Supporting Equitable Maternity Care
‍

We are incredibly excited to share the findings from a six-month Maternity Care project led by a small but mighty team at First 4 Health Group.  
‍
We know from the national MBRRACE report looking at gaps in maternal health in the UK, that a range of women’s medical and non-medical factors can impact their risk during their maternity journey. In this SBRI-Healthcare funded project, we focused on the non-medical factors that increase risk during women’s antenatal and postnatal stages. This information was used to develop an analytical tool (MpRisk) which helped us better identify which women were at highest risk. We then invited these patients to group clinics set-up by us to create a safe space to talk through their health concerns with relevant professionals and to interact with other women at a similar stage.  

The group clinics provided tailored education, follow-up, and emotional and practical support to three groups of women. These three groups included those who were planning to conceive, those who were already pregnant, and those who had recently given birth. Our findings showed that attending the group clinics led to an overall improvement in 62.5% of patient’s self-reported outcomes.  

The group clinic topics shown on the diagram below were designed using our learning from developing the MpRisk tool as well as through in-depth discussions with patients who shared their lived experiences of accessing or receiving maternal support.

The group clinics ran for 2 hours each, and were led by multidisciplinary teams including doctors, a nurse, a midwife, and a health coach. We also formed partnerships with the Newham Baby Feeding Helpline service who provided a Baby Feeding expert for the clinics, and with a charity (Maa Shanti) supporting victims of domestic abuse, who provided a Women’s Financial Advisor to lead some clinics. Finally, we partnered with a local charity called Skills Enterprise who provided in-person digital literacy and language interpretation support for our patients.
‍
At the end of every clinic, we anonymously collected feedback from patients. On average 86% of participants reported 100% satisfaction with their group clinic experience. Where participants were less satisfied, we learnt lessons for future approaches.

We also collected information about patient’s perceptions of their own maternal-health concerns at each clinic they attended, before and after the clinic. The chart below shows how much women felt their concerns either improved, worsened, or stayed the same after attending the clinics.



25 women reported an improvement with our interventional clinics (ranging from 1-point to 4-points’ improvements using an NHS-validated scale), 13 women stayed the same, and for two women their concerns worsened. For these two women, the concerns raised could not have been addressed in a group setting without a personal appointment, which was booked thereafter. In the absence of the clinics, these concerns may not have been brought to surface and flagged-up as rapidly as they have and with the context we now have about each patient.

This project also enabled us to identify areas of need that would not have otherwise been picked up. We identified and supported:
✔️ a patient who was well into her pregnancy but had not yet engaged with antenatal services
✔️ a patient hoping to conceive who did not previously have a smear test
✔️ a patient who had chosen to opt for a C-section based on myths about vaginal birth and was able to re-assess her options. 

The group clinics went a long way in forging friendships between participants as the clinics unfolded and building trust between healthcare professionals and patients.  💙

We remain committed to harnessing innovative approaches that enable the personalisation of care our women receive and we are grateful to the team for making this happen! 👏

Dr Sandra Nwokeoha, Innovation Lead 
Dr Neha Ahuja, Clinical Lead
‍