Access and engagement with maternity, social care and mental health services for perinatal migrant women with no recourse to public funds and irregular status: A cross-sectional study using the eLIXIR born in South London, UK, maternity-child data linkage

Rayment-Jones, H ORCID: 0000-0002-3027-8025, Burton, S ORCID: 0000-0003-3823-3275, Dasgupta, T, Barry, Z ORCID: 0000-0002-4513-7727, De Backer, K ORCID: 0000-0001-5202-2808, Baker, N ORCID: 0000-0001-6805-9568, Wilson, CA ORCID: 0000-0003-2169-5115, Stevenson, K ORCID: 0000-0001-5881-1402, Vowles, Z ORCID: 0000-0001-6989-2180, Kitchen, K, Easter, A, Jolly, A, Rankin, J, Fernandez-Turienzo, C, Sandall, J ORCID: 0000-0003-2000-743X, Poston, L, Magee, LA, Stewart, R, Edwards, D, Ashworth, M et al (2026) Access and engagement with maternity, social care and mental health services for perinatal migrant women with no recourse to public funds and irregular status: A cross-sectional study using the eLIXIR born in South London, UK, maternity-child data linkage. Public Health, 252. ISSN 0033-3506

Preview

Text 1-s2.0-S0033350626000442-main.pdf - Published Version Available under License Creative Commons Attribution. Download (640kB) | Preview

Abstract

Objectives
In the UK, an estimated two million migrants are irregular or subject to No Recourse to Public Funds (NRPF) visa conditions, restricting welfare access and often requiring payment for NHS maternity care. The impact on maternity and perinatal service use remains poorly quantified.

Study design
Retrospective cross-sectional study.

Methods
We used linked electronic health records from maternity, neonatal, and mental health services in South London (eLIXIR-BiSL cohort). The sample included 56,690 women with 67,308 pregnancies (Oct 2018–Oct 2023). Migration status was categorised as UK-born, migrants with recourse to public funds, NRPF, or unknown visa status. Adjusted risk ratios (aRRs) were estimated using generalised linear models, controlling for sociodemographic and clinical characteristics.

Results
Compared with UK-born women, migrants, particularly those with NRPF, had lower engagement with services. Women with NRPF were less likely to access early antenatal care (aRR 0.36 [0.33–0.38]), attend maternity triage (0.89 [0.82–0.96]), or birth in midwife-led settings (0.51 [0.36–0.71]). They were more likely to access care late (3.61 [3.33–3.92]), receive inadequate antenatal care (1.41 [1.30–1.53]), transfer providers (1.54 [1.36–1.74]), and experience prolonged postnatal stays (1.38 [1.21–1.57]). Women with NRPF had lower mental health care contact before (0.05 [0.03–0.08]) and during pregnancy (0.51 [0.37–0.69]), and reduced engagement with social care (0.36 [0.17–0.70]) and the criminal justice system (0.30 [0.19–0.44]).
Conclusions
Migrants with NRPF or unknown visa status face persistent barriers to maternity and mental health care. Inclusive reforms are needed to address inequity.

Item Type:	Article
Uncontrolled Keywords:	1117 Public Health and Health Services; Public Health; 4202 Epidemiology; 4203 Health services and systems; 4206 Public health
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RG Gynecology and obstetrics
Divisions:	Psychology (from Sep 2019)
Publisher:	Elsevier
Date of acceptance:	22 January 2026
Date of first compliant Open Access:	6 February 2026
Date Deposited:	06 Feb 2026 08:25
Last Modified:	06 Feb 2026 08:25
DOI or ID number:	10.1016/j.puhe.2026.106175
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28046

View Item