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Lookup NU author(s): Professor Judith RankinORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Authors. Objectives: In the UK, an estimated two million migrants are irregular or subject to No Recourse to Public Funds (NRPF) visa conditions, restricting welfare access and often requiring payment for NHS maternity care. The impact on maternity and perinatal service use remains poorly quantified. Study design: Retrospective cross-sectional study. Methods We used linked electronic health records from maternity, neonatal, and mental health services in South London (eLIXIR-BiSL cohort). The sample included 56,690 women with 67,308 pregnancies (Oct 2018–Oct 2023). Migration status was categorised as UK-born, migrants with recourse to public funds, NRPF, or unknown visa status. Adjusted risk ratios (aRRs) were estimated using generalised linear models, controlling for sociodemographic and clinical characteristics. Results: Compared with UK-born women, migrants, particularly those with NRPF, had lower engagement with services. Women with NRPF were less likely to access early antenatal care (aRR 0.36 [0.33–0.38]), attend maternity triage (0.89 [0.82–0.96]), or birth in midwife-led settings (0.51 [0.36–0.71]). They were more likely to access care late (3.61 [3.33–3.92]), receive inadequate antenatal care (1.41 [1.30–1.53]), transfer providers (1.54 [1.36–1.74]), and experience prolonged postnatal stays (1.38 [1.21–1.57]). Women with NRPF had lower mental health care contact before (0.05 [0.03–0.08]) and during pregnancy (0.51 [0.37–0.69]), and reduced engagement with social care (0.36 [0.17–0.70]) and the criminal justice system (0.30 [0.19–0.44]). Conclusions: Migrants with NRPF or unknown visa status face persistent barriers to maternity and mental health care. Inclusive reforms are needed to address inequity.
Author(s): Rayment-Jones H, Burton S, Dasgupta T, Barry Z, De Backer K, Baker N, Wilson CA, Stevenson K, Vowles Z, Kitchen K, Easter A, Jolly A, Rankin J, Fernandez-Turienzo C, Sandall J, Poston L, Magee LA, Stewart R, Edwards D, Ashworth M, Sandall J, Wolfe I, Gillett C, Absoud M, Pickard L, Grey A, Spring S, Kazeem T, Jewell A, Broadbent M, Higgins F, de Jongh L, Dasgupta T, Gill C
Publication type: Article
Publication status: Published
Journal: Public Health
Year: 2026
Volume: 252
Print publication date: 01/03/2026
Online publication date: 03/02/2026
Acceptance date: 22/01/2026
Date deposited: 17/02/2026
ISSN (print): 0033-3506
ISSN (electronic): 1476-5616
Publisher: Elsevier BV
URL: https://doi.org/10.1016/j.puhe.2026.106175
DOI: 10.1016/j.puhe.2026.106175
Data Access Statement: The data accessed by eLIXIR-BiSL remain within an NHS firewall and governance is provided by the eLIXIR Oversight Committee reporting to relevant information governance clinical leads. Subject to these conditions, data access is encouraged and those interested should contact the eLIXIR Chief Investigator (Professor Lucilla Poston; Lucilla.poston@kcl.ac.uk) or via the study web site https://www.kcl.ac.uk/research/elixir-1
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