School of Psychology, Cardiff University, Cardiff, United Kingdom.
School of English, Communication and Philosophy, Cardiff University, Cardiff, United Kingdom.
Hum Reprod. 2019 Sep 29;34(9):1735-1745. doi: 10.1093/humrep/dez156.
What are the views, experiences and healthcare needs of infertile women from a minority ethnic or religious background living in Wales?
Women from ethnic and religious minority backgrounds consider that their communities have highly pronatalistic attitudes and stigmatize infertility, and express the need for more infertility education (for themselves and their communities), as well as more socio-culturally and interpersonally sensitive fertility care.
Some people from minority ethnic or religious groups perceive pressure to conceive from their communities, experience social costs when they are unable to have children and stressful interactions with the fertility healthcare system while attempting to conceive.
STUDY DESIGN, SIZE, DURATION: This study was based on a one-day drawing workshop to collect visual (artwork produced by participants) and textual (all conversations and discussions during the workshop) data about the participants' views and experiences of infertility and their fertility care needs.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were nine adult women with a minority ethnic or religious status living in Wales, UK, who were experiencing or had experienced infertility in the past. The workshop comprised five activities: (i) small and large group discussion of infertility-related drawings, (ii) lide-based lecture consisting of an introduction to the basics of drawing objects and people and (iii) thoughts and feelings, (iv) free drawing session and (v) group sharing. Audio recordings of the workshop were transcribed verbatim. Textual data was analysed with thematic analysis. Risk for bias was addressed via individual coding by two authors followed by joint presentation and discussion of results with the research team and participants.
Forty-one themes were identified and grouped into eight distinct higher order themes. These themes described the emotional, relational and social burden of infertility experienced by women, which they perceived to result from their communities' highly pronatalistic attitudes and stigmatization of infertility. Themes also captured women's adaptive coping strategies and critical attitude towards pronatalist ideologies. Lastly, themes captured their overall positive evaluation of their fertility health care, their desire for more infertility education (for themselves and their communities) and for culturally competent and interpersonally sensitive care.
LIMITATIONS, REASONS FOR CAUTION: Our participants were a small, non-random sample recruited in collaboration with a local charity, which may mean that all participants were well integrated in their communities. Analysis focused on capturing commonalities in participants' experiences and this may sometimes result in homogenising diverse experiences.
More education about the infertility experiences of minority ethnic and religious groups at the community and healthcare delivery level may translate into lessened negative attitudes towards infertility and more culturally competent care, which can be beneficial for women.
STUDY FUNDING/COMPETING INTEREST(S): This research was funded by Welsh Crucible. The authors have no conflict of interests to declare.
居住在威尔士的少数民族或宗教背景的不孕女性的观点、经历和医疗保健需求是什么？
少数民族和宗教背景的女性认为她们的社区具有强烈的生育观念，并对不孕不育持污名化态度，她们表示需要更多的不孕不育教育（面向她们自己和社区），以及更具社会文化和人际敏感性的生育护理。
一些少数族裔或宗教群体的人认为自己的社区有生育压力，无法生育孩子会给他们带来社会成本，在尝试怀孕时与生育保健系统的互动也会带来压力。
研究设计、规模、持续时间：本研究基于为期一天的绘画工作坊，收集参与者对不孕不育的观点和经历以及他们的生育护理需求的视觉（参与者创作的艺术品）和文本（工作坊期间的所有对话和讨论）数据。
参与者/材料、设置、方法：参与者是 9 名居住在英国威尔士、具有少数民族或宗教背景的成年女性，她们在过去经历过或正在经历不孕不育。工作坊包括五个活动：（i）小组讨论与不孕相关的绘画，（ii）基于幻灯片的讲座，包括介绍如何绘制物体和人物的基础知识，（iii）想法和感受，（iv）自由绘画环节和（v）小组分享。工作坊的音频记录被逐字转录。使用主题分析对文本数据进行分析。通过两位作者的个体编码解决偏倚风险，然后与研究团队和参与者共同展示和讨论结果。
确定了 41 个主题，并将其分组为八个不同的高级主题。这些主题描述了女性经历的不孕不育带来的情感、关系和社会负担，她们认为这是社区强烈的生育观念和对不孕不育的污名化造成的。主题还捕捉到了女性的适应性应对策略和对生育主义意识形态的批判态度。最后，主题捕捉到了她们对生育保健的整体积极评价，她们希望获得更多的不孕不育教育（面向自己和社区），以及更具文化能力和人际敏感性的护理。
局限性、谨慎的原因：我们的参与者是一个小的、非随机样本，是与当地慈善机构合作招募的，这可能意味着所有参与者都很好地融入了他们的社区。分析侧重于捕捉参与者经历中的共同点，这有时可能会使不同的经历同质化。
在社区和医疗保健提供层面上对少数民族和宗教群体的不孕不育经历进行更多的教育，可能会减少对不孕不育的负面态度，并提供更具文化能力的护理，这对女性有益。
研究资金/利益冲突：本研究由威尔士坩埚资助。作者没有利益冲突需要申报。
