Experiences of postnatal care and support among Black women and birthing people in the UK: Systematic review and thematic synthesis.

The postnatal period is a time for recovery and social transition, yet it is often called the 'Cinderella service' of maternity care, due to its relative neglect in research and policy. Literature often conflates postnatal experiences with antenatal and intrapartum periods, risking overlooking distinct needs arising after birth. For Black women in the UK, structural barriers further shape experiences. This review synthesises literature on Black women's postnatal care and support experiences in the UK, up to the baby's first birthday, in both hospital and community settings.We included qualitative studies and qualitative parts of mixed-methods studies on the postnatal experiences of Black women in the UK, published between 2004 and 2024. We also included studies covering the antenatal and intrapartum periods, provided they included sufficient data on the postnatal period. Searches covered ten databases, including MEDLINE, CINAHL, and PsycINFO. Methodological quality was assessed using the CASP qualitative checklist, and data were analysed using Thomas and Harden's thematic synthesis.Nine papers met the inclusion criteria; only seven focused solely on Black women. Three key themes emerged: (1) inadequate and insensitive postnatal care, (2) barriers to formal mental health support, and (3) fragmented informal support and the expectation to cope. Women reported poor physical care in the wards, whilst community care was impersonal and routine, offering little opportunity to address emotional needs. Cultural stigma towards mental health discussion and cultural expectations of strength discouraged help-seeking.Our findings revealed that inadequate physical and impersonal care and limited informal support left women with unmet needs. Cultural expectations of strength further intensified these gaps, often leaving women to navigate this period in isolation. Addressing these gaps requires co-designed interventions with Black communities, rooted in lived experiences, to ensure care and support over the first year are equitable, culturally competent, and responsive to Black women's needs.