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Community REACH

Why is this project important?
Antenatal care is the first step in providing maternity services to pregnant women. It is recommended that antenatal care begins early in pregnancy so that women can get the full benefits from care and be supported to have a healthy pregnancy and birth. The first appointment with the maternity service for antenatal care is referred to as the ‘booking appointment’. It involves a health check and information on screening tests, nutrition, and exercise. This first appointment is also important for identifying women who may need additional medical or social support in pregnancy. The ‘Community REACH’ project aims to support women to have their first antenatal appointment with maternity services by the 12th week of pregnancy, in line with national guidelines.
What are we doing?
  • This project is working in partnership with local communities in 10 electoral ward areas in North and East London, and in Essex, where women are more likely to have a delayed start to antenatal care.
  • In autumn 2015, we spent 2-3 days in each area speaking with local people (on the street, in marketplaces, libraries, etc.) about their experiences with antenatal care and the strengths and challenges of their local community.
  • We also held a ‘co-design’ workshop in each area in early 2016. At these workshops local women, representatives from local organisations (e.g. Children’s Centres), and some midwives, worked together to develop ideas for key messages and plans to increase the number of women who begin antenatal care early in pregnancy.
  • In each of the 10 areas we worked in partnership with a local community organisation and local, trained community volunteers to communicate with women and their families about the value and benefits of early antenatal care and how women can access care early in pregnancy. This intervention took place over six months.
How is this project being evaluated?
  • The project is being evaluated through a cluster randomised controlled trial. We are looking at anonymous hospital data from local maternity services to see whether pregnant women living in the areas (wards) where the project took place begin their antenatal care earlier, and see greater benefits for both themselves and their babies, when compared with women living in a different 10 areas within the same boroughs.
  • We have interviewed local people who are involved with delivering this project, in order to explore any challenges or successes they experienced in communicating the messages about antenatal care within their communities. 
  • We have surveyed pregnant women to see whether or not the project influenced their decision about when to begin antenatal care. 
  • Finally, we are working with a health economist to determine whether the community project provides good value for money.


Co-design workshops were held in communities where the intervention is taking place