Perinatal Outcomes Among Migrant Women with No Recourse to Public Funds or Irregular Status: A Retrospective Cohort Study Using the eLIXIR 'Born in South London' Data Linkage

Rayment-Jones, H orcid iconORCID: 0000-0002-3027-8025, Burton, S orcid iconORCID: 0000-0003-3823-3275, De Backer, K orcid iconORCID: 0000-0001-5202-2808, Vowles, Z orcid iconORCID: 0000-0001-6989-2180, Baker, N, Stevenson, K, Barry, Z orcid iconORCID: 0000-0002-4513-7727, Kitchen, K, Rankin, J, Sandall, J orcid iconORCID: 0000-0003-2000-743X and eLIXER Born in South London Project (2026) Perinatal Outcomes Among Migrant Women with No Recourse to Public Funds or Irregular Status: A Retrospective Cohort Study Using the eLIXIR 'Born in South London' Data Linkage. Midwifery. ISSN 0266-6138

[thumbnail of Perinatal Outcomes Among Migrant Women with No Recourse to Public Funds or Irregular Status- A Retrospective Cohort Study Using the eLIXIR 'Born in South London' Data Linkage.pdf]
Preview
Text
Perinatal Outcomes Among Migrant Women with No Recourse to Public Funds or Irregular Status- A Retrospective Cohort Study Using the eLIXIR 'Born in South London' Data Linkage.pdf - Accepted Version
Available under License Creative Commons Attribution.

Download (1MB) | Preview

Abstract

Problem
Restrictive immigration policies limit maternity care access and exacerbate poverty and isolation among migrant women.

Background
In the UK, many migrant women face No Recourse to Public Funds (NRPF), restricting welfare access and making them liable for maternity care charges. Population-level evidence on perinatal outcomes remains limited.

Aim
To examine perinatal outcomes among migrant women with NRPF compared with UK-born women, migrants with recourse to public funds, and migrants with unknown visa status in an ethnically diverse urban UK population.

Methods
We conducted a retrospective analysis of linked maternity and neonatal electronic health records (eLIXIR -Born In South London) from 2018–2023, including 44,634 pregnancies. Multivariable regression estimated adjusted risk ratios (aRR) controlling for sociodemographic and clinical characteristics.

Findings
Migrant women with NRPF had higher risks of adverse maternal outcomes (emergency caesarean aRR 1.74, 95% CI 1.55–1.95; severe maternal morbidity 1.49, 1.33–1.67). Their infants were more likely to have low Apgar scores (1.53, 1.07–2.16) and less likely to receive skin-to-skin contact (0.92, 0.88–0.97). Infants of women with NRPF did not show higher risk of neonatal death (1.44, 0.85–2.29), whereas infants of women with unknown visa status had the highest risks of preterm birth (1.24, 1.13–1.35), low birthweight (1.28, 1.17–1.39), and neonatal death (2.27, 1.81–2.86).

Conclusion
Migrant women with NRPF and infants of women with unknown visa status face disproportionate risks of adverse outcomes. Addressing these inequities requires inclusive maternity care, accurate migration data collection, and reconsideration of NRPF and charging policies.

Item Type: Article
Uncontrolled Keywords: 1110 Nursing; 1114 Paediatrics and Reproductive Medicine; 1117 Public Health and Health Services; Nursing; 3215 Reproductive medicine; 4204 Midwifery; 4205 Nursing
Subjects: H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RG Gynecology and obstetrics
R Medicine > RT Nursing
Divisions: Psychology (from Sep 2019)
Publisher: Elsevier
Date of acceptance: 11 March 2026
Date of first compliant Open Access: 13 March 2026
Date Deposited: 13 Mar 2026 10:47
Last Modified: 13 Mar 2026 10:47
DOI or ID number: 10.1016/j.midw.2026.104773
URI: https://researchonline.ljmu.ac.uk/id/eprint/28240
View Item View Item