Migrant maternal health in the UK and Australia

This innovative project will broaden and quantify our understanding of what shapes the delivery of maternity services to migrants.

Infant and maternal mortality rates as well as birth outcomes are poorer in migrant groups than they are in general population. While mortality rates have decreased in the general population this trend has not been reflected in migrant populations. Although we know that there are inequalities in maternity care and outcomes, little is known about factors that shape the maternity services that migrants receive. Increasingly hostile policy environments which include the exclusion of some groups of migrants from free maternity care may be one factor, others have been proposed such as racism and discrimination, low levels of cultural health capital and high levels of mobility.

Given the increase in migration to the UK and Australia and the poor infant and maternal health outcomes, there has never been a more important time to develop mechanisms to understand the influences on migrants’ access to maternity service provision. This project will develop and pilot an innovative factorial survey tool capable of identifying the factors that shape midwives’ delivery of maternity services to migrants.

Research Objectives

The aim of this project is to develop and pilot an innovative survey tool that will enable the team to examine what factors influence midwives’ delivery of maternity care to migrant women in England and Australia.

Objectives include:

To develop a factorial survey (the tool) enabling us to consider the ways in which midwives understand and enact policy and guidance
To use the tool to make preliminary examinations of the barriers that midwives encounter when providing maternity care to migrants and how they overcome those barriers
To use the tool to examine influences on midwives’ attitudes and behaviours towards migrant care provision
To prepare a methodology paper based upon our findings
To prepare a major grant proposal based upon our findings

The focus is on maternity services in the northern and western suburbs of metropolitan Melbourne in Australia and in the West Midlands in England.

Outputs and Impact

The main output of the project is a factorial survey tool which will be tested with midwives. This is a major new innovation and a tool capable of developing new understandings about what shapes the delivery of maternity services including quantifiable outputs. While we plan to apply the tool to understanding service delivery to migrants, this tool can be used across midwifery. Thus, the potential for impact both methodologically and in terms of how the insight is used to support improved service delivery is huge. The knowledge gleaned will enable the development of interventions which can improve service delivery in midwifery.

Once the tool is piloted, the next stage of the project is to undertake a large-scale comparative study focusing upon the factors which shape midwives’ delivery of maternity services to migrants in Australia and the UK.

Research Team

Researchers from the University of Birmingham

Dr Caroline Bradbury-Jones

School of Nursing and Midwifery, Reader in Nursing

Caroline is a registered nurse, midwife and health visitor. Her research interests lie broadly within the scope of addressing inequalities and more specifically are focused on issues of family violence and child abuse and migrant maternal health. She has led or been actively involved in securing funding for a number of research projects relevant to these areas.

Caroline has undertaken research or engaged in scholarly activities with a number of countries including Japan, New Zealand, Denmark, Germany and Finland. Caroline leads the Risk, Abuse and Violence research programme at the University of Birmingham. She is an Associate Editor for Child Abuse Review and is an editorial board member for Journal of Clinical Nursing and International Journal of Social Research Methodology.

Dr Michell Chresfield

Department of History

Michell Chresfield is an intellectual and cultural historian of the 20th century United States. Michell’s research interests include the history of science and medicine, and the history of racial formation and identity making in twentieth century America. Her current research examines how Americans of Native, Black, and White descent have used social science, medicine, and the law to negotiate multiracial identities during the regime of Jim Crow. She is currently at work on a manuscript based on this research titled, "What Lies Between: Social Science, Medicine and the Prehistory of Multiracial America."

Dr Antje Lindenmeyer

Institute of Clinical Sciences, Lecturer in Medical Sociology

Antje has been a lecturer in medical sociology and qualitative methods since 2013. Her research interests are in migrant and transnational health as well as experiences of health and illness. Recently, she has been involved in research on migrants' health histories from a life course perspective; the experiences of primary care practitioners in caring for migrants and the health and wellbeing of vulnerable migrants who were unable to access statutory health services.

Pip McKnight

Registered Midwife

Pip McKnight is a Community Midwife with a background in providing care for pregnant asylum seekers living in Home Office accommodation. As an NIHR Fellow since November 2016, she has been developing research interests in migrant access to maternity care and maternity health inequalities and has published in Midwifery and Evidence-Based Nursing. She is currently completing her Masters in Migration, Superdiversity and Social Policy at University of Birmingham and is a regular guest lecturer and external examiner in Midwifery at Birmingham City University..

Professor Jenny Phillimore – Principal Investigator

Founding Director of the Institute for Research into Superdiversity
Professor of Migration and Superdiversity

Professor Jenny Phillimore is a Fellow of the Academy of Social Sciences and of the RSA. Her research interests span refugee integration with a particular focus on gender, health, housing and social networks and access to healthcare in superdiverse neighbourhoods. She has led multiple research projects for funders including the Economic and Social Research Council, the Arts and Humanities Research Council, the European Union, the Home Office and research foundations and has advised Governments in the UK, Canada, Australia, and Europe. Jenny has published widely in leading academic journals such as Social Science and Medicine, BMJ, Urban Studies, Public Health, Journal of Ethnic and Migration Studies, Policy and Politics Journal of Social Policy. This study builds upon her earlier work on migrant maternity which focused on the experiences of migrants who had given birth in the UK.

