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About this project
This website brings together the research, findings and public involvement work of the maternity and perinatal mental health research theme at the NIHR Applied Research Collaboration (ARC) South London — a programme dedicated to understanding and reducing inequalities in maternity care for women and babies in south London and beyond.
Why this research was needed
Women in the UK do not all have equal chances of a safe and positive experience of pregnancy, birth and early motherhood. The evidence is stark:
Black women are five times more likely to die in pregnancy or childbirth than white women (MBRRACE, 2019)
Asian women are twice as likely to die in pregnancy or childbirth as white women
babies are born prematurely each year in the UK — a higher rate than many other European countries
babies under one were placed in State Care in the UK in 2023 — nearly double the rate of a decade ago
Women living in the most deprived areas, from Black, Asian and minority ethnic backgrounds, or navigating complex social circumstances — including domestic abuse, mental illness, immigration challenges or involvement with social services — face compounding risks. Many have reported feeling judged, unheard or poorly supported by the healthcare system.
South London is one of the most ethnically diverse and socially varied parts of the UK, making it both a place where these inequalities are acutely felt and an ideal location from which to develop and test solutions that can benefit communities nationally and internationally.
Who carried out this research
The research was carried out by the maternity and perinatal mental health research theme at the NIHR Applied Research Collaboration (ARC) South London, based at King’s College London. The ARC is one of fifteen regional collaborations funded by the National Institute for Health and Care Research (NIHR) to produce applied research that directly improves health and social care services.
The theme was led throughout by Professor Jane Sandall CBE, Professor of Social Science and Women’s Health at King’s College London and an NIHR Senior Investigator. Professor Sandall was also appointed as Head of Midwifery Research at NHS England and Improvement in 2021, enabling direct translation of research evidence into national policy and strategy.
The team spans researchers, midwives, psychiatrists, psychologists and public involvement specialists, working in partnership with NHS Trusts, local community organisations, charities and women with lived experience of maternity care.
What we researched
Our work spanned six interconnected areas, all focused on the goal of safer, more equitable, and more humane maternity care:
Models of maternity care
Does continuity of midwife care — where a woman sees the same midwife or team throughout pregnancy, birth and the postnatal period — improve outcomes? We investigated this through cohort studies in Lambeth (the LEAP study), a large national study of nearly a million women, and updated international Cochrane reviews. We found consistent evidence that continuity models significantly reduce preterm birth, caesarean section rates and improve women’s experiences, particularly for women from deprived and ethnically diverse communities.
Inequalities in maternal outcomes
Why do Black and Asian women, and women in deprived areas, experience significantly worse outcomes? We investigated perinatal outcomes for BAME women (the BAME study), the experiences of women with social risk factors (Project 20), and how structural racism operates within maternity and social care settings. Our findings have directly informed the MBRRACE national reports and NHS policy on tackling health inequalities.
Perinatal mental health
Mental health conditions are among the leading causes of maternal death in the UK. Our research explored how to improve access to services for BAME women (the Oxleas study), evaluated an online anxiety intervention for pregnant women (the RELAX study), examined mental health outcomes for women with gestational diabetes and severe mental illness, and investigated digital tools to support preconception planning for women with SMI. We also studied infant feeding challenges for women with severe mental illness.
Safety, harm and open disclosure
When things go wrong in maternity care, how are families told, and how well are they supported? The DISCERN study examined the experiences of families and healthcare professionals following incidents in NHS maternity services, and identified five critical factors for improving open disclosure. We also produced a training film used by NHS Trusts to improve staff awareness and practice.
Global maternal health
Through the CRIBS programme and the 2YoungLives project, our researchers worked in Sierra Leone to evaluate a community-based mentoring scheme for pregnant adolescent girls. A pilot trial published in The Lancet found the scheme halved combined maternal and perinatal deaths. This work demonstrates that locally developed, community-led solutions can save lives, and has lessons for high-income country settings too.
Pandemic impact and resilience
Covid-19 fundamentally disrupted maternity services. We studied how care was reconfigured, how decisions were made by healthcare professionals, how women — particularly from BAME communities — experienced this disruption, and what lessons should shape more resilient services in the future (the RESILIENT study). This work continues to inform NHS post-pandemic recovery planning.
The role of public involvement
A defining feature of this programme was its commitment to involving women with lived experience as genuine partners in research — not as subjects, but as co-producers. This was led by Mary Newburn, the theme’s public involvement lead, alongside peer researchers including Rachael Buabeng, Vita Moltedo and others with personal experience of maternity care.
Public involvement shaped study design, interview guides, participant materials, logos and ethics. It also went further: women contributed to journal articles and conference presentations, trained as peer researchers, and helped develop a values charter for trauma-informed research engagement (MUMS@RISC Charter).
“At its best, PPI in research can improve the quality of research studies. When practised as a democratic process it can give groups of people a voice about their healthcare options, build confidence and skills among those involved in co-design, and increase trust in research with communities.”
Public involvement lead, maternity and perinatal mental health theme
Key results and impact
Across more than five years of research, the theme produced findings that have changed clinical practice, informed national policy and saved lives.
45%
reduction in risk of preterm birth for women receiving community-based midwife continuity of care, including 9.5% → 6.4% for BAME women (BJOG, 2026)
48%
reduction in combined maternal and perinatal deaths through community-based mentoring for pregnant adolescent girls in Sierra Leone (The Lancet, 2025)
922,000+
women included in the largest real-world study of midwife continuity of care in England, confirming breastfeeding benefits and reduced stillbirth for Black women (Communications Medicine, 2025)
5 critical factors
identified for improving open disclosure in NHS maternity services, with a training film now used by trusts across England (DISCERN study, Health and Social Care Delivery Research, 2024)
17 studies
synthesised in an updated Cochrane Review confirming that midwife continuity models increase spontaneous vaginal birth and reduce caesarean section across 18,533 women in five countries (2024)
41 studies
reviewed in a systematic review of perinatal healthcare when child protection is involved, producing four key recommendations on trauma-informed care, racism and multi-agency working (PLOS One, 2024)
Our findings have informed the NHS Better Births Review, the Three-Year Delivery Plan for Maternity and Neonatal Services, NHS England’s Core20PLUS5 health inequalities framework, and the NHS 10 Year Health Plan’s commitment to shifting care from hospital to community. Professor Sandall’s secondment as Head of Midwifery Research at NHS England and Improvement ensured these findings were directly embedded in national strategy.
“Our findings provide a potential solution to mitigating inequities in maternity care. Women get to know the small team of midwives, receive care close to home, and know that their midwives will coordinate with the wider health team when needed. One of the priorities in the NHS 10 Year Health Plan for England is shifting care from hospital to community, and our findings are supportive of this plan.”
Professor of Social Science and Women’s Health, King’s College London; theme lead, NIHR ARC South London maternity and perinatal mental health
About this website
The NIHR ARC South London programme came to a close in 2026. This website was created to preserve and share the legacy of the maternity and perinatal mental health theme — so that the research, the stories behind it, and the voices of the women who shaped it remain accessible to clinicians, policymakers, researchers, and the public.
It includes summaries of every research project, the team’s published papers and blogs, public involvement reports, and news of key findings. Where papers have been published open-access, links are provided directly to the original source.
This research was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration South London. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
NIHR ARC South London — Maternity and perinatal mental health research theme — southlondonmaternalhealthresearch.co.uk