Jeeva John

and 2 more

Objective: To explore ethnic minority women’s experiences of maternity care during the SARS-CoV-2 pandemic. Design: Qualitative study. Population: Sixteen Black, Asian and Minority Ethnic women who were pregnant, or had delivered within 6 weeks prior to interview in a predominantly urban Scottish health board area. Methods: Thematic analysis of semi-structured in-depth interviews. Results Four themes were identified: ‘communication’, ‘interactions with health care professionals’, ‘racism’ and ‘the pandemic effect’. Each theme had relevant sub-themes. ‘Communication’ encompassed respect, accent bias, language barrier and cultural dissonance; ‘interactions with health care professionals’: continuity of care, empathy, informed decision making and dissonance with other health care systems; ‘racism’ was deemed to be institutional, interpersonal and internalised; and ‘the pandemic effect’ consisted of isolation, psychological impact and barriers to access of care. Main outcome measures: To explore the experiences of pregnancy, childbirth, antenatal and postnatal care in women belonging to ethnic minorities and to identify any specific challenges that these women faced during the SARS-CoV-2 pandemic. Conclusions This study highlights specific challenges faced by ethnic minority women in pregnancy, which intersect with the unique problems posed by the ongoing SARS-CoV-2 pandemic to potentially widen existing ethnic disparities in experiences of maternity care. Funding: Ethical approval for this study was granted by the Research Ethics Committee of West of Scotland (20/WS/0168) on 26/11/2020.

Jeeva John

and 1 more

Black women are four times more likely to die than White women in pregnancy in the U.K. Black women are more prone to Hypertensive Disorders in Pregnancy (HDP). Outside of pregnancy, there are race based differences in the management of hypertension as Calcium-Channel Blockers (CCB) are more effective in reducing blood pressure in Black patients. It is unclear whether these differences in anti-hypertensive management extend to the management of hypertension in pregnancy. Objectives The primary objective was to address this gap in evidence by undertaking a systematic review of all randomised control trials investigating pharmacological management of HDP to assess whether CCBs are the most effective anti-hypertensive agent in Black pregnant women. Search Strategy The following electronic databases were searched: PubMed, MEDLINE and Embase. We used MeSH and free text terms in conjunction to increase sensitivity to potentially relevant studies. Selection Criteria Inclusion criteria: (1) study involved treatment of HDP; (2) study was of a randomised control trial design; (3) one of the treatment arms involved CCBs and (4) English full-text. Data collection and Analysis Information regarding baseline participant data, type of anti-hypertensive, and clinical outcomes was extracted from each study. Main results This current review highlighted one randomised control trial, which stratified HDP outcomes by ethnicity. Conclusions There is a lack of evidence to draw conclusions as to whether CCBs are the most effective anti-hypertensive agent for Black patients with HDP. Funding None Keywords Hypertension; pregnancy; pre-eclampsia; ethnicity; anti-hypertensive; Calcium-Channel Blocker; race; Black; maternal mortality; maternal morbidity