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‘My research is the tip of the iceberg in starting to explore what I think is a huge crisis unfolding in the UK’

As part of this year’s Big Give campaign, our researcher Sara Cumming talks about how her project aims to improve care for pregnant women experiencing homelessness


Wellbeing of Women is funding a project led by midwife Sara Cumming to investigate the impact of homelessness on pregnant women. Sara is particularly focusing on women living in temporary accommodation after identifying a gap in research. She tells Wellbeing of Women why she feels passionately about this project and how her work will help improve care and support for pregnant women and their babies.

As a midwife, you're trained to put women at the centre of care and make holistic assessments of their wellbeing. But the impact of being homeless in temporary accommodation on pregnant- women is not really known, so we need to start with listening to their stories. That's why this research matters.

As a midwife for 10 years, I have looked after women who were homeless and living in shelters or in the temporary accommodation system. I remember one woman in particular who had to declare herself homeless during her third trimester I was booking double appointments for her to give her extra support, and her GP and I were writing to her council to try to find her somewhere to live.

I was trying to find research to evidence my argument that this was having a phenomenally stressful impact on her, but I couldn’t find any. Most research was focused on homelessness as street sleeping.

Temporary accommodation, such as sofa surfing, hostels, B&Bs and council-owned accommodation, is a recognised form of homelessness, but I realised it is a grey area in research. I felt there was a huge number of women’s voices that were silenced as a result.

I also realised that, as a midwife, I wasn’t able to deliver the usual midwifery care to her. Despite booking double appointments for her, the threat of homelessness swallowed up all our appointment time – we didn't have as much time to talk about infant feeding options or birth plans, for example. I felt quite overwhelmed as a midwife because I'm not a housing expert or an expert in the homeless system but I was just doing whatever I could to support her.

Improving care for women and their babies

There’s a misconception that you’re not homeless if you have a roof over your head. But this doesn’t mean you have a home – they are two very different things.

There is also the threat of being moved at any time. I'm hearing stories about women who have been moved two weeks after giving birth with a newborn baby and no support. They never would have been able to manage it if it hadn’t been for a keyworker at a charity supporting them.

My project aims to ensure midwives are able to support women who are homeless appropriately. I am speaking to pregnant women living in temporary accommodation about how this housing insecurity affects their pregnancy – how does it impact their ability to engage with the pregnancy? How does it influence their infant feeding choices when they have no idea where they might be housed postnatally?

I am also speaking to keyworkers across the UK about how they work with midwives to provide joined-up support

I will then use my findings to develop a support tool – a practical five-point infographic – to help all midwives understand the specific needs of women who are homeless in pregnancy and tailor care to their needs, which will include working with keyworkers and others.

I will also be delivering a series of educational workshops to raise awareness of the issue and introduce the infographic. Not every trust has a specialist midwife to support vulnerable people during pregnancy, so awareness is vital if we are going to improve care and health outcomes.

The growing issue of homelessness

Without campaigns like the Big Give and charities such as Wellbeing of Women, research like mine wouldn’t be possible. I wouldn’t be collecting information or gathering stories that have the power to change people’s lives by reducing health inequalities and improving outcomes for women.

But my research is the tip of the iceberg in starting to explore what I think is a huge crisis unfolding in the UK, with more and more families in temporary accommodation.

We need to engage with this crisis and urgently understand what women’s needs are: how does it affect their pregnancy? What are their stories so that we can improve care? How can we contribute to change in that context?

In an ideal world, we would have everybody in safe, stable, long-term, sustainable housing. Some people argue that temporary accommodation is the stop gap that needs to stop, because it's a holding space where many can get stuck. We know from government statistics that pregnant women and families spend almost 212 days longer in temporary accommodation than single people and this in itself can become a source of stress, distress and trauma.

We need more research into what the implications of living in temporary accommodation are on people’s health and wellbeing. I hope that Wellbeing of Women, through fundraising campaigns like the Big Give, can continue to fund projects like mine, which will make a real difference to the lives of women and their babies.


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