Gina Higginbottom, Annalita S Bell, Julia Arsenault, Jennifer Pillay
The successful provision of appropriate maternity care requires recognition of and response to the experiences of immigrant women when accessing and receiving services. The purpose of this integrative review was to identify and descriptively synthesise current empirical literature on immigrants’ experiences of maternity healthcare services in Canada, to outline practice implications and to make recommendations for future research. Electronic bibliographic databases covering immigrant and maternal health literature (CINAHL, MEDline, Cochrane, Scopus and Web of Science) published in English between 2000 and 2010 were searched with the aid of a research librarian, and the reference lists of keypapers were reviewed for additional sources. Letters, editorials and commentarieswere excluded, but systematic and other reviews generating synthesised findings were included. Two individuals independently screened the citations (abstracts) for inclusion, and final selection was determined by full article review and reviewer agreement. After selection, articles were assessed for quality and study findings were grouped into themes for summary, integration and discussion. Of the 253 abstracts that were screened for inclusion, 30 were retained for review. The study findings were grouped into six themes, namely barriers to accessing healthcare, ethnoculturally determined perinatal customs and support, breastfeeding support and experiences, environmental factors, postpartum care and mental health, and pregnancy and birth outcomes. For immigrant women, the most important factors that prevented them from accessing maternity care services and achieving good outcomes were financial constraints, lack of social support, and language difficulties. This integrative literature review revealed not only the difficulties faced by the women in accessing health services, but also some potential reasons for these challenges as well as real and disparate maternal–infant outcomes. Based on these findings it is recommended that maternal health programmes and service research and development should be shaped through collaborative interactions with service users.
