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

Homelessness in pregnancy is an increasing issue, with 99% of midwives reporting they have cared for women living in hostels, temporary accommodation or shelters, according to the Royal College of Midwives and Channel 4 Dispatches.

Understanding the impact homelessness can have on women and their pregnancies is vital to provide good care. Midwife Sara Cumming is doing exactly this – researching the experiences of pregnant women in temporary accommodation, which is a recognised form of homelessness. Her research is being funded by the women’s health charity Wellbeing of Women and aims to support midwives to tailor care appropriately and engage with keyworkers and others.

Homelessness and pregnancy

Sara explains more about her project and why research like this is badly needed.

“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.

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“I’ve been a midwife for 10 years and 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 is a recognised form of homelessness

“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.

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.

A huge crisis is unfolding in the UK

“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?

“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.”

Educational workshops

Sara, whose research project will last for one year, will use her findings to develop a support tool – a practical five-point infographic – to support midwives in understanding the needs of women who are homeless in pregnancy. Sara will also run a series of educational workshops to raise awareness of the issue and the tool. The aim is to help midwives tailor care appropriately, including engaging with keyworkers and others, particularly in areas where a specialist midwife to support vulnerable people during pregnancy is not available.

“Not every trust has a specialist midwife to support vulnerable people during pregnancy,” Sara says. “So awareness is vital if we are going to improve care and health outcomes.

“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.”

Wellbeing of Women’s Big Give Christmas campaign

Sara is supporting Wellbeing of Women’s Big Give Christmas campaign, which aims to raise £32,000 for research to improve outcomes for vulnerable pregnant women. Thanks to matched funding from the Big Give and The Julia and Hans Rausing Trust, every pound donated between November and 6th December will be doubled.

“We need more research into what the implications of living in temporary accommodation are on people’s health and wellbeing,” says Sara. “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.”

Find out more

For more information about homelessness and pregnancy and to donate to Wellbeing of Women’s Christmas Challenge click here: Improving pregnancy care for vulnerable women (thebiggive.org.uk)

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