Wellbeing of Women, in partnership with the Royal College of Midwives and the Burdett Trust for Nursing, funded Sara Cumming’s research to investigate pregnant women’s experiences of homelessness in the UK.
Homelessness is on the rise across the UK. Women are considered more at risk of homelessness because they are less likely to own homes, more likely to rent, more likely to have caring duties and are the main victims in situations of domestic violence.
Pregnancy is a life changing event known to increase the risk of domestic violence and relationship breakdown which further increases housing insecurity and risk of homelessness.
However, no one knows how many pregnant women are currently experiencing homelessness in the UK because they aren’t recorded in current statistics as being pregnant. What we do know is that midwives say they are increasingly caring for pregnant women experiencing homelessness.
A survey by the Royal College of Midwives and Dispatches in 2019 discovered that more than 99% of midwives had seen a pregnant woman who was homeless in a six-month period. And, 2023 saw the highest numbers of families experiencing homelessness and living in temporary accommodation since records began.
As midwives, we know homeless pregnant women are more likely to give birth early or have a stillbirth. But most studies focus on the impact of street sleeping. There is a research gap around the experience of pregnant women living in temporary accommodation.”
Sara Cumming
Wellbeing of Women Research Midwife
Research has primarily focused on the health impacts of street sleeping whilst pregnant and until now, there have been few studies exploring the health impacts and experiences of pregnant women in temporary accommodation.
However, research led by Sara Cumming, a midwife based at the University of Dundee and NHS Tayside, has found that pregnant women in temporary accommodation face significant health challenges and barriers to accessing maternity care whilst homeless.
The study, funded by Wellbeing of Women, Royal College of Midwives, and the Burdett Trust for Nursing, involved speaking to 14 women across the UK who experienced homelessness whilst pregnant. Six keyworkers from charities supporting homeless pregnant women were also interviewed to provide complimentary insights of the challenges pregnant women face while homeless.
Over 22.5 hours of interview data was analysed using a thematic approach to understand the pregnancy impact of being homeless, experiences of maternity services and key needs from midwifery care.
Homeless pregnant women often have diverse life stories – they may be escaping domestic violence, are migrants or refugees, or from working households who have suffered severe financial hardship. It’s vital that midwives know more about their experiences to help them provide specialised women-centred care.”
Sara Cumming
Wellbeing of Women Research Midwife
The research showed that pregnant women felt living in temporary accommodation had significant health impacts on their pregnancy and their postnatal wellbeing. Other insights included:
The research also found that pregnant women experiencing homelessness face increased barriers to accessing maternity care. Women are often forced to move, with as little as 24 hours' notice, between different accommodation. This creates delays in accessing routine midwife care, including scans and important screening tests, as they have to re-register with new midwifery teams.
Further study findings revealed pregnant women often felt ‘unseen’ by midwives when these specific health challenges and barriers to accessing care were not acknowledged, or health advice, such as healthy eating in pregnancy or safe sleeping advice, was not adapted to their situations.
However, despite these increased challenges and barriers to accessing maternity care while homeless, the research found that pregnant women think midwives can have a huge impact in making them feel supported, seen and heard while homeless. Positive midwife interactions that were respectful and responsive to their complex situations were seen as having a significant impact on women’s sense of support in pregnancy.
The infographic was co-produced between Miss Cumming and research participants collaboratively to inform midwives about the key health challenges of being pregnant and homeless alongside what midwives can do to support pregnant women in temporary accommodation.
Next Steps:
The infographic has been presented at the Royal College of Midwives Conference 2024 and is now being used in some NHS maternity trusts to improve planned care for homeless pregnant women.
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Wellbeing of Women researcher Dr Emily Cornish has been exploring the potential to treat a little-known pregnancy complication that can have tragic consequences
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