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Women, Migration & Maternity Services

Women, Migration & Maternity Services. Dave Newall Principle Policy Officer West Midlands Strategic Migration Partnership Monica Tolofari Consultant Midwife in Public Health & Advanced Midwife Practitioner 28 th November 2011. Context for work on migration and maternity services.

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Women, Migration & Maternity Services

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  1. Women, Migration & Maternity Services Dave Newall Principle Policy Officer West Midlands Strategic Migration Partnership Monica Tolofari Consultant Midwife in Public Health & Advanced Midwife Practitioner 28th November 2011

  2. Context for work on migration and maternity services Regional and local focus on Infant Mortality Maternity, Mortality and Migration report 2008 Increasing complexity of migration and the different entitlements to health and social welfare Delivering in an age of super-diversity report (2010) Migrant Friendly Maternity services toolkit (2010) Maternity Action training pilot for work with refugee and asylum seeking mothers (2011)

  3. The UK population has become increasingly diverse over the past decade • 12% of the population in England & Wales were not born in the UK • 20.5% of Birmingham’s population is non UK born • 2009 Pupil Census 39% spoke a non-English 1st language in Birmingham schools. The impact of migration People migrate for many reasons, and immigration status effects entitlements to health and social welfare in England 42,000 individuals from over 150 different countries registered with a Doctor in Birmingham between July 2007 – June 2010

  4. 25% of babies born in England & Wales in 2010 were to women born outside of the UK • Last year the highest number of births to non UK born mothers was for Polish women (19762). • Births to women born in Pakistan, India and Bangladesh remain significant. • 38% of births in Birmingham in 2010 were to a women born outside of the UK. • Significant rise in births to women from the new EU and African nations. The impact of refugee communities can also be identified • The West Midlands and Birmingham in particular have some of the highest rates of infant mortality in the UK and Europe Births in England and Wales

  5. Infant MortalityDeaths under 1 year per 1000 live births (I2SARE.eu)

  6. Key findings from recent maternity research: migrant women’s perspectives • Majority of migrant women accessed services before 12th week of pregnancy • Difficulties, poor attendance at follow up appointments / antenatal care – range of factors identified • NRPF and spousal migrants least likely to attend all follow up appointments • Impact of financial and social factors on access to maternity services e.g. no money for travel • Most migrant women had a positive birth experience, well informed throughout the birth • > 2/5ths reported language, pain relief and cultural and religious needs were NOT met by maternity services • Health visitor home visitsnot understood • Lack of support with post-natal depression was raised

  7. HOBtPCT and England and Wales Infant Mortality Rates 2002 -2009

  8. Maternity service perspective…… Late booking for antenatal care – quarter of the Trusts in the UK have 26% of women that book late Access to antenatal care – understanding how to negotiate maternity services in the UK Delivering maternity services to migrant women

  9. Pregnancy Fast track Pharmacy scheme & Midwifery project POW support -Elsips Trial Doula’s Vulnerable women’s clinic risk assessing medical & social Forging links with hostels housing migrant women Care Pathway Changing services to meet needs Responses from the health service

  10. Commissioned from the voluntary sector as a result of the Maternity, Mortality and Migration research. • Recognised the need to ensure practical support and advice and advocacy for women who were pregnant. • Provided safe accommodation and financial support to enable maintenance of contact with health services • Casework and advocacy is provided to help resolve ongoing immigration issues and long term solutions for women once their baby has arrived. • Builds on existing link the voluntary sector has with this vulnerable group of women. Safety net provision (Hope Projects)

  11. Improving migrant registration with General Practitioners • Early and sustained contact with maternity services • Meeting Language and cultural needs • The changing NHS structure and responsibility for commissioning maternity care • Time for midwives to attend training • Impact of charging for secondary care services for overseas visitors • Tackling poverty and destitution • Dispersal of women • Mental Health Ongoing challenges

  12. Any questions? Thank you for listening

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