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Influence of culture, religion and experience on the decision of Pakistani women in Lothian, Scotland to use postnatal contraception: a qualitative study
  1. Annette Gallimore1,
  2. Tasneem Irshad2,
  3. Michelle Cooper3,
  4. Sharon Cameron2,3
  1. 1 Dept of Public Health, NHS Lothian, Edinburgh, UK
  2. 2 Medical Research Council (MRC) Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
  3. 3 Chalmers Sexual Health Clinic, NHS Lothian, Edinburgh, UK
  1. Correspondence to Annette Gallimore, Public Health, NHS Lothian, Edinburgh EH1 3EG, UK; annette.gallimore{at}


Introduction Evidence suggests that Pakistani women may experience difficulty accessing postnatal contraceptive (PNC) services. The study aimed to identify experience and decision-making around PNC provision for Pakistani women in Lothian, and to explore the views and experience of maternity staff who provide PNC counselling.

Methods Qualitative research including focus groups and 1:1 semi-structured interviews with women and staff. Participants were first- and second-generation Pakistani women with a child/children aged up to 5 years, or pregnant; community and hospital midwives, obstetric doctors who counsel or provide PNC. Data were coded and categorised using QSR NVIVO10. Inductive thematic analysis was carried out.

Results Women were receptive to discussion of contraception, including antenatally, and welcomed translated information. Some said the decision on PNC was theirs or made jointly with their husband; however, they acknowledged that in some marriages the husband will take the decision. Women stated they may face family expectation to have a baby early in marriage. Language was identified as a challenge by maternity staff, who utilised translation services to ensure women received the information they needed on contraception.

Conclusions Pakistani women value antenatal discussion about PNC. Maternity staff have an important role in providing quality information on contraception and should be supported with translated resources in a range of formats. Most importantly, staff should adopt a tailored approach to identify the individual woman’s needs and preferences.

  • family planning service provision
  • ethnic minority and cultural issues
  • qualitative research
  • hormonal contraception
  • intrauterine devices
  • long-acting reversible contraception

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  • Contributors AG, SC, MC, JS, SG and RI designed the research question and study approach. AG, SC, MC, JS, TI, SG and RI contributed to the design of data collection resources. AG, MC and JS carried out data collection from maternity staff and TI carried out data collection from the women with support from RI. AG carried out the data analysis with input from TI, SC and MC. AG, SC, MC and TI wrote the first draft of the manuscript and read and revised subsequent drafts. AG, SC, MC and TI all approved the final draft of the manuscript for publication and accept responsibility for the article as published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Additional unpublished data from this study are unavailable as they may enable participants to be identified.

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