Exploring the experiences and perceptions of black and ethnic minority pregnant women with fibroids in England: An interpretative phenomenological analysis

Title : Exploring the experiences and perceptions of black and ethnic minority pregnant women with fibroids in England: An interpretative phenomenological analysis

Abstract:

Background and Aims: Black and ethnic minority women have a higher prevalence of uterine fibroids, which cause adverse pregnancy outcomes, including preterm birth and caesarean delivery, and psychosocial burden. Although equity is a commitment of NHS England and Wales, there is a paucity of qualitative research on lived experiences in maternity care in the UK. The objective of this study was to gain insight into and understand the lived experience and views of Black and ethnic minority pregnant women with fibroids in English NHS maternity care, in relation to sociocultural, structural, clinical and intersectional factors.

Methods: This research is a qualitative study using Interpretative Phenomenological Analysis (IPA) (Smith et al., 2022). Purposive sampling was used to select ten pregnant women (any trimester) suspected of having uterine fibroids in NHS antenatal clinics. Semi-structured interviews (30–60 minutes) were audio-recorded, transcribed word for word, and analysed iteratively with IPA guidelines, and reflexivity, member-checking and supervisory debriefs were added to enhance trustworthiness.

Results: Five superordinate themes were identified in the preliminary analysis: (1) Navigating Uncertainty and Fear; (2) Intersectionality: Race, Stigma, and Embodied Identities; (3) Experiences of NHS Maternity Care (communication, monitoring, systemic barriers); (4) Resilience, Agency, and Coping Strategies (family support, self-advocacy); and (5) Unmet Needs and Advocacy for Equitable Care. Participants described amplified physical/emotional burdens, racial inequities, information gaps, and inconsistent culturally responsive support, alongside positive monitoring aspects.

Conclusion: This study shows the sociodemographic situation and intergenerational needs of this vulnerable population and identifies the shortcomings in the NHS that exacerbate quantitative differences. Results endorse culturally-based information, general screening of psychosocial issues, cultural competency training and pathways specific to fibroids for improving reproductive health equity and in line with NHS priorities. The idiographic insights support limited qualitative evidence in the UK and support practice change.

Keywords: Uterine Fibroids, Pregnancy Experiences, Black Ethnic Minority Women, NHS Maternity Care, Interpretative Phenomenological Analysis

Biography:

Zahrah is a PhD student in Nursing at the University of Salford and a Staff Nurse in the Gynaecology Department at St Mary’s Hospital. With over 10 years of nursing experience, she has developed a strong interest in women’s health, particularly the experiences of women from diverse ethnic backgrounds. She holds a Master’s degree in Leadership and Management in Health Sciences from the University of Salford. Her doctoral research focuses on “Exploring the Experiences and Perceptions of Black and Ethnic Minority Pregnant Women with Fibroids in England.” Through her clinical practice and research, Zahrah is passionate about improving the quality of care, promoting culturally responsive healthcare, and enhancing the experiences of women during pregnancy and beyond.