conducted with 10 migrant Pakistani clients and 10 practising midwives in South Wales. Client interviews and observations of midwife-client interaction took place during the antenatal period. Thematic analysis completed with the help of NVivo10. Ethical approvals gained from the researcher’s institution, NHS REC and local R&D.

Findings
Emerging findings: data analysis draws on theories of social ecology and authoritative knowledge to highlight the importance of a balanced, reciprocal, midwife-client relationship facilitated by an understanding of cultural differences and wider social relationships. Notable cultural differences are those of healthcare systems and responsibilities of healthcare professionals. PhD submission date is September 2015 therefore full findings will be presented at the conference.

Conclusions and Implications
Results indicate ways to improve communication and support between UK midwives and migrant/minority ethnic clients, by increasing understanding of the factors which influence the midwife-client relationship. This new information has the potential to improve UK midwifery education and practice, enhancing the experiences of migrant and minority ethnic clients. Findings contribute to the discussion around improving client outcomes through better understanding of user experience and the training needs of those delivering care.