Equal Start Oxford: Accelerating Action for Maternal Health Outcomes

Equal Start is a project which supports Black and other minority mothers and birthing people in East Oxford who predominantly face higher risk of complications during pregnancy and early parenthood. The project partners with the NHS Oxford University Hospitals Foundation Trust. The NIHR ARC OxTV through Centre for Research Equity supports Equal Start through project evaluation services.

A simple mission with complex challenges

Equal Start Oxford’s mission is straightforward yet powerful: to ensure “happy and healthy first 1001 days for every baby.” But the challenges behind this mission tell a more complicated story.

The latest national report on maternal and infant health (MBRRACE-UK 2023) reveals concerning maternal health inequalities across the UK, and Oxford itself presents a stark contrast. Despite its worldwide reputation for academic excellence, the city contains 17 neighbourhoods among England’s most deprived areas, with one in five children living in poverty.

These challenges hit hardest in East Oxford (OX4), where many residents face a triple barrier of language difficulties, cultural differences, and limited access to essential resources.

Breaking down barriers: a five-point approach

What sets Equal Start Oxford apart is how it tackles these challenges through five connected strategies:

• Maternal justice: Advocating for inclusive, culturally sensitive maternity services
• Health literacy: Providing antenatal classes with translation support
• Community resilience: Creating peer support networks for new mothers
• Raising voices: Empowering women to share experiences and shape services
• Early years support: Preparing children for school through play-based learning

Since August 2023, the project’s antenatal classes have emerged as a particular success story. Led by specialist Equality, Diversity and Inclusion midwives with dedicated translators, these sessions have already reached 73 women with life-changing information about NHS services, pregnancy care, labour, and postnatal recovery.

Making a difference where it matters most

The project exemplifies the Oxford Centre for Research Equity’s approach to tackling health inequalities through evidence-based, community-centred work.

Katherine Tucker, a representative from the NIHR ARC OxTV noted at the event: “In a time when healthcare systems face unprecedented pressures, initiatives like Equal Start Oxford demonstrate the power of partnership, co-production and cultural sensitivity to transform experiences and outcomes for families who might otherwise fall through gaps in provision.”

The project could also serve as a valuable supportive environment for researchers studying how multiple equity interventions can work together, generating insights that benefit both academic understanding and practical service improvements.

The power of cultural connection

Adelia, a maternity advocate and translator, is one of the crucial bridges between healthcare providers and non-English speaking communities. Her work is a prime example of how the project goes beyond simple translation to create genuine cultural understanding for the Timor-Leste community.

One particularly successful innovation has been group visits to the Spires Birthing Unit, allowing women to familiarise themselves with the birth environment alongside translators who can explain procedures in their own language.

The project has also tackled digital exclusion by partnering with Oxford University Hospitals to provide 34 women with free SIM cards offering unlimited minutes, texts and data so that they can access vital health information and stay connected with support services.

Stories of Change: an ongoing journey

Participant feedback has been consistently positive throughout the project’s journey. During last year’s International Women’s Day event (2024), the ‘Stories for Change’ film captured testimonials from Equal Start’s Maternity Advocacy trainees and mothers. This documentary showcased the triumphs and challenges faced by migrant women navigating maternal healthcare in a new country. The Stories for Change film is available to view here and provides valuable context to the ongoing work of the project.

This year’s feedback continues to highlight four key benefits: improved access to services, enhanced knowledge, meaningful engagement, and stronger community connections.

As one mother shared: “I received a lot of information about how to prepare for childbirth and take good care of my baby. Thank you very much for giving this lesson to our pregnant mothers.”

Another valued the social aspect: “Get many friends and we communicate with each other.”

Healthcare professionals also recognised the project’s impact. One midwife noted: “Women benefit from having sessions with other women that speak their language and from the same culture as them,” while another added: “For surgeries that have a high number of Tetum-speaking women, these classes are invaluable.”

Looking forward: room to grow

The event wasn’t just a celebration but also an honest discussion about challenges and opportunities. Participants suggested several improvements:

• Expanding translation services to include more languages
• Extending classes beyond the current 1.5 hours
• Introducing more hands-on learning opportunities
• Developing additional resources for postpartum mental health
• Improving awareness among the wider midwifery team

Scaling success

A key moment of the event was the “In My Shoes” session facilitated by Melissa Latchman, Flo’s Communities Manager. Flo’s is a community centre located at Florence Park where people from all backgrounds can connect. The centre houses the Equal Start project and aims to reduce inequalities and promote the environment by creating greater opportunities for the community to work, eat, play, study, and interact with one another. This interactive workshop divided attendees into small groups, each presented with a written scenario describing the situation of a mother facing specific challenges. The groups analysed case studies, identified potential barriers to care, and recommended support services. The exercise proved important as it fostered genuine empathy by considering diverse maternal experiences, highlighted gaps in current service provision, encouraged cross-disciplinary thinking among healthcare professionals, community workers and parents. It also revealed the interconnectedness of issues like language, transportation, childcare and cultural understanding.

Melissa Latchman commented,

This exercise wasn’t just theoretical. Putting ourselves in these mothers’ positions, we identified practical improvements that could make an immediate difference. Our greatest strength lies in these partnerships whether with communities, healthcare providers or policy makers. When we approach the challenges that mothers face with mutual respect and understanding, we create pathways for positive change. 

The panel discussion during the final part of the conference explored several key strategies to its effectiveness and future direction. Panellists emphasised the importance of revisiting and utilising focus groups with families and women to gather authentic feedback, investing in early years programmes to improve long-term outcomes for babies, strengthening strategic partnerships across sectors, and pooling financial resources to more effectively meet identified needs. These collaborative approaches were recognised as essential for creating sustainable impact and addressing the complex challenges facing families.

A model for community-led change

Equal Start Oxford offers valuable lessons for similar communities across the UK and beyond. Its holistic approach recognises that improving maternal health requires addressing practical barriers such as language, digital access, social connections and knowledge.

As the event concluded, one message stood clear: accelerating action for better maternal health outcomes requires sustained commitment, authentic partnership with communities, and a willingness to adapt based on lived experience.

For the families of Oxford, Equal Start represents not just better maternity care, but a community determined that every mother and baby should be equally supported, regardless of postcode or background.