Olakotan Olufisayo, Sudhakar Vedhapriya, Lim Jennifer Nw, Bhavsar Mina, Siddiqui Farah, Ayaz Rabina, Henry Gillian O'Brady, Pillay Thillagavathie
Department of Neonatology, Women and Children'S Directorate, University Hospitals Leicester NHS Trust, Leicester, UK.
Neonatal Unit, Leicester Royal Infirmary, University Hospitals Leicester, Leicester, LE1 5WW, UK.
BMC Health Serv Res. 2025 Feb 25;25(1):313. doi: 10.1186/s12913-025-12441-1.
Women from minority ethnic groups in the UK have the highest prevalence of obstetric anal sphincter injuries (OASI), including third- and fourth-degree perineal tears sustained during childbirth. Incorporating the voices of mothers at higher risk of OASI is crucial in developing strategies to improve care and well-being.
To identify strategies perceived as important by women with lived experience of OASI in Leicester, UK, to improve their care and well-being.
Women at high risk of and with lived experience of OASI in Leicester, UK, were invited, through our local maternity and neonatal voices partnership, to participate in a virtual focus group discussion (FGDs). Two FGDs were conducted to accommodate participants' availability. The first session included seven women, while the second session included three women. All participants were from underrepresented groups with lived experiences of OASI within the past one to ten years. A discussion guide was used to explore participants' perceptions and experiences of OASI care, as well as their views on culturally and linguistically sensitive maternal care strategies. The discussion was recorded and transcribed. The data were analysed using the six-step thematic analysis approach by Braun and Clarke.
The participants identified strategies to provide culturally appropriate care for obstetric anal sphincter injuries, including linguistically accessible prenatal resources, comprehensive midwifery training, updated prenatal education, standardized postpartum care, the inclusion of fathers in prenatal education, empathetic care, building trust, and community engagement and education.
This study highlights disparities in maternal healthcare outcomes for women from diverse ethnic backgrounds who experience OASI. Addressing these inequalities requires incorporating the voices of those directly affected to inform culturally sensitive policies and practices in maternal care.
在英国,少数族裔女性发生产科肛门括约肌损伤(OASI)的患病率最高,其中包括分娩期间发生的三度和四度会阴撕裂。在制定改善护理和福祉的策略时,纳入OASI风险较高的母亲的意见至关重要。
确定英国莱斯特有OASI实际经历的女性认为对改善其护理和福祉很重要的策略。
通过我们当地的孕产妇和新生儿声音伙伴关系,邀请了英国莱斯特有OASI高风险和实际经历的女性参加虚拟焦点小组讨论(FGD)。为了适应参与者的时间安排,进行了两次FGD。第一场有七名女性参加,第二场有三名女性参加。所有参与者都来自代表性不足的群体,在过去一到十年内有OASI的实际经历。使用讨论指南探讨参与者对OASI护理的看法和经历,以及他们对文化和语言敏感的孕产妇护理策略的看法。讨论进行了录音和转录。数据采用布劳恩和克拉克的六步主题分析方法进行分析。
参与者确定了为产科肛门括约肌损伤提供文化适宜护理的策略,包括语言上可获取的产前资源、全面的助产士培训、更新的产前教育、标准化的产后护理、让父亲参与产前教育、共情护理、建立信任以及社区参与和教育。
本研究突出了经历OASI的不同种族背景女性在孕产妇医疗保健结果方面的差异。解决这些不平等问题需要纳入直接受影响者的意见,以便为孕产妇护理中文化敏感的政策和实践提供信息。