Background: Global human migration has highlighted the need to provide culturally-appropriate maternity care, delivered in accordance with the recipient’s beliefs and practices. Objectives: This review aims to examine the impact of culture on access, utilisation, and care delivery of care for Muslim women during pregnancy, and postpartum, through the experiences of women, families, and maternity care-providers. Search Strategy: Six electronic databases were searched for published qualitative and mixed-methods studies, in English (01/January/2003-12/October/2023). Selection criteria: Studies undertaken in high-income countries reporting the experiences of either Muslim women accessing and utilising maternity services, or care-providers delivering those services. Data collection and analysis: Meta-ethnography was used to develop new concepts from included studies. Main results: Of 23,428 articles identified, 24 met inclusion criteria. Four themes were identified: ‘ Religious influences’, ‘Sociocultural interactions’, ‘Healthcare as a culture’, and ‘Disrupted communication’. Women’s negative experiences highlighted cultural insensitivity, providers’ unconscious bias, inflexible care models (and the conflict between expectations of services and those offered), and cultural stereotyping in addition to indifferent and uniform care. Care-providers’ experiences highlighted challenges with miscommunication and Muslim women’s reliance on information (and sometimes, misinformation) from their communities. Conclusions: Our findings highlight the challenges involved in delivering culturally-sensitive care to Muslim women; issues that extend beyond the confines of culture-specific awareness of religion and ethnicity, to the universal concept of personalisation. This is reflected in the theory, ‘ Recognise our differences, embrace our diversity, and care for me as an individual’.

Tisha Dasgupta

and 6 more

Objective: Refine the programme theory for OptiBreech Care Design: Concurrent mixed methods implementation process evaluation Setting: 6 NHS hospitals in England participating in the OptiBreech 1 Feasibility Study Sample: 15 women planning a vaginal breech birth at term and 6 breech lead midwives Methods: Outcomes were recorded on case report forms and descriptively analysed. Interviews were recorded, transcribed and analysed using the Theoretical Framework of Acceptability. Iterative analysis informed subsequent interviews and the on-going process of implementation across sites. Main Outcome Measures: Acceptability of service delivery models and their outcomes. Results: Actively recruiting Trusts implemented services through a dedicated clinic and/or a proficient intrapartum support service, organised and provided primarily by a Breech Specialist Midwife. While we identified challenges, this model has achieved 93% fidelity to the intervention’s goal of ensuring attendance of OptiBreech-trained professionals at vaginal breech births, and it is highly acceptable to women. Our initial suggested model of a multi-disciplinary team composed of 5 obstetricians and 5 midwives does not appear feasible, due to very low overall current breech experience levels and the context of current pressures on NHS services. Conclusions: Appointment of a Breech Specialist Midwife, whose role is to co-ordinate a dedicated clinic, training and a proficient intrapartum care team, appears to be highly acceptable to women. This model appears to be a feasible implementation strategy, in order to test the safety and effectiveness of OptiBreech Care in a clinical trial, but further work needs to be done to develop sustainability.