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Gender of Provider—Barrier to Immigrant Women's Obstetrical Care: A Narrative Review

      Abstract

      Objective

      To explore the preference for female obstetrician/gynaecologists among immigrant women, and providers' understandings of these preferences, to identify challenges and potential solutions.

      Methods

      Five databases (Medline, Embase, CINAHL, Global Health, and Scopus) were searched using combinations of search terms related to immigrant, refugee, or Muslim women and obstetrics or gynaecological provider gender preference.

      Study Selection

      Peer reviewed, English-language articles were included if they discussed either patient or provider perspectives of women's preference for female obstetrics or gynaecological care provider among immigrant women in Western and non-western settings. After screening, 54 met inclusion criteria and were reviewed.

      Data Extraction

      Studies were divided first into those specifically focusing on gender of provider, and those in which it was one variable addressed. Each category was then divided into those describing immigrant women, and those conducted in a non-Western settings. The research question, study population, methods, results, and reasons given for preferences in each article were then examined and recorded.

      Conclusion

      Preference for female obstetricians/gynaecologists was demonstrated. Although many will accept a male provider, psychological stress, delays, or avoidance in seeking care may result. Providers' views were captured in only eight articles, with conflicting perspectives on responding to preferences and the health system impact.

      Résumé

      Objectifs

      Étudier la préférence des immigrantes pour les obstétriciennes et les gynécologues de sexe féminin et la compréhension qu'en ont les fournisseurs de soins, relever les défis et proposer des solutions.

      Source des données

      Nous avons interrogé cinq bases de données (Medline, Embase, CINAHL, Global Health et Scopus) au moyen de combinaisons de termes liés à « immigrant », « refugee », « Muslim women » et « obstetrics or gynaecological provider gender preference ».

      Sélection des études

      Nous avons sélectionné les articles de langue anglaise évalués par les pairs abordant le point de vue des patientes ou des fournisseurs de soins sur la préférence des immigrantes pour les obstétriciennes ou les gynécologues de sexe féminin dans les milieux occidentaux et non occidentaux. Nous avons retenu et analysé 54 études répondant aux critères d'inclusion.

      Extraction des données

      Nous avons d'abord divisé les études en deux catégories, soit celles axées sur le genre du fournisseur de soins et celles ne faisant qu'aborder le sujet. Nous avons ensuite subdivisé ces catégories en deux : les études portant sur des immigrantes et celles menées dans des milieux non occidentaux. Pour chaque article, nous avons examiné la question de recherche, la population étudiée, les méthodes, les résultats et les raisons de la préférence, et avons consigné les données recueillies.

      Conclusions

      Nous avons observé une préférence pour les obstétriciennes et les gynécologues de sexe féminin. Même si bon nombre de patientes accepteront d'être soignées par un homme, cette situation peut être à l'origine de stress psychologique et de report ou d'évitement des soins. L'opinion des fournisseurs de soins n'était étudiée que dans huit articles; ceux-ci avaient des points de vue divergents sur la façon de faire face à ces préférences et les effets de cette situation sur le système de santé.

      Key Words

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