妊娠期或产后死亡移民女性所接受的产科照护：英国全国机密病例记录审查

原文

ABSTRACT Objective To co-produce a bespoke maternity care checklist for recently arrived migrant women in the UK. To use this to describe the maternity care received by recently arrived migrant women who died during or up to six weeks after pregnancy over the past decade in the UK, and generate hypotheses about areas for improvement. Design Confidential national review of medical records. Population Thirty-nine recently arrived pregnant or postnatal migrant women died in the UK between 2012 and 2021. Methods Maternal deaths amongst recently arrived migrant women were identified using UK Confidential Enquiry into Maternal Deaths and Morbidity (MBRRACE-UK) data. A national case note review was conducted using a co-produced migrant maternity care checklist developed with input from service users. Main Outcome Measures Assessment against the migrant maternity care checklist. Results Amongst those eligible for antenatal care, most (70%, n = 19/27) attended their first appointment after 13 weeks gestation. Amongst women needing an interpreter, 42% (n = 8/19) had professional interpreting services during antenatal care, 19% (n = 3/16) in intrapartum care, and 0% (n = 0/9) in postpartum care. Two fifths of women had documentation suggestive of discrimination or racism (41%, n = 16/39). Potential areas for improvement included access to formal interpreting services; access to first antenatal appointments before 13 weeks; and follow-up after non-attendance. Conclusions Results should be interpreted with caution given the small number of women included and the descriptive and hypothesis generating nature of this paper. However, this study identifies areas of care that are important to women and professionals and could be prioritised for further research and improved practice.