Six priorities for easier access
Participants in a qualitative study identified six priority areas for improving access to perinatal mental-health services, or support around pregnancy and birth: routine mental-health conversations in antenatal care, visible and accessible information, flexible service delivery, culturally sensitive design, community engagement, and integration with existing services. The proposals came from service providers and women with lived experience, and describe what participants thought could make support easier to reach. They were recommendations, not tested interventions.
What the interviews covered
The research focused on North East and North Cumbria, on socioeconomically disadvantaged women who had experienced perinatal mental-health challenges, and on the service providers who support this work. The two-phase study used semi-structured interviews. It included 43 participants: 23 service providers and 20 women with lived experience; three women took part with interpretation support.
Recruitment was purposive in both phases, with the second phase drawing on the first phase's professional networks. It continued until no substantially new themes were identified. Interviews were conducted virtually from September 2021 to January 2023, recorded and transcribed with accuracy checks, and preceded by written informed consent. Ethical approval covered both phases. Researchers used inductive thematic analysis: three researchers coded the same two transcripts, then the team mapped themes to Levesque's five-dimension framework for healthcare access.
Five women of child-bearing age with experience of maternity care and perinatal mental-health support also contributed to the study's design and methods. Their discussions informed the topic guide for the second phase.
Where the barriers appeared
One of the clearest gaps concerned routine antenatal care. Participants described it as dominated by physical-health checks, with mental-health conversations often overlooked or absent. They also identified limited service visibility, digital exclusion, language difficulties and a lack of childcare as barriers to finding and using support.
Providers recommended a mix of in-person and remote services to give women more flexibility. But they also reported that some of the most deprived women could not be reached online because of technology or data constraints. The accounts point to a practical tension: remote delivery can add flexibility while leaving out women who cannot get online.
Participants described cultural and religious beliefs as shaping how mental health was understood and whether support was sought. Culturally responsive care was viewed as important for trust and engagement. Community engagement and peer groups were described as trusted, safe spaces for shared experience, reassurance and practical help.
Perinatal mental-health support was also described as siloed from other essential services, with poor coordination. Participants and providers called for stronger referral pathways and care located alongside existing services.
What the findings do not show
Because this was a qualitative interview study, the findings describe participant-reported barriers and recommendations, not how common each problem is or whether the proposed changes improve access or mental-health outcomes. The purposive regional design does not establish that the same patterns would appear elsewhere.
The women participant sample did not directly include women experiencing homelessness, sex workers, or lesbian or transgender individuals. Provider accounts helped address that gap indirectly, but they were not substitutes for direct engagement with these groups when services are designed.
Paper data and sources
Original title: Bridging gaps in perinatal mental health services for socioeconomically disadvantaged women
Authors: Ngongalah Udeozor L, El-Zerbi C, Wildman J et al.
Journal/Repository: Frontiers in global women's health
Status: Peer-reviewed
First online: 2026-10-08
DOI: Not available
Original paper · Full text