Supporting young women and young birthing LGBTQ+ people in the perinatal period: a realist evaluation of community-based services

Research team

• PI: Dr Ruth Naughton-Doe & Professor Martin Webber

Co-Investigators

• Dr Beth Casey

• Associate Professor Stephanie Tierney, Nuffield Department of Primary Health Care Sciences

• Ang Broadbridge, Maternal Mental Health Services VCSE Project Manager, Ways to Wellness

• Rachel McDonald, Programme Lead (seconded), Perinatal Mental Health Provider Collaborative Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

• Jayde Edwards, lived-experience expert and advocate for young mothers

Project partners: Maternal Mental Health Alliance, the Children and Young People’s Coalition and the Hearts and Minds Partnership. 

Project Summary

Young women and young birthing LGBTQ+ people who have babies when they are under 25 years old are more likely to experience mental health problems than people who have babies when they are older. They may need support with independent living skills and they may have limited access to the social support and social connections that are vital for parental and child wellbeing. Other issues including poor housing and lack of money also affect their mental health.

Prevention and reduction of mental health problems during the perinatal period (covering pregnancy to two years post birth) is important, particularly as perinatal suicide rates are increasing. Perinatal mental health problems cost the UK around £8.1bn each year, mostly due to long-lasting impacts on children. Young women and birthing LGBTQ+ people who have experienced trauma as children, including care experiences or abuse, are particularly at risk. However, overstretched services (including midwifery, health visiting and mental health support); reduced resources for early years provision (e.g. Sure Start); combined with ongoing pressures from the Covid-19 pandemic, have meant that many services have lost their preventive focus. A community-based approach to perinatal support and prevention which uses social prescribing or peer support could be a cost- effective approach to addressing social issues and preventing mental health problems. Research evidence suggests that these services can improve parents’ wellbeing, but there is a lack of evidence about what works specifically for young mothers and young birthing LGBTQ+ people.

Our research was developed through public and patient involvement activities in an ongoing NIHR Three Schools Mental Health Programme Fellowship, partnerships with young mothers and people working in services and policy organisations. The research is funded by the NIHR Research Programme for Social Care and aims to develop an understanding and explanation about how community-based services can best support the mental wellbeing of young mothers and young birthing LGBTQ+ people during the perinatal period through:

• A review of published research
• An evaluation of four community-based services using different models of support. Data collection will involve exploring which services currently exist; looking at the data they collect; observing their work; interviewing staff and interviewing 10 young people using each service three times over nine months.

Two advisory groups will guide the research, one for people with lived-experience of having a baby before the age of 25 (young women and young birthing LGBTQ+ people) and one for other professionals and stakeholders. The research findings will be analysed by the research team and the advisory groups to develop ideas about what works, for whom, why and in what circumstances to improve the wellbeing of young women and young birthing LGBTQ+ people who have babies before the age of 25. We will produce guidance for commissioners, services and professionals; an academic journal paper; and an output for young people. These outputs will be shared in an online end-of-study event and through partner organisations and our wide networks