Morag Forbes volunteer midwife with the Medical Justice Network issues managing pregnancy in homeless women in detention.

1. Managing pregnancy in
homeless women
Focus on Migrants and the Medical Justice experience
Morag Forbes
Volunteer Midwife, Medical Justice
LNNM Conference, 17th April 2015
Morag Forbes
Volunteer Midwife, Medical Justice

2.  Asylum seekers:
- Can apply for housing support from the Home Office.
- Usually temporary accomodation (hostel etc), shared house or flat.
- No choice of location; usually outside SE England.
- Can remain in their accommodation during appeal process, providing
appeal is made on time.
 Refused asylum seekers:
- May be able to receive accommodation under section 4 of the
Immigration and Asylum Act 1999.
- Must show that they are destitute and have taken ‘reasonable steps’ to
leave the country (or that they are unfit for travel due to gestation
and/or pregnancy complications).
- Pregnant refused asylum seekers can also apply to their local authority
for support – however may be blocked from doing so depending on
details of their immigration history.
Legal housing rights 1
Source: Maternity Action http://www.maternityaction.org.uk

3.  Refugees:
- Can claim Housing Benefit and Council Tax benefit. 28 days to leave
Home Office accommodation.
 EEA nationals:
- Can claim Housing Benefit if habitually resident in the UK with the
“right to reside” here. (“Right to reside depends on length of time in
UK and employment/education status).
 Undocumented migrants:
-Not legally entitled to benefits or social housing.
-Fear that housing and healthcare providers will alert Immigration
authorities.
Legal housing rights 2
Source: Maternity Action http://www.maternityaction.org.uk

4.  “No recourse to public funds”:
- Usually issued to women on spousal visa, work permit or student visa.
- Housing provided under homelessness legislation, or funding for a
domestic violence refuge place counts as public funds.
- A claim for public funds could jeopardise a woman’s leave to remain or
lead to an application for indefinite leave to remain being refused.
- Possibility of three months’ public funds under the Destitution Domestic
Violence Concession to allow survivors of DV to lodge a claim for
indefinite leave to remain
 Trafficked women: May be granted a ‘recovery period’ in which safe
accommodation should be provided (up to one year leave to remain or
may claim asylum).
Legal housing rights
Source: Maternity Action http://www.maternityaction.org.uk

5. Medical Justice
httpwww.medicaljustice.org.uk/

6. My work with Medical Justice
3 Claiming asylum
3 Asylum refused
6 Undocumented
September 2013 – March 2015: Twelve women assessed

7. Accommodation before detention
1 in Home Office
Accommodation
4 Staying with family
2 Staying with friends -
stable accommodation
2 Private renting
2 NFA
1 Detained on arrival

8. Accommodation after detention
1 in Home Office
Accommodation
3 Staying with family
2 Staying with friends -
stable accommodation
2 Private renting
2 NFA
1 Mental Health
inpatient

9. Was the woman in the same
accommodation after detention as she
was before?
Yes
No

10.  Missed antenatal care
 Missed antenatal screening
- Delayed anomaly scans
- Incorrect advice on haemoglobinopathy screening
 Deterioration in mental health/delay in mental health
support (can affect housing situation)
 Delay in assessment and support for additional social
needs – safeguarding issues
What effects does this have on
women’s pregnancies?

11.  Of the 20 women in the sample, nine were
released to different addresses than those
they had lived at pre-detention. (Although
three were detained on arrival into the UK;
one was removed; and one voluntarily
returned to her home country).
Findings from Expecting Change

12.  Most women who were released stayed in the address
they were released to until after the birth of their child.
However, there were some women who moved two to
three times following their release, often because they
were dispersed to hotel/ hostel temporary accommodation
that was time limited.
 In one case, the Refugee Council telephoned the relevant
Home Office caseowner, expressing concern over a
woman who had been told to leave her temporary
accommodation at 28 weeks pregnant after just one day,
allegedly because her appeal rights were exhausted and
had no entitlements.
Findings from Expecting Change 2

13.  The impact of interrupted antenatal care was identifed in one of
the MLRs where the doctor wrote: ‘She has been parted
from her previous midwife with whom she had a
helpful and supportive relationship and received
confusing contradictory advice about the treatment
of her streptococcal infection.’
Findings from Expecting Change 3

14.  Upon leaving detention, some women were left to travel
alone great distances. One woman in interview recalled the
trauma of having to make her way from Bedford to
Middlesbrough. ‘When I left the detention centre, I was
with all my luggage and they left me at the train
station. I had to carry all my luggage with me and had
to go all the way to Middlesbrough. I was 7 months
pregnant and it was hard. I did not ask anyone to help
me because I was so scared. It was very sad.’
Findings from Expecting Change 4

15.  The law around migrant housing rights is complex and
could be very confusing for vulnerable women and
those whose first language is not English.
 Immigration detention disrupts women’s antenatal
care and can disrupt their housing.
 This disruption can lead to physical and psychological
harm.
Summary

16. http://www.medicaljustice.org.uk/images/stories/reports/
expectingchange.pdf
http://www.maternityaction.org.uk/wp/advice-2/mums-
dads-scenarios/3-women-from-abroad/
https://www.rcm.org.uk/sites/default/files/Women%20in%2
0Custody_4.pdf
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