Regional Programme —

Perinatal Health Equity

A place-based approach to improving health and wellbeing outcomes for women and birthing people during pregnancy, and babies up to a year old. 

Newborn baby with parents
Programme
Overview

Engaged with service users at a local level and women who face a range of health inequalities. 


Identified and enabled the spread of innovative practice to help address the equity gaps in the health and wellbeing of mothers and families.   


Our programme ran from April 2021 to June 2023.

 

Detailed Programme Information

Covering pregnancy and the first year of life, the perinatal period is key to the future health, development and life chances of a child. Making a difference in this window carries significant benefits further down the line. 

Health Innovation South West sought to improve health equity during the perinatal period by shaping elements of perinatal care, improving access and outcomes, and engaging with those who were least likely to seek support. 

Our Perinatal Health Equity Programme was developed from our Health Equity Strategy, based on evidence and engagement with stakeholders in the South West. This research showed that women and babies in certain populations, including marginalised groups and those living in more deprived settings such as rural locations are experiencing health inequity in the form of limited access to care and opportunities for living a healthy life and the reduced likelihood of having individual agency to manage their own health. 

A literature review and in-depth user research with 45 individuals was carried out. The aim was to understand women and birthing people’s experiences, perceptions, and feedback on ways to improve perinatal health access, outcomes, and experience. Through focus groups, interviews and online conversations we were able to engage women who face a range of health inequalities. Details of the findings are available in our case study here. 

Development of our Perinatal Health Equity Regional Programme commenced in April 2021, with delivery taking place from June 2021 to June 2023. The programme took a place-based approach to engaging with service users at a local level, which has informed how we deliver our other programmes across the organisation. 

 

Outcomes

Improved access to health and social care services for people facing inequity throughout pregnancy and the first year of life

We supported the APPEAL research team at the University of Exeter and WILD Young Parents Project to improve pelvic floor muscle exercise (PFME) education resources for pregnant women. The first phase of the project involved the creation of a set of videos to support women to perform PFME during and after pregnancy to prevent urinary incontinence. The resources were co-produced by the APPEAL research team and mothers experiencing health inequality. APPEAL is an evidence-based programme of training and resources to improve advice and education about PFME provided during pregnancy. We are now supporting the local maternity and neonatal teams in Somerset, Devon and Cornwall to implement the APPEAL training programme as part of their new perinatal health services.

APPEAL social media graphic


We supported the
University of Exeter to evaluate a
Future Learn course which upskilled charitable sector healthcare professionals working with women in the community with mild to moderate post-natal depression (PND) symptoms. The training was found to be a feasible, accessible and effective model for improving capability to reach and support more people with mild to moderate parental mental health problems. 

 

Improved quality of health and social care for people facing inequity

We worked with two midwives from Yeovil District Hospital to develop a Perinatal Bias & Newborn Assessment ‘Train the Trainer’ package. This was delivered to 21 attendees, ranging from maternity and neonatal clinicians to commissioners and university lecturers. The purpose of the training was to strengthen participants’ knowledge of assessing the deteriorating mother/baby and to improve understanding of bias and its impact on the care of mothers, birthing people and babies. 

Following the course, 92% of respondents felt confident to deliver the perinatal bias training within their own organisations. 

Midwives Becky Cockings and Bea Chubb deliver Perinatal Bias & Newborn Assessment Training in our Innovation Space at Vantage Point, Exeter

Midwives Becky Cockings and Bea Chubb deliver Perinatal Bias & Newborn Assessment Training at Health Innovation South West, Exeter

 

A reduction in the modifiable risk factors associated with poorer health – focus on deprived communities in the South West 

In partnership with the Lullaby Trust, we implemented and evaluated a safer sleep resource in eight settings across the region, with potential for national rollout. Parents reported an increase in awareness of some of the risk factors identified in the resource and making changes to their babies sleeping arrangements to reduce the risk of Sudden Infant Death Syndrome (SIDS).  Read more about our work with the Lullaby Trust here.

“Working with Health Innovation South West has been an example of how collaborative working can bring about positive public health messaging, by supporting professionals to have tailored conversations with families experiencing perinatal health inequalities due to their living circumstances.”

Stella Parkin, National Lead for Care of Next Infant Programme, The Lullaby Trust

 

People are able to make more informed decisions about their care, as they have been provided with better information

Outcomes suggest that respondents accessing the APPEAL pelvic health resources had better awareness of PFME and were confident to perform PFME and to talk to a healthcare professional. They also reported performing PFME often enough to improve muscle strength.   

Valuable insights from user engagement are shaping DadPad ® to model good communication skills, emotional literacy and address culturally specific barriers. This will help inform future development of the app, which provides dads and dads-to-be with the knowledge and practical skills to enable their babies to get the best possible start in life. 

 

Improved access to resources for health care practitioners – to facilitate meaningful conversations about the health inequalities patients may be facing

Practitioners who received Perinatal Bias & Cultural Competency Training had a better understanding of appropriate clinical practice and felt adequately trained to provide culturally competent care. 

As part of the APPEAL project, three video resources were co-produced with women experiencing health inequity. These will now be incorporated into APPEAL training for midwives and APPEAL resources for women. 

 

Working with innovators 

Below are examples of how Health Innovation South West has worked with its partners to improve access to, and quality of, perinatal care and increase individual agency when it comes to managing perinatal health. 

  • Supporting University of the West of England researcher Dr Laura Goodwin to understand which women are most at risk of giving birth before arriving at hospital (BBA). Read more in our news item.  
  • Working with the University of Exeter to examine the impact of Future Learn evidence-based training of individuals who support women with mild to moderate depressive symptoms experiencing perinatal mental health disorders. Further details are here.  
  • Working with the team behind DadPad to develop their award-winning app providing information for new fathers, with a second phase focused on tailoring support to DadPad users from diverse ethnic backgrounds and cultures – to facilitate their participation in early family life. DadPad was one of the winners of the first round of our Health Equity Challenge Fund 

 

Working with health and care teams 

Below are examples of how we have worked with local health and care teams to support service provision. 

  • Supporting The Lullaby Trust to develop a safer sleep resource to facilitate supportive conversations between midwives or care professionals and parents or families who find themselves marginalised, or in challenging housing or domestic circumstances. Learn more here. 
  • We have evaluated the impact of cultural awareness training courses delivered to 45 midwives across the region. The training sought to highlight healthcare barriers and discrimination faced by minoritised communities whilst providing participants with the tools to understand their own attitudes and values towards race, migration and diversity.   

Key findings from the follow-up survey issued to participants include:  

  • 100% of respondents having conversations with colleagues about what they had learnt.  
  • 100% of respondents wanting to improve outcomes for Black, Asian, Minority Ethnic and Refugee (BAMER) communities. 

See ourcase study for more details. 

Learning from the Perinatal Health Equity Programme will support the development of the Peninsula Research and Innovation Partnership (PRIP) maternity and neonatal mission, which addresses inequities in maternal and neonatal care in partnership with colleagues from across the South West Peninsula.  

 

Contact

For more information about this programme, please contact Charlotte Burrows, Programme Director, Health Innovation South West  

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