FOCUS ON: Global Issues in Maternity Care
IN THIS ISSUE:
Author: Dr Amanda Norman and Clair James
Author title: Dr Amanda Norman is a Senior Lecturer in Education (Early Years) at the University of Winchester, UK, a psychotherapeutic counsellor and author.
Clair James has extensive experience in early years and is an author and PhD candidate at the University of Winchester, UK
Description: Matrescence - the transition from woman to mother – is often shaped and narrated by medicalised digitalised and commercial pressures. This often silences the emotional complexity of new mothers’ experiences. Predominately rituals have been studied from wide sociocultural perspectives, with little emphasis on the psychological processes surrounding them. By reflecting on the inner and outer understandings of rituals during matrescence, and delving into psychological aspects of rituals, we gain greater insights into the important role they play.
Author: Susana Lopes, Carla Bruço
Author title: Susana Lopes, Secretary-General, Prenatal Alliance Acknowledgement, Carla Bruço, Obstetric Nurse and Founder/Coordinator of the Harmony for Life Pregnancy Center (Centro Gestacional Harmonia para a Vida).
Description: Increasing evidence shows that pregnancy is not merely a biological event, but a sensitive period that shapes physical, emotional, and relational health throughout life. The environment in which a woman experiences her pregnancy, including the level of support, information, attentive listening, and safety, has a direct impact on her well-being and on the baby’s development. However, in many contexts, prenatal care remains fragmented, focused primarily on examinations, protocols, and clinical outcomes, leaving
the woman’s subjective experience, her emotions, fears, and support needs in the background. It is in this context that initiatives such as the Harmony for Life Pregnancy Centre (Centro Gestacional Harmonia para a Vida) emerge, offering a broader and more integrative approach to pregnancy, recognising it as a human, relational, and transformative process.
Author: Tisha Dasgupta, Zenab Barry and Hannah Rayment-Jones
Author title: Tisha Dasgupta, Zenab Barry and Hannah Rayment-Jones Department of Women and Children’s Health, King’s College London.
Description: Inequalities in maternal and infant health remain widespread across high income countries. This situation is driven mainly by social determinants such as poverty, ethnicity, migration status, housing insecurity and language barriers. These factors often intersect, creating compounded disadvantage that affects access to timely, appropriate and respectful maternity care. Evidence shows that continuity of carer, community- based models, advocacy and effective communication can improve engagement and outcomes for women experiencing multiple disadvantages. Conversely, fragmented and inflexible services can deepen inequities. Existing guidance in the United Kingdom relies on narrow categories of vulnerability and does not reflect contemporary evidence on intersectionality or structural determinants of health. Addressing maternity inequalities requires updated guidance, investment in relational and culturally responsive care and system level approaches that ensure services reduce rather than reinforce inequity.
Author: Susana Lopes
Author title: Secretary-General, Prenatal Alliance, Norway
Description: World Pregnancy Day aims to focus attention on prenatal wellbeing. Observed annually on March 22, it seeks to bridge science, education, and policy by highlighting pregnancy as a critical period for prevention, relational health, and intergenerational resilience. By positioning prenatal well-being as a public health priority and a human rights concern, the initiative encourages multidisciplinary collaboration and systemic investment in the earliest stages of life.
Author: Qorinah Adnani, Nur Alima Amelia, Eunice Lumsden
Author title: Qorinah Adnani, Midwifery Lecturer, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, West Java, Indonesia
Nur Alima Amelia, Midwife, Cikal Mulia Clinic, Jakarta, Indonesia
Eunice Lumsden, University of Northampton, England, UK
Description: Indonesia’s complex geography and diverse population create significant barriers to delivering equitable, high quality midwifery care. Although the Midwifery Act 2019 strengthened regulation and aligned education with international standards, challenges persist in training quality, clinical exposure, and workforce distribution. Recent research indicates that midwifery students can lack confidence and competence due to limited practice opportunities and gaps between theoretical knowledge and clinical reality. Broader issues of retention, professional recognition, and unequal access to continuing professional development impact service provision. Strengthening education, leadership and system level support offer opportunities to improve outcomes for women and families.
