The Impact of Culture on Access to and Utilisation of Maternity Care Amongst Muslim Women in High-Income Countries: A Qualitative Systematic Review

Abstract

Background: Global human migration has highlighted the need to provide culturally appropriate maternity care, delivered in accordance with the recipient's beliefs and practices. Objectives: This review aims to examine the impact of culture on access, utilisation, and care delivery of care for Muslim women during pregnancy and postpartum through the experiences of women, families, and maternity care-providers. Search Strategy: Six electronic databases were searched for published qualitative and mixed-methods studies, in English (01/January/2003-12/October/2023). Selection Criteria: Studies undertaken in high-income countries report the experiences of either Muslim women accessing and utilising maternity services, or healthcare professionals delivering those services. Data Collection and Analysis: Meta-ethnography was used to develop new concepts from included studies. Main Results: Of 23 428 articles identified, 24 met the inclusion criteria. Four themes were identified: ‘Religious influences’, ‘Sociocultural interactions’, ‘Healthcare as a culture’, and ‘Disrupted communication’. Women's negative experiences highlighted cultural insensitivity, providers' unconscious bias, inflexible care models (and the conflict between expectations of services and those offered), and cultural stereotyping in addition to indifferent and uniform care. Healthcare professionals' experiences highlighted challenges with miscommunication and Muslim women's reliance on information (and sometimes, misinformation) from their communities. Conclusions: Our findings highlight the challenges involved in delivering culturally-sensitive care to Muslim women; issues which extend beyond the confines of culture-specific awareness of religion and ethnicity, to the universal concept of personalisation. This is reflected in the theory, ‘Recognise our differences, embrace our diversity, and care for me as an individual’. Registration: International Prospective Register of Systematic Reviews (PROSPERO): CRD42024499304.