New research from the University of Bedfordshire’s Maternal and Child Health Research Centre has revealed how confusing healthcare systems, language barriers, and lack of accessible information are preventing some migrant and ethnically diverse women from accessing maternity care early in pregnancy.
The study, led by Dr Shuby Puthussery, Associate Professor in Maternal and Child Health and Director of the Maternal and Child Health Research Centre at the University, explored the experiences of women who began antenatal care later than the recommended first 10 weeks of pregnancy.
The study, published in BMJ Public Health, is believed to be the first in England to focus specifically on the experiences of migrant and ethnically diverse women who accessed antenatal care later than recommended.
Early antenatal care is known to play an important role in protecting the health of both mothers and babies. However, women from migrant and ethnic minority backgrounds are more likely to access care later and experience poorer maternity outcomes.
Through interviews with 20 women living in the East of England, researchers found that delays were often not caused by a lack of interest in maternity care, but by difficulties navigating the healthcare system and accessing the right support at the right time.
Many women said they did not know how to begin maternity care in the UK or found the process difficult to understand. Others described problems with language support, unanswered enquiries, rushed appointments, and practical challenges such as transport costs and childcare responsibilities.
The findings also showed the positive impact of supportive healthcare professionals, clear communication, and strong family or community networks in helping women engage with services.
The study highlights the need for maternity services that are easier to access and understand, particularly for women who may be unfamiliar with the UK healthcare system. The researchers call for clearer information, better interpretation services, stronger community outreach, and more continuity in care to help reduce inequalities in maternity outcomes.
Speaking about the findings, Dr Shuby Puthussery said: “Our findings show that most women wanted to access maternity care as early as possible, but many faced barriers that made the system difficult to navigate. For women who are unfamiliar with the UK healthcare system, even knowing where to start can be challenging.
“As the UK moves towards achieving a step change in maternity inequalities, our research highlights the importance of providing clear information, culturally responsive support, and maternity services that are easier to access and understand. Improving early access to antenatal care is essential to reducing inequalities in maternity outcomes and ensuring all women receive the support they need during pregnancy.”
The researchers have used the study findings to co-design accessible, culturally responsive educational resources and community-based outreach delivered by trained local mothers with lived experience of maternity services acting as ‘antenatal care champions’ to ensure all women are able to access care early in pregnancy, regardless of their background or circumstances.
Dr Marie Therese Sangy, Research Fellow on the study, added: “The women who took part in this study shared how difficult it can be to navigate maternity services when information is unclear or support is limited. Their experiences highlight the importance of designing services that are more inclusive, accessible, and responsive to the needs of diverse communities.”
The research underpinning this work can be accessed at: https://bmjpublichealth.bmj.com/content/4/2/e003287
