Engagement with antenatal education in Nottingham: Working with hardly reached communities to improve place-based inclusivity and wellbeing

2024 PhD Project

About The Project

Antenatal Education is not a universally commissioned NHS service in England, and financial pressures have led to many NHS maternity services discontinuing their antenatal services. This has resulted in the space being filled by a plurality of providers – including hospitals, charities, and community-led organisations.

A key report by MBRACE in 2022 found evidence of considerable racial disparities in maternity care in the UK, with Black, Asian, and mixed ethnicity women more likely to die than their White counterparts, while women living in the most deprived areas were almost three times more likely to die than those in the most affluent areas. Many of the women who died struggled to engage with services to meet their complex intersecting health and social care needs.

Nottingham University Hospitals NHS Trust’s (NUH) maternity services are currently subject to a government-commissioned review prompted by bereaved parents seeking answers about poor maternity care.

This research project will examine how antenatal education activities are conducted and engaged with – and by whom – in Nottinghamshire, with a subsequent consideration of resultant implications for inclusivity and wellbeing amongst under-represented groups. The research will explore existing antenatal maternity services, in terms of types of service providers, the focus of provision and how services are delivered. Investigating whether the approaches of antenatal educators in Nottingham are demonstrating an appreciation, understanding and empathy for a broad spectrum of cultures could contribute to safer and more personalised care for all mothers in Nottingham.

The research project will also investigate factors that affect individuals’ decisions whether to participate in antenatal education using participatory research activities to co-produce findings with maternity service users. From this, the research will examine how potential exclusion from, antenatal maternity services may impact prospective parents’ wellbeing.

This research, undertaken with Nottingham University Hospitals NHS Trust, aims to spotlight areas in which service provision can better meet the needs of currently under-represented groups. As a result, it hopes to increase the agency of hardly reached groups in engaging with antenatal care to improve the wellbeing of parents/prospective parents and babies, and to provide a more inclusive offer in the antenatal space.

Project Aims

The overall aims of this research are:

To identify the current antenatal provision offered in Nottingham City by examining the existing suite of antenatal maternity services that are available.
To consider the implications for both user wellbeing and the inclusivity of the antenatal offer from the point of view of a wide range of potential users, including vulnerable groups.
To provide robust evidence on the usefulness of co-production in developing effective solutions to local problem(s) relating to antenatal education.