Pregnant and Homeless in the UK: A Qualitative Analysis of Maternal Experiences in Temporary Accommodation.

Abstract

Background: In the UK, families in temporary accommodation reached record numbers in 2023. Pregnant mothers experiencing homelessness are at risk of poor health outcomes, yet little is known about their experiences. Most biomedical research emphasizes obstetric outcomes rather than maternal experiences. Our study aimed to explore maternal experiences of pregnancy while living in temporary accommodation in the UK.

Methods: Using an interpretivist paradigm and critical feminist theory, we collected and analyzed semi-structured interview narratives from pregnant and postnatal mothers experiencing homelessness. Interviews with key workers from relevant Third Sector Organisations provided complementary insights. Study planning included Patient and Public Involvement. Data were analyzed using reflexive thematic analysis.

Results: Fourteen mothers and six keyworkers were interviewed. Reflexive thematic analysis generated three themes. Theme one, Pregnant/postnatal bodies in unsafe spaces, described participants' experiences with unsafe accommodations, exposure to environmental hazards, and frequent moves which affected physical and mental health. In Undermining mothers, participants explained how the constant struggle to meet basic needs eroded opportunities to engage with caring roles and destabilized their sense of being "good" mothers. Together these contributed to pregnancy disengagement and feeling unprepared for birth. The third key theme, Feeling unseen in midwifery blind spots, describes barriers to accessing maternity services, as well as interactions with midwives that often reinforced feelings of being invisible.

Discussion: Living in temporary accommodations whilst pregnant negatively impacts physical, mental, and emotional well-being. Improving care for pregnant mothers experiencing homelessness requires systemic change within housing and maternity services to acknowledge housing security as an essential need for pregnant and parenting mothers.