Access and engagement with maternity, social care and mental health services for perinatal migrant women with no recourse to public funds and irregular status: A cross-sectional study using the eLIXIR born in South London, UK, maternity-child data linkage
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: In the UK, an estimated two million migrants are irregular or subject to No Recourse to Public Funds (NRPF) visa conditions, restricting welfare access and often requiring payment for NHS maternity care. The impact on maternity and perinatal service use remains poorly quantified. STUDY DESIGN: Retrospective cross-sectional study. METHODS: We used linked electronic health records from maternity, neonatal, and mental health services in South London (eLIXIR-BiSL cohort). The sample included 56,690 women with 67,308 pregnancies (Oct 2018-Oct 2023). Migration status was categorised as UK-born, migrants with recourse to public funds, NRPF, or unknown visa status. Adjusted risk ratios (aRRs) were estimated using generalised linear models, controlling for sociodemographic and clinical characteristics. RESULTS: Compared with UK-born women, migrants, particularly those with NRPF, had lower engagement with services. Women with NRPF were less likely to access early antenatal care (aRR 0.36 [0.33-0.38]), attend maternity triage (0.89 [0.82-0.96]), or birth in midwife-led settings (0.51 [0.36-0.71]). They were more likely to access care late (3.61 [3.33-3.92]), receive inadequate antenatal care (1.41 [1.30-1.53]), transfer providers (1.54 [1.36-1.74]), and experience prolonged postnatal stays (1.38 [1.21-1.57]). Women with NRPF had lower mental health care contact before (0.05 [0.03-0.08]) and during pregnancy (0.51 [0.37-0.69]), and reduced engagement with social care (0.36 [0.17-0.70]) and the criminal justice system (0.30 [0.19-0.44]). CONCLUSIONS: Migrants with NRPF or unknown visa status face persistent barriers to maternity and mental health care. Inclusive reforms are needed to address inequity.
Source: Public Health
Authors: Hannah Rayment-Jones, Sam Burton, Tisha Dasgupta, Zenab Barry, Kaat De Backer, Natasha Baker, Claire A. Wilson, Kerrie Stevenson, Zoë Vowles, Kirsty Kitchen, Abigail Easter, Andrew Jolly, Judith Rankin, Cristina Fernandez-Turienzo, Jane Sandall, Lucilla Poston, Laura A. Magee, Robert Stewart, David Edwards, Mark Ashworth, Jane Sandall, Ingrid Wolfe, Cheryl Gillett, Michael Absoud, Lucy Pickard, Amanda Grey, Sarah Spring, Toyin Kazeem, Amelia Jewell, Matthew Broadbent, Finola Higgins, Leonardo de Jongh, Tisha Dasgupta, Carolyn Gill
Institutions: King's College London, Liverpool John Moores University, University College London, University of Birmingham, Newcastle University, South London and Maudsley NHS Foundation Trust, National Institute for Health and Care Research, NIHR Maudsley Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust, Evelina London Children's Healthcare, King's College Hospital NHS Foundation Trust, King's College Hospital, ELIXIR, Guy's Hospital
Language: English
Topic: Migration, Health and Trauma
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,130
Funders: National Institute on Handicapped Research, South London and Maudsley NHS Foundation Trust, National Institute for Health and Care Research, Department of Health and Social Care, King's College London, Liverpool John Moores University, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, NIHR Maudsley Biomedical Research Centre, Medical Research Council, Research Trainees Coordinating Centre, National Institute for Health Research Applied Research Collaboration South London
Awards: MILLENIA: MultIpLe Long-tErm conditions in pregnancy aNd experiences of mIdwifery cAre – a mixed methods study, G2695184213, G3442092653, The Migration And MAternal Health (MAMAH) Study: Identifying clinical and policy interventions to improve maternity care for underserved migrant women in the UK, Maternity Experiences and perinatal oUtcomes of Mothers facing Removal of their Infant due to Social Care proceedings - MUMS@RISC study, The eLIXIR (early LIFe data Cross-Linkage in Research) Cohort., G5326254153, G632724385, Pregnancy planning for parents with mental illness, eLIXIR, Early Lifecourse data Cross-LInkage in Research; a Multidisciplinary Partnership
OpenAlex ID: W7127268532