Women's experiences of community-based midwifery continuity of care in South London: A longitudinal intersectional...

Women from ethnic minority groups and those living in deprived areas are disproportionately at risks of adverse perinatal outcomes, including stillbirth, preterm birth, and poor-quality care. Despite growing policy attention, it remains unclear which interventions are most effective in addressing these inequalities.

In the United Kingdom, a national inequalities strategy called NHS CORE20PLUS5 prioritises midwife continuity of care as a targeted intervention for women from Black, Asian and Minority Ethnic backgrounds and those living in the most deprived areas. An intersectional lens offers critical insight into overlapping systems of inequality.

To explore whether a place-based midwifery continuity model can improve care experiences for women living in an ethnically diverse and socially deprived area of South London METHODS: A longitudinal qualitative study was conducted with fifteen women who received care through a community-based continuity model. Semi-structured interviews were carried out across three timepoints: third trimester, 0-3 months postpartum, and 9-12 months postpartum. Narrative analysis informed by intersectionality explored temporal experiences across settings.

Two narrative themes were identified: organisational power and interpersonal power. Organisational power reflected systemic constraints, institutional fragmentation, and women's marginalisation in standard maternity pathways which can contribute to inequity. In contrast, interpersonal power, particularly relationships with named midwives, enabled continuity, trust and engagement.

This study shows how community-based continuity models can redistribute power and enhance relational care in ways that matter to women. Findings strengthen the evidence for continuity as a protective intervention and inform future policy and service design to address perinatal inequalities.