Evaluating the extent to which health inequalities - including a focus on the Equality Diversity and Inclusion Agenda - impact on pregnancy outcomes

This research project will examine the effect of health inequalities on the outcomes of pregnancy for both mother and baby, within the East Suffolk and North Essex NHS Foundation Trust (ESNEFT) maternity services.

A pregnant woman sitting cross-legged on a yoga mat in front of a bed, cradling her bump

It is well established that socio-economic deprivation and black and ethnic minority status can result in poorer pregnancy outcomes for women and their babies in the UK and elsewhere.

This project will examine disparities in pregnancy outcomes for a number of different groups of women who have minority or disadvantaged status in the population.

NHS East Suffolk and North Essex NHS Foundation Trust (ESNEFT) logo

We will examine routinely collected data, and speak to women and staff within ESNEFT, to explore how these, and other markers of disadvantaged or minority status, affect maternity care, pregnancy outcomes and the experience of accessing maternity services in the Trust.

The research will also explore how existing services attempt to reduce health disparities for these groups of women.



This project will have several quantitative and qualitative workstreams.

Examination of routinely collected data

Workstream 1 will include an examination of routinely collected trust data to explore which groups of disadvantaged or minority women are using ESNEFT maternity services, and to examine whether the routinely recorded maternity outcomes for these groups differ from the majority population.

Qualitative research

Further workstreams will explore in depth the experience of selected minority groups of women, using qualitative methods. The experience of both staff and women will be sought, and will include their views on existing services to reduce health inequalities.

PhD research

A PhD project will focus narrowly but in depth on one specific aspect of the experience and outcomes for one group of women.

ESNEFT partners

Marie Alexander

Marie Alexander

Marie began training as a mental health nurse in 1994 at the School of Nursing and Midwifery, based at Ipswich Hospital. Following graduation in 1997, she worked in several hospital and community roles before moving into clinical education in 2010.

She transitioned back into clinical services in 2015, holding senior leadership roles including General Manager for adult and specialist mental health with Cambridge and Peterborough Foundation Trust.

In 2019 Marie moved to Health Education England (HEE) as Regional Senior Nurse, a role that provided an opportunity to work on system, region, and national footprints and to lead a number of workstreams including RePAIR, Retention, Mental Health and (during the first wave of Covid) Health and Wellbeing.

Marie then moved from HEE to the Queen Elizabeth Hospital in King's Lynn, working as part of the Divisional Leadership Team in Clinical Support Services.

Most recently, Marie has taken up a new role with ESNEFT as Associate Chief Nurse for Education and Research, with a portfolio that includes all nursing, midwifery and allied health professional learners, Advanced Clinical Practice, and the development of clinical academic roles. She is undertaking a Professional Doctorate with University of Essex.

Cat Cracknell

Cat Cracknell

Cat began her career as a midwife at Ipswich Hospital in 2015 after training at the University of Bedfordshire. She has specialised in perinatal mental health, low risk midwifery care and community midwifery for families with additional and complex needs.

She has been a Professional Midwifery Advocate since 2018 and has recently taken on the role of Lead Professional Midwifery Advocate across ESNEFT.

Cat has Level 2 and 3 qualifications in Counselling, and is passionate about supporting birthing people and staff, and helping them to understand and maintain their mental health and wellbeing.

Cat is often a guest lecturer and has spoken at conferences. Outside of work, she is a trustee for a charity which supports birth mothers whose children live outside of their care.

ARU project team

Susan Walker

Susan Walker

Associate Professor

Susan Walker's profile page

[email protected]

Follow Susan on Twitter

Claire Hooks Profile Picture

Claire Hooks

Associate Professor

Claire Hooks's profile page

[email protected]