Completed Research

Accessing Maternal Healthcare in a Hostile Environment

University College London

Over the past decade, forced and voluntary migration has been increasing while simultaneously becoming more complex. Historically, the London borough of Camden has been home to many refugees, people seeking asylum, and undocumented migrants. The area has witnessed not only a rise in the population of these migrant groups, but also changes to the barriers they face in accessing basic services, including quality maternal healthcare. Many of these barriers are directly tied to the UK’s so-called hostile environment immigration policies and the political climate they create to alienate and discourage “illegal” migrants from coming into the country, while implicating ordinary citizens in their implementation.

This case study maps the direct impact of the hostile environment policies and the culture they create to understand the impact on maternal health service provision and the responses by the community organizations and healthcare professionals supporting this hard to reach population.

Hard to Reach

Refugees, People Seeking Asylum, and Undocumented Migrants seeking maternal healthcare in Camden.

Key Takeaways

While systemic and wider policy change are essential, certain actions can be implemented concurrently to enable greater support for groups seeking maternal healthcare including:

  1. Collaboration between service providers.
  2. Stronger connections should be established to enable simpler pathways of support for pregnant people and their families, as well as easier sharing of the available resources.
  3. Continuity of care in the healthcare sector.


This research was made possible through the Reach Alliance, a partnership between the University of Toronto’s Munk School of Global Affairs & Public Policy and the Mastercard Center for Inclusive Growth. Research was also funded by the Ralph and Roz Halbert Professorship of Innovation at the Munk School of Global Affairs & Public Policy. This research was completed by researchers at University College London’s Institute for Innovation and Public Purpose, Institute for Women’s Health, and Faculty of Engineering, members of the Reach Alliance. We are deeply grateful to all those who supported and participated in this research. There were so many individuals who gave their valuable and limited time to share their insights on the challenges that refugees, people seeking asylum, and undocumented migrants face. This also enables the opportunity to develop more
compassionate policies and services that centre these individuals. We want to acknowledge the ground-breaking research in this sphere that helped to shape our understanding, particularly the work of Maternity Action, which provided a strong foundation on which to build, while also underscoring the essential work that we must all still do together.

A note on language: To be gender inclusive we are intentional throughout the report to speak about “pregnant individuals” unless we are directly quoting one of our interviewees, recognizing that multiple gender identities have reproductive capacity. We acknowledge that those who do not align with the gender binary tend to experience higher levels of marginalization. While specific outcomes based on gender identities were not explored during our research, this could be a focus for future research and practices.