Author: Judith Rees, Lauren Seager-Smith
Author title: Judith Rees, Chief Operating Officer, The For Baby’s Sake Trust
Lauren Seager-Smith, Chief Executive Officer, The For Baby’s Sake Trust
Description: Domestic violence and abuse (DVA) is a widespread public health issue with profound intergenerational consequences. The perinatal period (pregnancy and the first 12 months after childbirth) represents a period of heightened vulnerability to DVA for parents and babies, yet also offers a critical window for early intervention, prevention, recovery and the opportunity to break cycles of harm. This article explores the complex and often under-recognised relationship between DVA, the perinatal period, and the impact of DVA on infant cognitive and socio-emotional development in the first 1001 days of life. Drawing on emerging evidence, practice learning from the work of The For Baby’s Sake Trust, and insights
from neuroscience, infant development and trauma-informed care, the authors examine how abusive behaviours, including coercive control, emotional abuse and reproductive coercion, frequently emerge or intensify during pregnancy. The article centres on the developmental needs and experiences of babies, emphasising that exposure to chronic stress in utero and early infancy has profound implications for brain development, emotional regulation and long-term well-being. Practical reflections are offered to support midwives, health visitors and other professionals in recognising risk, responding with confidence and compassion, and embedding evidence-based approaches that understand the symbiotic relationship between a baby and its parents.
Author: Professor Laura Abbott
Author title: Professor of Maternal Health and Criminal Justice, University of Hertfordshire, UK.
Description: Pregnant women and new mothers in prison experience significant health and social inequalities. For some, imprisonment results in the compulsory separation of mother and baby shortly after birth, with profound implications for maternal mental health, parenting identity and infant wellbeing. Despite its significance, separation in prison remains underexplored within birth and parent education literature. This paper draws on findings from the Lost Mothers project, an Economic and Social Research Council (ESRC)-funded, co-produced study led by women with lived experience of imprisonment and maternal separation. Using qualitative methods, including interviews with women and professionals and observation of Mother and Baby Unit decision-making processes, the study explores how women experience parenting, separation and loss following childbirth in prison. Findings show that separation is experienced as a visceral, embodied trauma characterised by intense grief, disrupted parenting identity and unmet emotional needs. The paper considers implications for birth and parent education, emphasising trauma-informed, relational approaches that recognise separation contexts.
Author: Maria Velo Higueras, Lecturer
Author title: Registered Midwife and PhD candidate, School of Health, Robert Gordon University, Scotland UK
Description: In recent years, an apparent growing number of women are planning to birth alone without professional attendance, a practice commonly referred as freebirth. While this practice is not new, freebirth has gained recent media visibility and ignited a contentious debate about the boundaries of women’s choices and the adequacy of current maternity care provision. This article provides an accessible overview of what freebirth entails, the factors driving families in the United Kingdom (UK) to consider this option, and how practitioners can support them in a trauma-informed manner to promote safety, wellbeing and a positive start to the first 1001 days of parenthood.
Author: Emeritus Professor Eunice Lumsden and Dr. Mrs. Jemima Araba Dennis-Antw based in Ghana
Author title: Emeritus Professor Eunice Lumsden Editor IJBPE
Dr. Mrs. Jemima Araba Dennis-Antw, a distinguished midwife, public health nurse, systems leader and women’s health advocate based in Ghana
Description: This article presents a conversation between Emeritus Professor Eunice Lumsden and Dr. Mrs. Jemima Araba Dennis-Antw, a distinguished midwife, public health nurse, systems leader and women’s health advocate based in Ghana. Over the course of her career, she has moved across clinical practice, national policy work, international development and global advocacy. Her work has demonstrated a consistent commitment to improving maternal and newborn health, strengthening midwifery education and championing respectful maternity care.
Author: Bridget Supple
Author title: Coordinator: Foster Hall Prison Services with Birth Companions and Perinatal Educator UK
Description: Globally, national inquiries and reports of mistreatment highlight the urgency for informed, confident parents and therefor parent education should be an essential offering for all new parents. Women and their birthing partners need to be empowered and have the right knowledge to make informed decisions, especially about interventions and the actual birth process. Evidence shows that while there is burgeoning information about the birth process, many women lack knowledge and would make different choices in future pregnancies, especially when they have had a traumatic birth.
Author: Mary Nolan
Author title: Founding Editor IJBPE; Emerita Professor of Perinatal Education, University of Worcester, UK
Description: Emerita Professor Mary Nolan emphasises that investing in babies hinges on the mental wellbeing of their primary carer with a focus on maternal mental health.