Women's health

Key messages for primary care practitioners

In general:

  • See country pages on infectious diseases, nutritional and metabolic concerns and women's health for specific information about issues of relevance to female patients from particular countries.
  • Be aware of possible religious and cultural sensitivities when discussing sexual and reproductive matters.
  • Where language is a problem in discussing sexual/reproductive matters, offer a female interpreter. It is inappropriate to use children as interpreters for adults and particularly so when discussing intimate concerns.
  • If you have concerns that a patient may be a victim of trafficking you can contact the UK Human Trafficking Centre [external link].
  • Be aware of cultural practices that may expose women to chemical hazards.

With respect to sexual/reproductive health:

  • Menstruation, pregnancy and childbirth are associated with different beliefs/practices in different religions/cultures and these may impact on health/treatment compliance. Explore the patient's beliefs and understanding.
  • Enquire about past history of cervical and breast screening (where age appropriate) and provide information about the NHS programmes [external link].
  • Offer girls up to age 18 immunisation against human papilloma virus.
  • A sexual history is an important part of an overall health assessment. On the basis of country of origin and sexual history consider whether the patient may require a full sexual health screen for sexually transmitted infections.
  • Sexual health promotion including safer sex advice is important to address with all sexually active people. 
  • Enquire about family planning requirements and inform patients that contraceptive services are free and confidential.
  • Be aware of the practice of female genital mutilation affecting women from certain countries.

With respect to pregnancy:

  • For women planning pregnancy, or who are pregnant, inform them of their rights to maternity care and explain the NHS system of antenatal care, including routine antenatal screening, as they may have different expectations from their previous experience in their country of origin. 
  • Guidance on the management of rash illness and the exposure to rash illness in pregnancy is available from the HPA.
  • Listeria infections have been found to be more common in pregnancy among ethnic minority groups in England and Wales [1].
  • Encourage anyone who might be eligible to apply for the Healthy Start [external link] scheme to make an application.
  • Some pregnant women may choose to travel back to their country of origin to be with family for their delivery. Women who intend to travel during pregnancy will need advice in relation to health risks associated with this (e.g. malaria is very high risk in pregnancy). See travel health and NaTHNaC [external link] for information on travel health issues. Different airlines have different rules about flying in pregnancy and the woman should be advised to check both with the airline she intends to fly with, and with her insurance company.

Patient information (English only)

Patient information (English and other languages)

Other useful resources

References

Patient information (English only)

Family Planning Association Guide to contraception [external link]

Testing for infections in pregnancy [external link] (NHS screening programme leaflet)

Breastfeeding: Off to the best start [external link] (Department of Health information leaflet)

Cervical screening NHS information leaflet [external link]

Listeria - keeping food safe [external link] (Department of Health information leaflet)

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Patient information (English and other languages)

Cervical screening NHS information leaflet [external link] Available in Arabic, Bengali, Chinese, Farsi, French, Greek, Gujarati, Hindi, Kurdish, Italian, Portuguese, Polish, Punjabi, Spanish, Somali, Ukranian, Urdu, Vietnamese.

NHS Cervical Screening Programme: the colposcopy examination [external link] (Department of Health information leaflet) Available in English, Arabic, Bengali, Chinese, Polish, Punjabi, Urdu.

NHS Cervical Screening Programme: what your abnormal result means [external link] (Department of Health information leaflet) Available in English, Arabic, Bengali, Chinese, Polish, Punjabi, Urdu.

NHS Breast Screening leaflet [external link] Available in English, Arabic, Bengali, Chinese, Farsi, French, Greek, Gujarati, Hindi, Italian, Kurdish, Portuguese, Polish, Punjabi, Somali, Spanish, Ukranian, Urdu, Vietnamese.

Be breast aware [external link] (Department of Health information leaflet) Available in English, Arabic, Bengali, Chinese, Farsi, French, Greek, Gujarati, Hindi, Italian, Portuguese, Polish, Punjabi, Spanish, Somali, Sorani, Ukranian, Urdu, Vietnamese.

Breast screening: Over 70? You are still entitled to breast screening [external link] (Department of Health information leaflet) Available in English, Arabic, Bengali, Chinese, Polish, Punjabi, Urdu.

Leaflets on endometriosis [external link] have been produced by the ENDOCUL (Endometriosis and Cultural Diversity) project, each specifically tailored to one of the communities involved in the project.

Healthy Start patient leaflets [external link]

Pregnancy and maternity rights for Spanish speaking workers [external link] leaflet in English and Spanish developed by the Latin American Women's Advice Services in partnership with Maternity Action.

Information for female sex workers [external link] is available in a range of languages from TAMPEP (European Network for HIV/STI Prevention and Health Promotion among Migrant Sex Workers).

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Other useful resources 

NHS cervical screening programme [external link]

HPA Human papillomavirus (HPV) page - cervical cancer and genital warts (including links to information on the UK HPV immunisation programme)

NHS Choices: pregnancy [external link]

NHS Infectious Diseases in Pregnancy Screening Programme [external link]

HPA Rashes in pregnancy page 

Routine antenatal screening [external link] (Patient UK information)

Endometriosis and Cultural Diversity: Improving Services for Minority Ethnic Women [external link] a resource for health professionals produced by the Endocul project.

Healthy Start [external link] information about the scheme (which has replaced the Welfare Food Scheme) and the role of health professionals

Maternity Action [external link] a national charity working to end inequality and promote the health and well-being of all pregnant women, their partners and children from before conception through to the child's early years.  

Medact [external link] information on maternity rights

Flying during pregnancy [external link] (NHS choices)

NaTHNaC frequently asked questions on malaria prevention, including pregnancy-specific questions [external link]

Royal College of Obstetricians and Gynaecologists: The prevention of malaria in pregnancy [external link]

Asian Women, Domestic Violence and Mental Health - A Toolkit for Health Professionals [external link] by EACH

Forced marriage & honour based violence screening toolkit [external link] by resolution

ForcedMarriage.net [external link] a website that provides practical information and sources of advice and help on forced marriage.

UKHTC [external link] (United Kingdom Human Trafficking Centre); a multi-agency centre that provides a central point for the development of expertise and cooperation in relation to the trafficking of human beings. The UKHTC provides tactical advice and victim support 24 hours per day, every day of the year.

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References

  1. Mook P, Grant KA, Little CL, Kafatos G, Gillespie IA. Emergence of pregnancy-related listeriosis amongst ethnic minorities in England and Wales [external link]. Euro Surveill. 2010;15(27).

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