Methodology
This research will be conducted in three phases:
Retrospective analysis of routine data
Routinely collected data from the maternity information systems on births between April 2020 and March 2023 from three NHS trusts: Luton and Dunstable University Hospital (L&DUH), Bedford Hospital NHS Trust, and Milton Keynes University Hospital will be extracted and analysed. The analysis will focus on understanding patterns of antenatal care initiation and spatial distributions of late initiation to identify potential areas for intervention delivery.
Qualitative study
We will conduct qualitative semi-structured interviews to examine views and experiences of women who faced difficulties in accessing antenatal care on time and to attend adequate number of antenatal appointments.
We will co-produce the community-based intervention with service users (expectant and recent mothers/fathers) and maternity care providers in Bedfordshire, Luton and Milton Keynes. We will undertake co-production sessions with approximately 20 local parents (expectant/recent mothers/fathers) in Bedfordshire, Luton and Milton Keynes. We will offer participants a choice of attending a workshop or one-to-one conversations.
Intervention implementation
A Research Midwife will lead the intervention in areas identified as having late antenatal care initiation (from phase 1). Antenatal care Champions will be recruited and trained to deliver at least 60 group-based interactive sessions across BLMK areas in addition to individual sessions. These sessions will be supported by an intervention script that aims to build awareness of the importance of timely antenatal care and opportunities and benefits of timely antenatal care and how and when to access care, alongside opportunities for participants to clarify any queries directly with the midwife.
Intervention evaluation
We will undertake a mixed-methods evaluation of the intervention's implementation, acceptability, feasibility and preliminary effectiveness, including innovation, context, people, fidelity, reach, utility and potential outcome measures.