Supporting engagement with and access to maternity services
Research Team: Judith Rankin, Ryc Aquino, Nicola Heslehurst, Heather Brown, Ruth Kipping, Abimbola Ayorinde, Oluwaseun Esan, Kerry Brennan-Tovey
Who's involved: Fuse, LiLaC, University of Bristol, PHRESH
1st September 2023 – 31st December 2025
This project will explore the barriers experienced by women on low incomes in accessing maternity care. This will contribute to the evidence base for applied public health practice and help inform public health decision making around pregnancy and maternity care.
In England, women living on low incomes are at increased risk of experiencing poor health during pregnancy. This project will explore how to ‘poverty proof’ access to support, that is, identify the barriers that exist and create solutions. Improving access to services will help lead to improvements in health for women and babies.
This project aims to explore the barriers experienced by women on low incomes to accessing maternity services and use this to identify solutions to increase access to these services.
Women living on low incomes in England are at increased risk of experiencing poor health during pregnancy. Our recent review of the evidence found that women and babies living with socioeconomic disadvantages had a 40% increased risk of worse pregnancy outcomes including stillbirth, low birth weight and babies being born early. Women may also experience mental health issues following pregnancy, birth or in the first year after birth. Women with lower access to financial, educational, social and health resources engage less in care during pregnancy – called antenatal or maternity care.
‘Poverty proofing’ is an approach in which barriers to access support faced by those living on low incomes are identified and solutions created. Using this approach, we will explore how access to support can be improved by poverty proofing maternity care. Improving access to services may lead to improvements in health for women and babies.
This project includes several areas of work. These include:
• Investigating the available support provided by maternity services and voluntary, community and social enterprise sector (VCSE) organisations in four areas in England: Newcastle, Bristol, Coventry and Liverpool.
• Interviewing 20 women who are currently or recently pregnant (from birth to 18 months) and living on low incomes, and their partners (if they have a partner), to identify barriers to accessing maternity care in Newcastle.
• Interviewing 20 professionals (health care and those from VCSE organisations) who support pregnant women living on low incomes in Newcastle to identify barriers to maternity care access and ways to improve access.
• Undertaking a survey (online and paper) to estimate the costs of pregnancy (such as transport, time off work, childcare) and accessing maternity care for women.
• Bringing the different parts of the project together to develop a toolkit of practical changes to improve access to maternity care in Newcastle.
• Sharing the findings with PPI groups in Bristol, Liverpool and Coventry to inform undertaking this work in other areas.
• Developing an application for funding to evaluate the impact of the changes introduced on access to maternity care.
We have discussed this study with a parent who lives on a low income, a representative from the Maternity Voices Partnership (MVP) and the charities Children North East (with expertise in the poverty proofing approach), and MumSpace (a local community group run by mums for mums, and local public health professionals). We will continue to work with our public and patient members throughout the project. We will meet with our PPI members to review study documents, input on recruitment approaches, and dissemination.
We will carry out a range of dissemination activities throughout the project including posting project updates on our webpages. In addition to academic journal publications and conference presentations, we will explore disseminating our findings through social media, blogs, and podcasts to engage optimally with our target audiences.
Background Oral health is a key part of overall health and has significant links with quality of life and wellbeing. However, oral conditions including dental caries, periodontal disease and oral cancer, amongst others, remain highly prevalent with very high burdens on individuals and populations. In particular, dental caries (tooth decay)…
Background Many children in England are overweight. In 2022/23, about 23 out of 100 children aged 10–11 years were obese. Some children drink lots of sugary drinks, eat too much highly processed food and do not eat enough fruit and vegetables. It can be harder for families with less money…
Background Discrimination is a profound social injustice that fundamentally affects people’s physical and mental health. People often experience more than one form of discrimination at a time, based on race, age, gender, sexual orientation, etc, and this makes its impacts even more complex. We know that…