Perspectives on Contraception amongst Ethnic Minority Groups: A Qualitative Study. (Work in progress)

Problem

Unplanned pregnancies carry increased risks to mother and baby yet account for a significant proportion of UK births. Evidence suggests that women from ethnic minorities (EM) suffer from inequitable access to contraceptive services. There is a paucity of evidence regarding the views of EM women in this field. NICE suggest that ‘additional support’ is needed to provide contraceptive counselling to women from minority ethnic groups but provides little guidance on what this entails. Worryingly, recent research suggests that women from marginalised groups feel their communities are disproportionately ‘targeted’ to use LARCs. We will explore the perspectives of women from EM communities towards different methods of contraception, aiming to identify barriers and facilitators to access.

Approach

We will use a qualitative study design comprising focus groups and interviews. We will use purposive sampling to recruit a diverse sample of women from ethnicities including Black African, Black Caribbean and South Asian as well as participants who do not speak English. To improve inclusivity, we will offer participants a choice of interview or a focus group. Analysis will follow the principles of Braun and Clarke’s reflexive thematic analysis.

Community engagement is integral to our methodology. We have close links with several community groups working with people from ethnic minorities. We have recruited 3 women from these groups as community research workers (CRW) and they have co-designed the research. We are providing training on generic and topic-specific research skills. The CRWs will then be supported to contribute to recruitment, facilitate the focus groups and triangulate the analysis.

Findings

Extensive PPI confirmed the importance of the topic amongst the participating women from ethnic minorities. The in-depth discussions which took place suggest that we will obtain rich data. Findings are likely to be contraception specific but also about the wider role that ethnicity plays in family planning. We will conduct focus groups and interviews in the next 6 weeks. Analysis will be performed thereafter and presented.

Consequences

We expect our findings to be far reaching. By gaining perspectives on contraceptive types, we can make clinicians aware of what culturally pertinent information should be covered in consultations. Exploring opinions about if, where and how EM women would like to access contraceptive advice will allow for more equitable provision of services. We will also gain insights into whether our participants feel access to contraception is a significant health concern. This is particularly important given that EM are known to suffer adverse outcomes in maternity settings. Finally, through recruiting and training CRWs we hope to forge long-lasting links with communities who are traditionally under-represented in research, such that they can effect change beyond the scope of this project.