Pregnancy needs 'poverty-proofed' to improve antenatal care

07 September 2018

Pregnant women on low incomes are less likely to attend antenatal classes than more affluent mums-to-be for fear of being judged, according to a new study on maternity experiences.

Campaigners have called for pregnancy to be “poverty proofed” to remove the hidden costs and ensure all women receive the best possible care.

The call comes after researchers from Glasgow Caledonian University and the Poverty Alliance interviewed women from low-income groups, in the north and south of Glasgow, who had given birth in the 1980s, 1990s and early 2000s.

Women told of the stress and anxiety of having to rely on their GP to confirm their pregnancy as they were unable to afford a home-test kit.

Another mum spoke of breastfeeding her baby at work as she needed to return to her job within weeks of the birth to maintain her employment.

Others said they avoided postnatal or mother-and-baby groups after their baby was born because of a lack of confidence.

The study, which funded by the Wellcome Trust, stresses antenatal care in Scotland has undergone significant improvements in recent years. Women are now offered the chance to disclose domestic violence through routine enquiry and more information is available about the warning signs of postnatal depression, but non-attendance at antenatal classes remains an issue.

Dr Janet Greenlees, of SPIRU at Glasgow Caledonian University, said: “These are the women whose voices are never heard. They felt the stigma of living on a low income, of being judged.

“If you look at statistics across the western world, it is the women in the poorest communities who are least likely to attend antenatal care on a regular basis.

“In short, the women felt marginalised as new mothers living in poverty, with assumptions made about their knowledge of maternity and available services, as well as their circumstances.”

The research was carried out by the Centre for the Social History of Health and Healthcare (CSHHH), the Scottish Poverty and Inequality Research Unit (SPIRU), which are both based at Glasgow Caledonian University, and the Poverty Alliance.

Interviews were conducted with 19 women last year. Examples were given of women having to work late-on in their pregnancies for financial reasons and employers requesting to see appointment cards before granting time off for antenatal checks.

Low income had a critical role to play in terms of how the women coped with pregnancy and led to increased stress due to worry about additional costs, particularly for those in insecure or part-time employment.

Fiona McHardy, research and information manager at the Poverty Alliance, said: “Women’s care in pregnancy across all stages should be poverty proofed to remove the hidden costs and barriers that many women face.

“The importance of supporting low-income mothers during pregnancy is critical. Pregnancy is recognised as being a key trigger that increases the risk of women living in poverty.” 

The findings will be shared with policymakers and health providers across Scotland involved in antenatal care and support.