Role of Midwifery Continuity of Care in Reducing Health Inequalities

Completed

• Conditions: Public Health; Pregnancy Related; Health Knowledge, Attitudes, Practice; Social Determinants
• Interventions: Other: Interviews only.

• Registration Number: NCT04524286
• Lead Sponsor: Bournemouth University

Brief Summary

The impact of living in a deprived area has far reaching consequences on maternal and infant health. Studies in England show women living in deprived areas have some of the poorest experiences of care, poor birth outcomes and are 50% more likely to die of pregnancy related complications than women in the least deprived neighbourhoods. Life expectancy has also stalled for women living in the most deprived areas and the global COVID-19 pandemic has further amplified existing health inequalities.

The Social Determinants of Health (SDH) are the conditions in which people are born, grow, work, live, and age, and are mostly responsible for health inequities - the unfair and avoidable differences in health seen within and between populations. Evidence shows taking action on the SDH alongside Midwifery Continuity of Care (MCC) models, improves birth outcomes and reduces health inequalities. How midwives working in MCC models in areas of high deprivation address the SDH as part of their public health and prevention role is currently not clear. There is also a lack of qualitative evidence exploring the SDH from the perspectives of women themselves.

Drawing on Constructivist Grounded Theory methods, this research will take place in a low-income setting in England. Through the use of semi-structured interviews with women and midwives working in an NHS MCC model, the study will generate theory to help explain how and indeed whether midwives take action to address the SDH as part of their public health role. The study also seeks to understand the SDH impacting upon women's lives and what mechanisms exist to support or obstruct engagement with the SDH. Examining these domains will contribute to the evidence base about the impact of MCC and the public health and prevention strategy in NHS maternity services.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-08-14
• Study First Submitted QC: 2020-08-20
• Study First Posted: 2020-08-24
• Study Start: 2020-11-06
• Primary Completion: 2022-03-31
• Study Completion: 2022-03-31
• Status Verified: 2022-04
• Last Update Submitted: 2022-04-21
• Last Update Posted: 2022-04-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 38

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Public - Childbearing Women	Interviews only.	Childbearing women living in three deprived areas in a city in the South of England.
Staff - Midwives	Interviews only.	Midwives working in caseloading teams providing continuity of care to women living in three deprived areas in a city in the South of England.

Primary Outcome Measures

Name	Time	Method
Interview with midwives	12 months	Midwives willing to participate and share their knowledge about their public health role and how the actions they take to meet the needs of women.
Interviews with childbearing women	12 months	Women living in the case setting willing to participate and share their childbearing experiences in one-to-one interviews.

Secondary Outcome Measures

Name	Time	Method
Memo writing	12 months	Memos will be written throughout data collection and incorporated into data analysis.
Document analysis	12 months	Analysis of documents such as policies, reports and guidelines which focus on maternal health inequalities, the public health role of midwives, and the role of midwifery-led continuity of care.

Trial Locations

Locations (1)

Princess Anne Hospital - University Hospital Southampton; 🇬🇧 Southampton, United Kingdom