Pregnant migrants and ‘the local’

This research explores migrant women’s experiences of maternity care within the NHS in three areas: Leeds, Manchester, and Kirklees.  When discussing my project, I’m often asked, ‘Why these three areas’?  In fact, why focus on specific locations at all?   Why not extend the project to the entirety of England?

Broadly speaking, we should not assume that migrants’ experiences will be roughly uniform across one country.  To the contrary, it is in their local neighbourhoods, towns, and cities, that migrants go about their daily lives, make friends and allies, and resist the policies and institutions that exclude them from full participation in the UK.   Local government and civil society can influence attitudes towards, and services available to, migrants.  My PhD research, which focused on migrant women’s activism in Manchester and Sheffield, found that each city offered particular resources, and presented particular obstacles, for the women with whom I worked.

With regard to migrant women’s experiences of maternity care, there are a few reasons to believe that the local might play an important role.  First of all, the NHS has become increasingly decentralized, especially since the passage of the 2012 Health and Social Care Act.   Local Clinical Commissioning Groups are responsible for managing the NHS budget for an area, ‘purchasing’ services from different secondary providers.  In 2016, control of the health and social care budget for Greater Manchester was devolved to the Greater Manchester Combined authority.

Secondly, migrant women’s experiences of maternity care within the NHS may be influenced by the support they get from their friends and neighbours, and local charities and civil society organisations.  Befriending schemes, special midwifery teams for migrants, and the availability of antenatal classes, may all affect how migrant women experience maternity care.    Each town and city has its own services and support groups, and it will be useful to look at the impact of various services, and consider how the most beneficial can be expanded to other regions.

Finally, each city and town has its own specific histories, culture(s), and institutions, and it’s interesting to think about how these effect not only the particular services available to pregnant migrants, but also the wider ‘atmosphere’ in which migrants are living.  Is the area in question multicultural and diverse, where a pregnant migrant might encounter broadly friendly attitudes?  Or is it an area where a migrant woman might feel isolated and unsupported?  Something as simple as the availability of familiar food might make a big difference to a pregnant migrant – and might depend on the neighbourhood in which she is living.

Manchester, Leeds, and Kirklees are all really interesting places to explore these sorts of issues.  As mentioned, Greater Manchester Combined Authority has control over its own health and social care budget, and I want to look at whether this has an influence over how migrant women in Manchester experience NHS maternity services.  Furthermore, Manchester has a long history of migration and a wide range of organisations offering support to migrant mothers.  Leeds similarly has a history of migration, and several organisations that provide support to refugees and asylum-seekers in particular.  Critically, for this project, Leeds is also the birthplace [pardon the pun] of the City of Sanctuary Maternity Stream, which campaigns for better maternity services for ‘women seeking sanctuary’, and supports women in accessing these services.   This project will explore how these histories of migration, and the availability of third sector support, influence migrant women’s experiences of maternity care.

Kirklees is less urban than either Manchester or Leeds – the borough boundaries include a large town (Huddersfield), and some smaller towns and villages.  Some parts of the borough are very diverse and have a significant migrant population, while in other parts, the population is almost entirely white British.   As my past research projects have largely been based in cities, I am very interested in learning more about the experiences of migrants in towns and villages, especially in those villages where there may be very few migrants.

As fieldwork for this project progresses, it is already clear that the presence of support networks, whether made up of family and friends, or accessed through local charities and self-help groups, play an important role in pregnant migrants’ access to, and experiences of, maternity care.  I am looking forward to further exploring the impact of the local environment on pregnant migrants’ experiences, and am hopeful that the pandemic will soon be controlled enough to permit in-person research.