City Research Online

Abstract

Background: Women seeking sanctuary as refugees and asylum seekers face significant barriers accessing maternity services in the UK. Whilst existing research largely focuses on women’s experiences, this study explores the lived experiences of specialist midwives navigating their relationships with women seeking sanctuary within complex institutional and socio-political contexts.

Aim: To explore the lived experiences of specialist midwives developing relationships with women seeking sanctuary.

Methods: A hermeneutic phenomenological approach was used to explore the experiences of six specialist midwives working with women seeking sanctuary in England. In-depth interviews were analysed interpretively, drawing on Foucault’s theories of disciplinary power and governmentality, alongside the concept of positive deviance.

Findings: Five themes were identified: (1) bridging between services, (2) specialist knowledge, (3) adapting care, (4) building trust, and (5) navigating hostility. Midwives described relational practices that often defied institutional norms, positioning themselves as advocates and change makers.

Conclusion: Specialist midwives' were able to work within institutional constraints to achieve positive relationships with women. The ability to develop meaningful relationships with women seeking sanctuary was facilitated by protected roles which afforded time, autonomy, continuity and flexibility. These findings highlight the value of positively deviant practices in sustaining compassionate, relational maternity care. The study calls for investment in specialist midwifery roles to better support women seeking sanctuary and advance equitable maternity care.

Publication Type:	Article
Additional Information:	© 2026 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )
Publisher Keywords:	Refugee, Asylum-Seeker, Midwife-mother relationship, Inequalities, Institutionalisation
Subjects:	H Social Sciences > HN Social history and conditions. Social problems. Social reform H Social Sciences > HQ The family. Marriage. Woman H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services R Medicine > RT Nursing
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:	Symplectic Administrator

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