New research from the University of Liverpool gives a powerful voice to Muslim women, revealing their spiritual needs during pregnancy and birth—and offers a clear roadmap for healthcare professionals to provide truly woman-centred care.
Introduction: The Unspoken Gap in Maternity Care
The journey to motherhood is one of life’s most profound transitions. In the UK, the NHS strives to provide personalised, woman-centred maternity care. Yet, for a significant and growing part of the population—Muslim women, the UK’s second-largest religious group—this care often misses a vital dimension: their faith.
A landmark qualitative study led by researcher Shaima M. Hassan at the University of Liverpool has bridged this gap. By listening intently to the experiences of 43 Muslim women and healthcare professionals (HCPs), the research offers an unprecedented, evidence-based roadmap. It moves beyond assumptions to provide concrete recommendations, showing how simple awareness and small adjustments can transform a clinical experience into one of profound respect, dignity, and spiritual support.
This isn’t just about religious tolerance; it’s about excellence in clinical care. When a woman’s core beliefs are acknowledged, her anxiety decreases, her trust in her caregivers increases, and her overall experience—and potentially health outcomes—improve.
Part 1: The Study – Lifting the Veil on Lived Experience
The research, published in BMC Pregnancy and Childbirth, used a robust three-phase qualitative design to capture deep, personal narratives:
- Phase One: Longitudinal interviews with first-time pregnant Muslim women, tracking their journey from late pregnancy to four months postpartum.
- Phase Two: Focus groups with 23 Muslim mothers who had given birth in the UK within the last three years.
- Phase Three: In-depth interviews with 12 experienced HCPs, including midwives, nurses, and a sonographer.
This triangulated approach ensured the findings reflected both the expressed needs of women and the practical realities faced by staff. The result is a comprehensive list of religious practices observed across pregnancy, labour, and the postnatal period.
Table 1: A Glimpse into the Spiritual Journey: Common Religious Practices During Maternity
| Religious Practice | Purpose & Significance | Stage of Maternity |
|---|---|---|
| Recitation of Quran & Supplications (Dua) | For comfort, strength, and divine protection. Creates a calming, spiritual atmosphere. | Pregnancy, Labour, Postnatal |
| Maintaining Modesty (Hijab/covering) | Preserving dignity and privacy during examinations and labour. A core aspect of religious identity. | Labour, Postnatal |
| Preference for Female HCPs | Aligns with religious guidelines on modesty. Reduces anxiety and increases comfort. | All Stages |
| Eating Dates in Early Labour | Following the Sunnah (tradition) of Prophet Muhammad; believed to ease pain and provide energy. | Labour |
| Adhan & Iqamah (Call to Prayer) | Whispered into the newborn’s ears; first words the baby hears are the remembrance of God. | Immediately after Birth |
| Tahneek | Rubbing a softened date on the newborn’s palate. A blessed tradition with emerging scientific parallels (sugar gel for preterms). | After Birth |
| Breastfeeding | Highly encouraged in Islam for up to two years, seen as a rewarded act and a right of the child. | Postnatal |
| Aqiqah | Sacrifice of a sheep on the seventh day, with meat distributed to family and the needy; an act of gratitude. | Postnatal |
Part 2: The Heart of the Findings: Awareness vs. Active Support
One of the study’s most practical contributions is categorising practices based on what HCPs need to provide:
- Category 1: Practices Requiring HCP Awareness. Simply knowing these practices exist allows HCPs to avoid causing inadvertent distress or misunderstanding.
- Category 2: Practices Requiring HCP Awareness & Active Involvement. Here, positive action from staff is needed to facilitate the practice safely and respectfully.
Table 2: The Healthcare Professional’s Role: From Awareness to Action
| HCP Action Needed | Example Practices | Recommended Action for HCPs |
|---|---|---|
| AWARENESS is Key | • Silent Birth (preference for quiet as baby is born) • Tahneek (date ritual) • Aqiqah & Community Visits • Burying the Placenta | • Ask and listen. Create a safe space for women to express these wishes. • Avoid judgement. Understand these are meaningful spiritual acts, not mere “traditions.” • Provide information. For practices like placenta burial, explain hospital policies and explore options. |
| ACTIVE SUPPORT is Crucial | • Maintaining Modesty • Preference for Female HCPs • Facilitating Prayer/Recitation • Supporting Informed Choice (e.g., on fasting in Ramadan, animal-based meds like Vitamin K) • Signposting for Male Circumcision | • Use extra sheets/curtains; ask before exposing. • Offer a female professional where possible; don’t make the woman ask. • Allow use of audio devices (phones) for Quran recitation; provide a CD player if needed. • Initiate non-judgmental conversations about fasting and medicine ingredients. • Have information ready on NHS and accredited private circumcision services. |
Part 3: The Emotional Reality: Confidence, Anxiety, and the “Burden” of Asking
The study powerfully highlights the emotional landscape for many Muslim women. A recurring theme was a lack of confidence in expressing their needs, stemming from fear of being seen as “difficult,” a “burden,” or facing cultural ignorance.
- On Modesty: “I felt like I was in a situation where I could not even say… I feel like he may think ‘Oh here we go, a Muslim woman complaining'” – Samah, study participant.
- On Silent Birth/Adhan: Many women performed rituals like the Adhan secretly or waited for staff to leave, worried HCPs would “not understand” or interrupt.
- On Birth Plans: Many women were unaware of birth plans or doubted midwives would have time to read them or understand religious components.
Conversely, when HCPs demonstrated awareness, the impact was profoundly positive:
- “It made me feel good that she respected that.” – A participant whose midwife respectfully discussed Ramadan fasting.
- “Then she made more of an effort.” – Sahar, after a midwife noticed her need for a headscarf and covered her legs.
Part 4: The Path Forward: Evidence-Based Recommendations for Inclusive Care
The study culminates in actionable recommendations to embed true woman-centred care for Muslim women:
- Proactive, Sensitive Communication: Don’t wait for the woman to ask. Use open questions: “Is there anything important to you from a faith perspective that you’d like us to know about your care?”
- Cultural Competency Training: Move beyond one-off training. Integrate understanding of common religious practices into core midwifery and nursing education.
- Practical Facility Adjustments: Ensure easy access to female practitioners, privacy for prayer, and policy clarity on practices like placenta release.
- Resource Development: Create simple, visual information leaflets (in relevant languages) about common practices, fasting in pregnancy, and local resources like circumcision services.
- Empower Through Birth Plans: Actively introduce and encourage the use of birth plans as a tool for Muslim women to document their religious wishes clearly and confidently.
Conclusion: A Call for Compassionate, Informed Partnership
This research is a vital toolkit, not a critique. It celebrates the dedication of NHS staff while providing them with the knowledge to enhance their care further. For Muslim women, it validates their experiences and empowers them to voice their needs.
Ultimately, it’s about seeing the whole woman—not just a patient, but a person whose faith is a source of strength, comfort, and identity during one of life’s most vulnerable and beautiful chapters. By closing the gap in understanding, the UK can lead the way in delivering maternity care that is not only clinically excellent but also deeply humane and inclusive.
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