Ethnic and social inequalities in women's experience of maternity care in England: results of a national survey
Ethnic and social inequalities in women's experience of maternity care in England: results of a national survey
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DOI：
10.1258/jrsm.2010.090460
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发表时间：
2010-05-01
影响因子：
17.3
通讯作者：
Hallt, K.
中科院分区：
文献类型：
--
作者：
Raleigh, V. S.;Hussey, D.;Hallt, K.
目的探讨英国女性产科护理经验的种族和社会不平等。设计2007年全国16岁及以上女性产科护理经验调查。采用多元Logistic回归分析方法，对不同种族、伴侣身份和受教育程度的不平等进行了分析。调查对象为英国149个NHS急性信托基金和2个初级保健信托基金(PCT)。少数民族妇女比英国白人妇女更有可能延迟获得服务，20周后不进行扫描，并在怀孕和分娩期间经历并发症。她们更有可能主动进行母乳喂养，并表示她们得到了尊重和尊严的对待。单身女性对几乎所有问题的回答都比有丈夫/伴侣的女性更消极。她们不太可能在怀孕12周内获得护理(OR 0.45，95%CI 0.39~0.52)，在20周时进行扫描(OR 0.49，95%CI 0.39~0.63)，参加NHS产前课程(OR 0.56，95%CI 0.49~0.65)，产后检查(OR 0.67，95%CI 0.60~0.75)，开始母乳喂养(OR 0.57，95%CI 0.51~0.62)，更容易发生并发症。与16岁及以下完成教育的女性相比，19岁以上完成教育的女性更有可能提前获得服务(OR 1.21，95%CI 1.04~1.40)，参加产前课程(OR 1.48，95%CI 1.31 1.67)，产后检查(OR 1.19，95%CI 1.07~1.32)和开始母乳喂养(OR 3.88，95%CI 3.56~4.22)，并发生并发症的可能性较小。那些完成教育的年龄较早的人获得产科服务的时间较晚，结果较差，报告在某些--尽管不是所有--产妇保健方面的经历较差。在护理的某些方面，不同群体之间没有或不一致的种族差异。我们建议委员、信托基金和医疗保健专业人员使用这些调查结果，为改善高危群体的产科服务和减少不平等提供信息。
Objective To examine ethnic and social inequalities in women's experience of maternity care in England.Design A 2007 national survey of women (16 years or over) about their experience of maternity care. Multiple logistic regression analysis, controlling for several maternal characteristics, was used to examine inequalities by ethnicity, partner status and education.Setting Sample of records of 149 NHS acute trusts and two primary care trusts (PCTs) providing maternity services in England.Results A total of 26,325 women responded to the survey (response rate 59%). Ethnic minority women were more likely than White British women to access services late, not have a scan by 20 weeks, and experience complications during pregnancy and birth. They were more likely to initiate breastfeeding and say they were treated with respect and dignity. Single women responded more negatively to almost all questions than women with a husband/partner. They were less likely to access care within 12 weeks of pregnancy (OR 0.45, 95% Cl 0.39-0.52), have a scan at 20 weeks (OR 0.49, 95% Cl 0.39-0.63), attend NHS antenatal classes (OR 0.56, 95% Cl 0.49-0.65), have a postnatal check-up (OR 0.67, 95% Cl 0.60-0.75), and initiate breastfeeding (OR 0.57, 95% Cl 0.51-0.62), and were more likely to experience complications. Women completing education at 19+ years were more likely to access services early (OR 1.21, 95% Cl 1.04-1.40), attend antenatal classes (OR 1.48, 95% Cl 1.31 1.67), have a postnatal check-up (OR 1.19, 95% Cl 1.07-1.32) and initiate breastfeeding (OR 3.88, 95% Cl 3.56-4.22) than those completing education at 16 years or younger, and were less likely to experience complications.Conclusions Ethnic minority women, single mothers, and those with an earlier age at completing education access maternity services late, have poorer outcomes, and report poorer experiences across some - though not all - dimensions of maternity care. Ethnic differences were absent or inconsistent between groups for some aspects of care. We recommend these findings are used by commissioners, trusts and healthcare professionals to inform improvements in maternity services for high-risk groups and reduce inequalities.