Abstract Overview:
Fragmented health and social care systems pose serious challenges to maternal and child health, especially in rural areas. In Estonia, the centralisation of maternity services and the closure of smaller obstetric units have raised concerns about accessibility, interprofessional collaboration, and public trust. While policy-level support for integrated care exists, its implementation remains limited, creating structural constraints for both service users and professionals. These challenges are not unique to Estonia but reflect broader international concerns about health system fragmentation, equity, and the sustainability of maternity care in the context of global health reform.

Aims and Objectives:
The aim is to explore barriers and opportunities for integrated health and social care in improving maternal and child health outcomes. Objectives: (1) analyse coping strategies of mothers and professionals; (2) identify interprofessional collaboration mechanisms; (3) assess systemic and policy-related implementation factors.

Method:
A mixed-methods design was employed, drawing on three peer-reviewed studies conducted within the framework of an ongoing doctoral dissertation. The first study uses a quantitative approach to explore public perceptions of obstetric unit closures. The second applies Bourdieu’s capital theory in qualitative interviews with young mothers to analyse how different forms of capital shape agency. The third combines focus group interviews with concentric circle analysis to map collaboration structures among health and social care professionals. This approach was guided by network governance theory. The dissertation is currently in the process of finalising an analytical overview that integrates the findings.

Results:
Findings show that reforms often overlook local needs, deepening inequalities and diminishing trust. Women's agency depends on their economic, cultural, and social capital, while professionals adapt to structural rigidity through informal networks. Concentric circle analysis revealed midwives and social workers as central actors, while others remained peripheral. Persistent barriers such as fragmented funding and institutional silos continue to hinder holistic care.

Conclusion:
Improving maternal and child health outcomes requires more than structural reform. It necessitates recognising agency at all levels, fostering interprofessional trust, and supporting adaptive governance that connects policy intentions with lived realities.