Dr Beck Taylor

Institute of Applied Health Research
Clinical Research Fellow
Honorary Consultant in Public Health

Beck Taylor is a clinical academic researching maternity services and policy at the University of Birmingham, and an Honorary Consultant in Public Health Medicine at Public Health England. She is funded by the Maternity Theme of the West Midlands NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) Programme. She has extensive experience of conducting collaborative, multi-method research with midwives and women in the NHS, and a long-standing interest in health inequalities, migrant health and maternity care in research and clinical practice. She has strong networks with the Royal College of Midwives, NHS maternity services, and the NHS England maternity policy team.

Professor Julie Taylor

School of Nursing and Midwifery
Professor of Child Protection

Julie Taylor is a nurse scientist specialising in child maltreatment maternal health. She is Professor of Child Protection at the University of Birmingham, in partnership with Birmingham Women’s and Children’s Hospital NHS Foundation Trust. Her recent work has focused on witchcraft related violence and abuse against children in East Africa. Julie also has a strong focus on developing strategic research leadership. In 2018 she was appointed to the Research Excellence Framework for Allied Health, Dentistry, Nursing, and Pharmacy, panel UoA3 for REF 2021, having also served there for REF 2014.

Researchers from University of Melbourne

Dr Karen Block

Vanguard Fellow, University of Birmingham

Associate Director of the Jack Brockhoff Child Health and Wellbeing Program
Melbourne School of Population and Global Health

Karen has a strong national profile in the area of migration studies, exploring the interplay between host communities and migrants and the complex ways in which this interaction affects health inequalities, integration, inclusion and social cohesion. Her recent and current research includes a range of projects involving immigrant and refugee-background young people, women and families focused on social inclusion across the life course, health inequalities, gender-based violence, evaluating complex interventions, and working in collaborative partnerships with communities and community-based organisations. She is an active member of a number of interdisciplinary groups including Researchers for Asylum Seekers (RAS) and the Melbourne Refugee Studies Program.

Dr Meghan Bohren

Centre for Health Equity, Melbourne School of Population and Global Health

Meghan is a Senior Lecturer in Gender and Women’s Health in the She currently leads research projects working to improve women’s experiences with pregnancy and childbirth care in low- and middle-income countries. This includes primary mixed-methods research on the mistreatment of women during childbirth and respectful maternity care in Nigeria, Ghana, Guinea and Myanmar. Meghan is also an Associate Editor with Cochrane’s Effective Practice and Organization of Care (EPOC) review group, where she focuses on systematic reviews impacting populations and systems in low- and middle-income countries, and methodological research related to qualitative evidence syntheses.

She has worked as a researcher at the World Health Organization (WHO) Department of Reproductive Health and Research (Switzerland), Johns Hopkins Bloomberg School of Public Health (USA), University of Medical Sciences and Technology (Sudan), and Population Services International (USA). She has led and collaborated on research projects in Australia, Sudan, Ghana, Guinea, South Africa, Uganda, Nigeria, India, Myanmar, Thailand and USA.

Ms Sarah Khaw

Research Assistant, Centre for Women’s Health, Gender & Society

Sarah is currently working on ‘Listening for a change’ participatory research project working with women from Assyrian Chaldean backgrounds investigating family violence prevention within migrant and refugee communities and the ‘More than the sum of my parts’ investigating the sexual and reproductive health and rights of women from migrant and refugee backgrounds living with disability. She is passionate about gender and women’s health issues specifically understanding how social positionalities such as gender, sexuality, disability, race and ethnicity intersect and affect women’s health. Sarah's interests also lie within participatory research methods and understanding how these methodologies can translate to sustainable change.

Dr Cathy Vaughan

Vanguard Fellow, University of Birmingham
Centre for Women’s Health, Gender & Society

Dr Cathy Vaughan is a Senior Lecturer in Gender and Women’s Health, and Acting Head of the Gender and Women’s Health Unit, at the Melbourne School of Population and Global Health. Cathy leads research on gendered health inequalities and violence against women in diverse settings, working primarily with migrant and refugee women, women with disabilities, and young people.

Her current and recent research projects include examining refugee and migrant women's experience of violence and accessing violence-response services in Australia; exploring the role of settlement services in responding to violence against refugee women; participatory action research to understand the role of faith leaders and faith communities in preventing violence against women; and work to build national capacity to measure the prevalence of violence against women in Asia and the Pacific. Cathy also leads the Melbourne Social Equity Institute’s university-wide programme on community-engaged research.