Peer Review Report For: Experiences of women from ethnic minorities and underserved, marginalised and disadvantaged groups in communicating with health professionals during antenatal care: An overview of qualitative systematic reviews [version 1; peer review: 1 approved with reservations]

Background Maternal mortality rates show disproportional disparities among disadvantaged groups. Objective To conduct an overview of qualitative systematic reviews to summarise the antenatal care experience of ethnic minority and underserved, marginalised and disadvantaged women in high-income countries. Search strategy Seven electronic databases were searched to identify reviews published between 2011-2022. Selection criteria Two reviewers independently screened search results and full texts of potentially eligible articles. Data collection and analysis Data were extracted by two independent reviewers, critically appraised using the JBI tool and assessed for overlap. A thematic analysis was conducted. Main results Nineteen qualitative reviews were included. Most were conducted in the UK (n=12) and provided a thematic synthesis of findings. Studied populations included women from minority ethnic groups and those who were migrants, homeless, refugees, asylum seekers, disabled, obese, or had experienced genital mutilation or human trafficking. Common challenges included language and cultural differences, and lack of effective interactions with healthcare professionals. Many women experienced discrimination, isolation, limited awareness of available services and negative attitudes from maternity care staff. Limited access to maternity services was influenced by various factors, including costs and communication barriers. Positive experiences included interactions with culturally responsive healthcare professionals, support from social groups, and access to interpreters. Conclusions Our findings highlight the complex challenges some women face during maternity care. Future research should focus on more personalised care solutions, long-term evaluations of maternity services, training of healthcare professionals, and ways to improve the quality of information provided and the interaction with healthcare professionals.