Postnatal mental health and the prevention of accumulating inequalities
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26 January 2022 — adopted January 2022 • completed July 2023
Postnatal mental health and the prevention of accumulating inequalities
Maternal health is one of the starkest examples of racial inequalities in the UK.
higher maternal mortality for Black African/Caribbean women vs White women (Knight et al, 2019)
higher maternal mortality for South Asian women (Pakistanis and Bangladeshis) vs White women
These inequalities have only been exacerbated by the Covid-19 pandemic, and therefore there is potential to see worsening inequalities in maternal health for years to come.
Why this research is needed
There is evidence that the prevalence of maternal mortality, morbidity and co-morbidity is not being reduced, and risk factors such as deprivation and racism play a large part in this. Long-term conditions (LTCs) such as poor mental health, diabetes and heart disease are risk factors for developing further LTCs. It is well known that age increases the chance of being affected by multiple long-term conditions (mLTCs), but people living in deprived areas, lower socio-economic groups and Black and minority ethnic groups are more likely to be affected earlier in their lives than their white counterparts.
In south-east London, the accumulation of multiple long-term conditions is both more prevalent and starts earlier in life among its ethnic minority groups, who also experience discrimination and inequalities throughout their lives. Racial discrimination is associated with high rates of common mental health conditions, particularly in the city’s Black ethnic groups, and poor mental health is associated with mLTCs such as diabetes and hypertension.
This study therefore focuses on the postnatal period to explore the experience of mental health conditions among Black Caribbean and Black African women in Lambeth, and through life history interviews places these experiences in the context of the lifecourse to interrogate the interconnections between health, racism and other factors.
Study aims
To understand how multiple inequalities over the lifecourse shape postnatal mental health and the accumulation of mLTCs among Black Caribbean and Black African women in Lambeth.
Specific objectives:
To interrogate how racism and racialisation have shaped women’s experience of health and healthcare over their lives
To explore how the experience of inequalities informs how women experience current postnatal mental health conditions, multimorbidity and related healthcare
To use the understanding of life histories and the key transitional life stage of parenthood to inform the development of early interventions to prevent the transition to mLTC
How the research will be carried out
Qualitative life history interviews with up to 40 Black Caribbean and Black African women who have had a baby within a year of the interview.
These interviews will explore how racism and racialisation have shaped women’s relationship with health and other social services, how this affects their experience of mental health and care during the postnatal period, and what can be done during this life-stage to prevent the accumulation of ill-health and disadvantage.
How patients and the public are involved
Patients and the public informed the development of the research proposal; the topic and study design was discussed with an informal advisory group including members of a perinatal mental health charity based in south London, health visitors, and local public health professionals.
A formal PPIE group meeting held three times over the course of the research
A feedback forum to which people from wider networks will be invited
Potential benefits of the project
Inform the development of intervention strategies that engage with the underlying causes of mLTC disparities, supporting women from a very early stage to prevent the accumulation of ill health and disadvantage
Contribute to the evidence base on the prevention of intergenerational cycles of health disparities nationally
Produce summaries relevant to Public Health in Lambeth and Southwark, the NHS Race & Health Observatory, and the NHS England Policy team on inequalities
Project lead
Dr Sarah Milton
Senior research fellow, King’s College London
Related content
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Informing national policy on perinatal mental health and maternity care - →
Improving representation in maternity research - →
Maternity and perinatal mental health research at ARC South London
Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.