Immigrant women’s food choices in pregnancy: perspectives from women of Chinese origin in Canada

Objective: Following migration, pregnant immigrant women may encounter social, cultural, and economic challenges that negatively affect their food choices and subsequent health outcomes. Culturally appropriate health care is crucial during the perinatal period to ensure the health of immigrant mothers and their children. This project aims to explore and understand how the health beliefs and practices of Chinese immigrant women affect their food choices during the perinatal period. Design: This qualitative study used the methodology of focused ethnography. Women participated in one semi-structured interview, followed by a second photo-assisted, semi-structured interview which incorporated photographs taken by the women themselves. Results: The food choices and health behaviors of immigrant women were influenced by their general health beliefs, cultural knowledge concerning particular types of foods, traditional Chinese medical beliefs, social advice and information, and socio-economic factors. Conclusion: The provision of culturally appropriate health care is crucial during the perinatal period, as it is not only a vulnerable life stage for women and their children but also a sensitive period of interaction with the Canadian health-care system. Understanding these intersecting factors can help to ensure culturally appropriate care and optimized health outcomes for Chinese immigrant women during the perinatal period

Seeking culturally safe care: a qualitative systematic review of the healthcare experiences of women and girls who have undergone female genital mutilation/cutting

Objective: To explore the experiences of accessing and receiving healthcare related to female genital mutilation/cutting (FGM/C) across the life course from the perspective of women and girls who have undergone FGM/C. Design: A systematic review of qualitative research studies using a thematic synthesis approach. Methods: Inclusion criteria were qualitative studies (including grey literature) of any design, from Organisation for Economic Co-operation and Development (OECD) countries, of any date and any language. Sixteen electronic databases were searched from inception to December 2017, supplemented by reference list searching. Papers were screened, selected and quality-appraised by two reviewers using established tools from the Joanna Briggs Institute. NVivo software was used to extract study characteristics and code study findings. An inductive thematic synthesis approach was undertaken to identify descriptive themes and interpret these into higher order analytical constructs. Confidence in the review findings was assessed using Grading of Recommendations, Assessment, Development and Evaluations-Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual). Results: Fifty-seven papers (from 55 distinct studies) from 14 different OECD countries were included (50% published within the last 8 years). One-third of studies focused exclusively on maternity care experiences, whereas others covered a range of foci. No studies reported explicitly on girls’ experiences or on experiences of health service-led safeguarding interventions. Only three studies addressed psychological care. The synthesis developed 17 descriptive themes, organised into 5 analytical constructs. These related to communication, access to care, experiences of cultural dissonance/integrity, disempowering care experiences and positive care encounters. The themes illuminate significant challenges to obtaining timely and holistic care (especially for deinfibulation), and highlight different ways in which women may experience care as disrespectful, unsafe and disempowering. Key elements of ‘culturally safe care’ are identified. Conclusions: This review has highlighted key knowledge gaps, especially around (1) girls’/unmarried women’s experiences and (2) the impact of recent safeguarding interventions. There is an ongoing need for community engagement, service development and staff training. PROSPERO registration number: CRD420150300012015

Young people of minority ethnic origin in England and early parenthood: Views from young parents and service providers

The paper explores the phenomenon of early parenthood in minority ethnic communities in England. The data were collected using focus group interviews, in-depth semi-structured interviews and a telephone survey. The sample consisted of 139 participants (41 service providers, 10 grandmothers, 88 young parents). The findings map out the complexity and diversity of experience of early parenthood amongst young people of minority ethnic origin, not least the multiple attachments many experience in relation to their social groups, religious affiliations and the traditional patterns of parenting within their immediate and extended family. Both the young parents and professionals in this study constructed early parenthood in more positive terms than is currently portrayed in the contemporary policy. The findings are analysed and discussed in relation to ethnic identity, social inclusion and exclusion. We explore participants' attempts to counter negative 'deficit' models of early parenthood with reference to perspectives on youth, parenthood and contemporary strategic policy. In conclusion, we suggest an unambiguous focus on the reduction of pregnancy is not a credible message when teenage pregnancy is a social norm for a particular ethnic or cultural group. For young parents of Muslim faith in particular, teenage parenting within marriage is not necessarily considered a 'problem' or seen as a distinctive event. Most participants did not view early parenthood as a barrier to re-establishing career and educational aspirations. A wide diversity of experience amongst young parents is evidenced in the communities studied; this needs to be reflected more comprehensively both in UK policy and in support services.Minority ethnic young people Early parenthood Social exclusion UK England