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To systematically map the extent, range and nature of qualitative studies that explored female sex workers' own perspectives on barriers to accessing reproductive healthcare services.
A scoping review of the literature utilizing Arksey and O'Malley's method.
A search of the electronic databases MEDLINE/ PubMed, PsycNET, Sociological Abstracts, ProQuest, ScienceDirect, HeinOnline, Scopus, Web of Science and Google Scholar was conducted for items published in English between 2001 and 2021.
Twenty-one studies were included in the review, the majority of which were conducted in lower-middle-income countries. RHC themes studied were diverse, with a few more studies focusing on STI/HIV, contraceptive use and pregnancy than those focusing on childbirth and postnatal care. The findings indicate barriers in four main domains: socio-legal barriers, health services-related barriers, interpersonal barriers and personal history-related barriers. Stigma was a major multifaceted barrier.
Female sex workers experience exclusion in utilizing reproductive healthcare services globally. As such, healthcare services are advised to adopt a nonjudgemental approach, to enhance physical accessibility and to train nurses and other healthcare professionals on reproductive health needs of female sex workers. Finally, knowledge production processes on the RHC of FSW should adopt a holistic view of FSW, by exploring their needs and barriers related to childbirth and maternity care and by including the perspectives of FSW in high-income countries.
The review offered an in-depth understanding of female sex workers' own perspectives regarding needs and barriers in utilizing reproductive healthcare services. Findings indicated socio-legal barriers, health services-related barriers, interpersonal barriers and personal history-related barriers. The review could inform the training of nurses and other healthcare professionals in reproductive healthcare services globally. Researchers should adopt a holistic view of female sex workers, by exploring their family planning needs, including barriers related to childbirth, maternity and postpartum care.
We adhered to the EQUATOR guidelines PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation.
Commentary on: Madeley AM, Earle S, O'Dell L. Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery. 2023 Jan;116:103532. doi: 10.1016/j.midw.2022.103532. Epub 2022 Oct 30
Nurses should strive to understand women’s needs, past experiences and sociocultural background as a basis for discussing their choices in a non-judgemental way. Research on non-normative choices in childbearing should include ethnic and sexual minorities, and evaluate protocols for sensitive, women-centred discussion of birthing choices.
Preferences about childbirth range along a wide continuum from physiological, sometimes even unassisted births, to caesarean sections by maternal request. Despite this wide range, most births in the western world take place in medical settings, making it in practice a medical event, reflecting society’s and health professionals’ views of risk and safety that define birth choices which are considered normative....
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