Health issues and access to services

NHS Health Scotland's Dimensions of Diversity report highlights some key variations in pregnancy and maternity by different groups:

  • Migrants' access to maternity and other services can be restricted by language and cultural issues
  • Birth weight is an indicator of maternal health. Socio-economic, maternal and infant factors are important to different degrees in the low birth weight found in Indian, Bangladeshi, and Pakistani infants
  • Teenage pregnancy can affect education and employment especially for women, while absent and single parenthood can result in depression or role overload and difficulties in financial coping for parents. The resulting socio-economic disadvantage and lack of social support may have repercussions for parents and children.

According to research by One Parent Families (2009), 27 per cent of lone parents have a long-standing health problem or disability as do 19 per cent of children living with a lone parent.

The maternal and early years website provides up-to-date statistics and useful resources in relation to pregnancy, maternity and early years, including information on inequalities in access to antenatal services, breastfeeding, nutrition and other health issues.

NHS Health Scotland has published 'Antenatal health inequalities: a rapid review of the evidence' (2010). This review found that women with complex social needs face barriers to engaging and maintaining contact with services. This is due to how interactions are experienced by the women themselves, including feeling awkward or worrying about being judged and how they are experienced by staff, including judgemental or poor attitudes, lack of knowledge about available support and lack of understanding of the issues faced by the woman. The review highlights the importance of continuity of care and communication in maintaining the engagement of women with complex social needs.

A report by the Centre for Maternal and Child Enquiries (2011) on perinatal mortality states:
'Inequalities begin before birth and can adversely impact health throughout adult life. Inequalities can impact on pregnancy, including maternal and perinatal death. Ethnicity and deprivation remain important associates of stillbirth and neonatal death and reducing stillbirths and neonatal deaths in these groups remain a difficult but vital public health challenge' (p 9).

The Growing up in Scotland Sweep One Survey describes two thirds of pregnant women under 20 as not attending any antenatal classes, citing reasons such as not liking groups or not knowing where antenatal classes are. Young parents can experience negative attitudes among mainstream maternity professionals and older service users. Health professionals are perceived by some young fathers as dismissive of their involvement. Pregnant teenagers and young fathers are less likely than older people to access maternity care early in pregnancy and are less likely to keep appointments.

The Scottish Refugee Council has conducted research, in partnership with Strathclyde University Law School, on access to maternity services by asylum seekers. In contrast to England where asylum seeking women may be asked to pay for health care, in Scotland entitlement to free NHS care is still available for those asylum seekers who have had their claim to stay in the UK refused.

Updated May 2015

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