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CONFERENCE PROCEEDING
Disparities in access to ambulance services during pregnancy, birth and the postpartum period in Northwest England: Associations with maternal and neonatal outcomes (DIAAS)
1
Manchester University NHS Foundation Trust, Maternal and Fetal Health Research Centre, Manchester, United Kingdom
2
Sheffield Hallam University, School of Health and Social Care, Sheffield, United Kingdom
3
The University of Manchester, Division of Psychology and Mental Health- Centre for Women's Mental Health, Manchester, United Kingdom
4
Manchester University NHS Foundation Trust, St Mary's Hospital, Manchester, United Kingdom
5
The North West Ambulance Service, Consultant Midwife, Lancashire, United Kingdom
Eur J Midwifery 2026;10(Supplement 1):A204
ABSTRACT
BACKGROUND:
Access to high-quality, timely maternity care is essential for safe pregnancy and birth. In emergencies, ambulance services play a critical role, yet their role in maternity care is poorly understood, particularly for under-served populations. Emerging evidence suggests that women facing social deprivation or systemic disadvantage are more likely to experience delays in care and adverse outcomes.
OBJECTIVES:
To explore the characteristics and outcomes of women accessing maternity care via ambulance services during the perinatal period, and to understand disparities linked to social determinants of health.
METHODS:
This mixed methods study uses retrospective analysis of electronic ambulance service and hospital records (Aug 2022–Aug 2024). In Work Package 1, we compare two cohorts at a large tertiary NHS Trust in the Northwest of England: women who accessed care via ambulance and those who did not. In Work Package 2, qualitative analysis of free-text paramedic records will explore underlying contextual factors for a sample of women identified as higher risk in WP1. Data was used under existing ethical approval. All records were anonymised, and NHS Data Opt-Out was applied.
RESULTS:
Preliminary findings show that Black/Black British women comprise 11% of the maternity population but 18% of ambulance users. Women from the most deprived areas make up 30% of the general cohort but 44% of the ambulance group. Severe maternal outcomes, including postpartum haemorrhage >2000ml, were more common in the ambulance cohort.
CONCLUSIONS:
These early findings suggest that women facing social and structural disadvantage may have reduced access to timely, preventative maternity care, resulting in higher reliance on emergency services and worse outcomes.
KEY MESSAGE:
Midwives have a vital role in identifying and supporting women at risk of poor maternity care access and maternal/neonatal outcomes, advocating for integrated pathways that address health inequities and support early intervention. Marginalized - minorities
Access to high-quality, timely maternity care is essential for safe pregnancy and birth. In emergencies, ambulance services play a critical role, yet their role in maternity care is poorly understood, particularly for under-served populations. Emerging evidence suggests that women facing social deprivation or systemic disadvantage are more likely to experience delays in care and adverse outcomes.
OBJECTIVES:
To explore the characteristics and outcomes of women accessing maternity care via ambulance services during the perinatal period, and to understand disparities linked to social determinants of health.
METHODS:
This mixed methods study uses retrospective analysis of electronic ambulance service and hospital records (Aug 2022–Aug 2024). In Work Package 1, we compare two cohorts at a large tertiary NHS Trust in the Northwest of England: women who accessed care via ambulance and those who did not. In Work Package 2, qualitative analysis of free-text paramedic records will explore underlying contextual factors for a sample of women identified as higher risk in WP1. Data was used under existing ethical approval. All records were anonymised, and NHS Data Opt-Out was applied.
RESULTS:
Preliminary findings show that Black/Black British women comprise 11% of the maternity population but 18% of ambulance users. Women from the most deprived areas make up 30% of the general cohort but 44% of the ambulance group. Severe maternal outcomes, including postpartum haemorrhage >2000ml, were more common in the ambulance cohort.
CONCLUSIONS:
These early findings suggest that women facing social and structural disadvantage may have reduced access to timely, preventative maternity care, resulting in higher reliance on emergency services and worse outcomes.
KEY MESSAGE:
Midwives have a vital role in identifying and supporting women at risk of poor maternity care access and maternal/neonatal outcomes, advocating for integrated pathways that address health inequities and support early intervention. Marginalized - minorities
| eISSN: | 2585-2906 |
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