Housing ‘blindspot’ jeopardises women’s rights to safe maternity care

New research recommends greater attention to housing issues in the context of maternity care.

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Housing problems now are a major barrier to women’s legal rights to safe, appropriate and dignified maternity care, a new report says.

Almost all of the women who took part in the research – released today (18th June) by the charities Birth Companions and Birthrights – experienced pregnancy and early motherhood while living in temporary, insecure or unsuitable accommodation.

The charities are calling for greater attention to be given to housing issues in the context of maternity care, taking advantage of the NHS Long Term Plan’s commitment to greater integration between local services.

Housing was cited as a central problem in the lives of those women taking part in the research, causing or exacerbating mental health problems and jeopardising their access to care.

Several participants were in housing designated as ‘temporary’ but had been there for months, or in some cases years.

Others were moved during pregnancy or shortly after birth, disrupting relationships with maternity and broader support services, which can vary significantly between local areas.

Midwives talked of women having to stay on postnatal wards after they would normally have been discharged, because they didn’t have housing arranged, or having to attend the housing office while still physically and emotionally vulnerable post birth.

Other professionals spoke of supporting women who had left violent relationships, only to see them re-housed in units where domestic violence was a frequent occurrence.

“In our research, women in temporary or transient housing struggled to access the proven benefits of continuity of carer or services based on long-term therapeutic relationships,” said Amy Gibbs, chief executive of Birthrights.

“We heard about women in unstable or inappropriate accommodation who did not have a place where they felt safe to be during early labour, or confident returning to with their newborn during the highly vulnerable postnatal period.

“This is a blindspot that requires urgent action across the entirety of the health, care and social support system – human rights law demands every woman has equal access to safe, appropriate maternity care that protects her human dignity,” she said.

Naomi Delap, director of Birth Companions, said the experiences shared in the research “show us that the housing needs of these women and their babies seem to be largely overlooked, with direct consequences for their care”.

Recommendations in the report include:

  • Integrated Care Systems need to ensure housing and other local authority services are fully embedded in their services, including active engagement of housing in the community hubs being rolled out under the maternity transformation programme Better Births
  • Housing, social care and health services should work more closely together when women facing severe and multiple disadvantage are relocated during pregnancy or in the postnatal period to ensure smooth transfers of care
  • Local authorities should consider how housing allocation policies and prioritisation decisions reflect the needs and rights of pregnant women and their babies, and providing a single point of contact to professionals supporting pregnant women facing severe and multiple disadvantages

The report, Holding it all together: understanding the rights issues experienced by women facing disadvantage during pregnancy, birth and postnatal care, was funded by Trust for London.

Research was conducted during 2017-2019, in the form of 12 in-depth interviews with women who faced significant disadvantages during their perinatal journey and interviews with 26 midwives, health visitors, family nurse practitioners and birth supporters.

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