Research into maternity care shows access is universal

Mother and baby: SRC Sept 2010  c. Jenny Wicks  ongoing use   0001  35
Mother and baby

Scottish Refugee Council is calling for the role of the NHS in providing maternity care to asylum seekers to be protected and celebrated after a study highlighted the importance of free access.

The study – Women and Children First? – looked at the experiences of pregnant women whose asylum claim had been refused, and found that their insecure immigration status did not appear to preclude or constrain their access to maternity care in Glasgow.

Researchers Sylie Da Lomba of Strathclyde University and Nina Murray, Women’s Policy Officer at Scottish Refugee Council were pleased to find that, in line with Scottish regulations, Scottish Government Guidance and practices within the NHS in Glasgow, the principle of universal access to maternity care was being upheld.

Charges threatened

The study took place in the context of the Immigration Bill, currently progressing through the UK Parliament, which proposes charging refused asylum seekers for primary health care. This group is already subject to being charged for secondary health care, such as maternity care, in England.

Nina Murray said: “Positively, the findings broadly indicate that pregnant women refused asylum are seen by health professionals in Scotland first and foremost as women in need of care, and that their insecure immigration status does not preclude or constrain their access to maternity care.

“We did not find any evidence that women were expected to pay for any of their care nor that their status as refused asylum seekers had an impact on the services they could access.

It is crucial that the NHS remain committed to ensuring access to maternity services for all." Nina Murray

“Women overwhelmingly reported no change in their ability to access healthcare following a refusal on their asylum claim and the majority reported positive experiences of support from their midwife, health visitor, and when giving birth in hospital.

“It is crucial that this is recognised and celebrated and that the NHS remain committed to ensuring access to maternity services for all.”

Gillian Smith, Director of The Royal College of Midwives Scotland, said: “It is with some pride that midwives and others can look at the findings of this paper and be reassured that the principle of universal access to maternity is being upheld and that this provides some security to those women and their families who need to use the service.”

Put at risk

However, the research also highlighted a range of factors that were impacting in a detrimental way on asylum seeking women. Researchers found that Home Office asylum policies, such as enforced destitution or providing cashless support for pregnant women who had been refused often put them at risk and made it more difficult for them to get to maternity appointments, or to phone the hospital to request help, even when in labour.

Even those on emergency ‘Section 4’ support – £35 a week made available on a payment card - struggled to afford healthy food to eat, while others were placed in unsuitable accommodation such as hostels without cooking facilities.

Other women interviewed reported difficulties with the provision of interpreting with some women reporting that an interpreter had not been booked, or that male interpreters were provided for maternity appointments.

Awareness needed

Evidence collected by the research team also suggests that asylum seeking women are often not aware of their entitlements to additional pregnancy or health-related support, particularly reimbursement or payment of travel costs. Others struggled to access antenatal classes due to language barriers or a lack of information.

The women interviewed were often in very difficult and stressful circumstances, and relied on friends to rally round and support them.

One explained: “We got a letter to tell us that we’ve to move out of the house…and they told us our support is going to end…I was six months pregnant at that time…so we went to see the lawyer…and we applied for Section 4. I think we only stayed for two weeks without support…I was a bit lucky because my friends were really supportive, most of the time they made sure that, like especially the last few months of my pregnancy, they made sure that I have like a bit of maybe £5 in my phone so that if anything happens I can manage to call.”

The report, which is published today (April 23), makes a number of recommendations and calls for women not to be forced into destitution by the Home Office while pregnant.

Read the report: Women and Children First?