The women told us they have often been told what contraception to use, felt rushed during appointments, and pressured to use particular methods, including long-acting reversible contraception (LARC). In other instances, they recalled being steered away from more expensive LARC methods due to the cost to the NHS - something they unanimously agreed would not be said to white women. The women shared that they often feel they have to fight to have their voices heard and to make their own decisions about contraception. 

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Some spoke of difficult experiences with post-natal healthcare professionals and health visitors, saying they felt humiliated and judged for having several children in a few years. They described being pressured into choosing contraception too soon after giving birth and said they had to work hard to justify their choices. They also highlighted how the way contraception is raised in postnatal care matters, and that current approaches often lack sensitivity and can make women feel pressured to make a choice. 

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One woman recalled a midwife who recognised her in the hospital after birth and remarked, “You’re like a cat” - a comment steeped in a racist stereotype that Muslim women, and particularly Muslim women of colour, have ‘too many’ children.  

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Another important issue during the focus group was the specific contraceptive needs of Muslim women in relation to prayer and bleeding. In Islam, ritual purity is required for daily prayers. If a woman experiences certain types of bleeding - including prolonged or irregular bleeding (known as istihada) - this can interrupt her ability to perform prayer and other religious duties. Some contraceptive methods, such as the copper coil, may cause spotting or irregular bleeding that creates distress and can interrupt prayer. The women noted that these concerns are rarely acknowledged in appointments with GPs and nurses.  

 
The women reported that they would like to see HCPs consider the following during contraception appointments: 

 

• Their patient’s past experiences with recorded or perceived side effects and hormonal implications of contraceptive methods, validating and listening to concerns rather than dismissing 

• Their patient’s reproductive and fertility goals, beliefs and preferences, which could be related to cultural, ethnic or religious reasoning – which HCPs should be supported to understand 

• Their patient’s priorities and reasons for accessing contraception – for example to avoid pregnancy, to address heavy menstrual bleeding (HMB) or other hormonal issues  

 

Moreover, women were eager to be provided with more ownership over their contraceptive choices, and the ability to make informed decisions. For example, they valued the opportunity to come together as a community to learn more about contraceptive options in their own language, and wanted to see HCPs provide more regular touch points to review how women were getting along with their chosen method – providing reassurance that different options are available, and that women do not have to persevere with a method that is not working for them.