Better Births
2019
A participatory action research project for NHS North Central London Integrated Care.
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Project resources
Better Births report
We worked with NHS North Central London Integrated Care to support the Better Births initiative - a national programme to improve maternity services across England. This Participatory Action Research project explored the experiences and priorities of women and their families across Barnet, Enfield, Haringey, Camden and Islington, focusing on how maternity care could be made more personal, consistent, and family-centred.
Our Approach
We trained and supported 15 women as Patient and Public Voice Partners to act as community researchers. Using PAR methods, these community researchers engaged 179 women and families over five months through creative and visual tools designed to break down barriers and enable open, honest discussion. The approach ensured that the voices of parents, including those not usually heard through traditional consultation methods, directly shaped local maternity policy and service improvement.
Working with researchers embedded within their own communities, we:
Designed and delivered participatory appraisal training across five days.
Supported peer researchers to carry out over 30 participatory sessions in local venues.
Analysed findings collaboratively to identify shared priorities and actionable recommendations.
Facilitated validation workshops with NHS stakeholders to ensure the findings were understood, respected, and used to drive change.
Key Findings
The research identified three central themes that shaped women’s experiences:
Single point of access: Women valued clarity, consistency, and good communication throughout their maternity journey, highlighting the need for streamlined booking systems, reliable information, and coordinated care.
Continuity of care: Strong relationships with midwives built trust and confidence. Lack of continuity caused stress and frustration, especially when women had to repeat their history to multiple staff.
Choice and personalisation: Respect, empathy, and flexibility were key. Women wanted meaningful choice in how and where they gave birth and wanted their birth plans and individual circumstances respected.
Recommendations
The project produced a clear set of priorities for improvement, including:
Expanding the use of community venues for antenatal and postnatal care.
Providing clear, accessible, and realistic information on birth options.
Ensuring continuity by assigning a named midwife or small team throughout care.
Enhancing postnatal support, including breastfeeding advice and peer networks.
Embedding respect, communication, and cultural awareness training for staff.
Providing interpreters and targeted support for Black, minority ethnic and vulnerable groups.
Involving women and families directly in the ongoing evaluation and design of maternity services.
Impacts and learnings
Following the project, community researchers continued to work with the Better Births team to:
Co-develop a people-centred training module for all maternity staff, embedding empathy, respect and lived experience into everyday practice.
Lead further participatory research exploring the specific and disproportionate poor experiences and outcomes faced by Black women within the maternity care system helping to drive more equitable and responsive care across North Central London.
“What really made me happy is that we had such a mixed group. Four different ethnic groups and they really supported each other and exchanged ideas.”
Community Researcher
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