Exploring experiences of pregnancy and midwifery care for women with multiple long-term conditions (MLTC)

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Adopted project
23 September 2024 — May 2024 to April 2027

Exploring experiences of pregnancy and midwifery care for women with multiple long-term conditions (MLTC)

A study by maternity researchers at ARC South London will explore how pregnant and postnatal women with two or more long-term health conditions use health services and experience midwifery care.

~20%

of pregnant women in the UK have two or more physical or mental health conditions before pregnancy

These women often have lots of appointments with different healthcare professionals during pregnancy and are at risk of experiencing poorer pregnancy outcomes.

Understanding how best to provide midwifery care for these women is critical to improving their experience. Despite this, there is limited research into this area.

We do not currently know how these women:

Use maternity and other health services

Feel about the care they get from midwives

Want their care to be, or how they would like different healthcare professionals to work together to provide the best and safest care for them

The MultIpLe Long-tErm conditions in pregnancy aNd experiences of mIdwifery cAre (MILLENIA) study aims to address these research gaps. Supporting better care of people with multiple long-term conditions has been identified as a priority within NIHR ARC South London.

“The findings of this research will be applicable to the local population and could inform which kind of service delivery models work to reduce inequalities in access to and experiences of maternity care.”

Zoe Vowles — NIHR doctoral clinical academic fellow, Guy’s and St Thomas’ NHS Foundation Trust / King’s College London

What are the aims of this project?

This study has multiple aims. The researchers want to:

✓

Explore how pregnant and postnatal women with multiple long-term conditions use health services and experience midwifery care, identifying any inequalities and areas for improvement

✓

Explore the experience of midwives and healthcare professionals providing multidisciplinary maternity care for women with multiple long-term conditions, understanding the role of the midwife within the team

✓

Co-design guidance to optimise care and improve women’s experience of midwifery care as part of multidisciplinary maternity care, reducing potential inequalities and treatment burden on patients

How will the research be carried out?

This mixed methods study, being undertaken as a PhD, will be carried out in three phases:

Retrospective cohort study

Using anonymised research data to analyse how women with multiple long-term conditions use and experience health services during pregnancy and postnatally

Qualitative interviews and observation

Interviews with pregnant or postnatal women, midwives and other maternity staff, along with observation of care, to explore how women with multiple long-term conditions experience midwifery care as part of wider maternity care — and how midwives and other professionals provide care and collaborate

Co-design workshops

Developing guidance on midwifery care for women with multiple long-term conditions, using findings from phases one and two to inform the process

How are patients and the public involved?

Involvement of service users and the public is integral to this study. A PPIE group made up of women with lived experience of pregnancy, birth, and postnatal care with multiple long-term conditions will continuously inform the study, as well as co-authoring and co-presenting publications and findings.

A Project Advisory Group (PAG) including leading charities the Maternal Mental Health Alliance and Action on Pre-eclampsia, and multidisciplinary stakeholders (such as obstetricians, midwives and perinatal mental health specialists), will advise the team throughout the research.

Collaborators

This project has a wide range of collaborators including:

University of Birmingham (Institute of Applied Health Research)
Maternal Mental Health Alliance
Action on Pre-eclampsia

This research is funded by the NIHR. It began in May 2024 and is expected to complete in April 2027. It was adopted by ARC South London in September 2024.