Addressing language barriers in maternity emergency care in the UK: A mixed methods quality improvement simulation study

Abstract

Background

Language barriers in maternity care compromise patient safety and quality, with poorer maternal outcomes observed when communication between obstetric staff and women with limited English proficiency is hindered, especially during emergencies.

Objective

To explore obstetric and maternity staff understanding of language barriers when caring for women during obstetric emergencies.

Methods

A six-week mixed-methods quality improvement study in a UK National Health Service (NHS) Trust maternity unit. Forty maternity and obstetric clinicians were recruited. Participants engaged in postpartum hemorrhage simulations using a simulation mannikin programmed to speak a foreign language. Data collection involved presimulation Likert-scale questionnaires (five items) and postsimulation debriefs. Quantitative data were analyzed descriptively; qualitative data underwent thematic analysis.

Findings

Presimulation data revealed limited staff confidence: 52% were dissatisfied with interpretation services, 60% were very dissatisfied with communication support, and 57% were neutral about understanding communication in obstetric emergencies. Thematic analysis identified three key themes: (a) unavailability of interpreting services during emergencies, (b) undervaluing the importance of communication in urgent scenarios, and (c) opportunities for enhancing simulation-based communication training.

Discussion

Significant knowledge gaps and inadequate systems hinder effective communication with women facing language barriers during obstetric emergencies.

Conclusion

Urgent action is needed to strengthen training in interpretation services, enhance communication infrastructure, and raise awareness among maternity teams about the critical role of communication in emergency care.