ArticleBirth (Berkeley, Calif.)2019
How do women with social risk factors experience United Kingdom maternity care? A realist synthesis.
Article in Birth (Berkeley, Calif.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Experiences of women from ethnic minorities and underserved, marginalised and disadvantaged groups in communicating with health professionals during antenatal care: An overview of qualitative systematic reviews.NIHR open research · 2026Pooled it
- Pooled it
- Targeted health and social care interventions for women and infants who are disproportionately impacted by health inequalities in high-income countries: a systematic review.International journal for equity in health · 2023Pooled it
- Black, Asian and minority ethnic women's experiences of maternity services in the UK: A qualitative evidence synthesis.Journal of advanced nursing · 2022Pooled it
- Improving Diversity in Recruitment: Lessons Learned During the REACH Pregnancy Circles Pilot Trial.Health expectations : an international journal of public participation in health care and health policy · 2025Trial
- Advancing maternal health equity: the need for cultural awareness and inclusivity in maternity service delivery in the UK: anchored in the MBRRACE-UK 2025 findings.International journal for equity in health · 2026Article
- The Role of Ethnicity and Migration in Perinatal Inequalities: A Retrospective Cohort Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- The role of poverty-related social determinants in maternal and perinatal health inequities: a cross-sectional study using the eLIXIR born in South London, UK maternity-child data linkage.International journal for equity in health · 2026Article
- Professional perspectives on barriers to accessing maternity care in England: a qualitative study.BMC pregnancy and childbirth · 2026Article
- Maternal and early childhood health and social outcomes of migrants in high-income countries and the impact of policies that restrict access to healthcare; a systematic review and meta-analysis.Journal of migration and health · 2026Review
- Article
- What Do Antenatal Women Want From Their Antenatal Education? A National Survey.Maternal and child health journal · 2025Article
- Optimising digital clinical consultations in maternity care: a realist review and implementation principles.BMJ open · 2024Review
- Understanding access to general practice through the lens of candidacy: a critical review of the literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Review
- Impact of maternal risk factors on ethnic disparities in maternal mortality: a national population-based cohort study.The Lancet regional health. Europe · 2024Article
- Barriers to accessing and receiving antenatal care: Findings from interviews with Australian women experiencing disadvantage.Journal of advanced nursing · 2023Article
- A qualitative study of the dynamics of access to remote antenatal care through the lens of candidacy.Journal of health services research & policy · 2023Article
- Reflective, pragmatic, and reactive decision-making by maternity service providers during the SARS-CoV-2 pandemic health system shock: a qualitative, grounded theory analysis.BMC pregnancy and childbirth · 2023Article
- Observational
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundEchoing international trends, the most recent United Kingdom reports of infant and maternal mortality found that pregnancies to women with social risk factors are over 50% more likely to end in stillbirth or neonatal death and carry an increased risk of premature birth and maternal death. The aim of this realist synthesis was to uncover the mechanisms that affect women's experiences of maternity care.
methodsUsing realist methodology, 22 papers exploring how women with a wide range of social risk factors experience maternity care in the United Kingdom were included. The data extraction process identified contexts (C), mechanisms (M), and outcomes (0).
resultsThree themes, Resources, Relationships, and Candidacy, overarched eight CMO configurations. Access to services, appropriate education, interpreters, practical support, and continuity of care were particularly relevant for women who are unfamiliar with the United Kingdom system and those living chaotic lives. For women with experience of trauma, or those who lack a sense of control, a trusting relationship with a health care professional was key to regaining trust. Many women who have social care involvement during their pregnancy perceive health care services as a system of surveillance rather than support, impacting on their engagement. This, as well as experiences of paternalistic care and discrimination, could be mitigated through the ability to develop trusting relationships.
conclusionsThe findings provide underlying theory and practical guidance on how to develop safe services that aim to reduce inequalities in women's experiences and birth outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.