Navigating No Recourse to Public Funds and NHS maternity charging: health and social care professionals' experiences of supporting pregnant women in the UK.

In the UK, many migrant women are subject to the No Recourse to Public Funds condition, which restricts access to welfare and can result in liability for maternity care charges, contributing to poverty, delayed care, and health inequities. This mixed-methods study examined health and social care professionals' knowledge, confidence, resources, and training needs when supporting women with this status during pregnancy and early motherhood. Focus groups with 16 health and social care professionals and an online survey of 65 professionals and students were conducted across maternity, social care, and voluntary sector settings in England; data were analysed thematically and descriptively. Findings showed wide variation in the support provided, driven by limited understanding of immigration rules, available perinatal support, and maternity charging, alongside inconsistent access to specialist advice. Professionals reported low to moderate confidence in supporting women and responding to charging-related questions, with substantial variation in preparedness across roles and settings. Although most respondents wanted to improve their understanding, only 14% had received prior training. These findings highlight how policy complexity and workforce knowledge gaps may contribute to inconsistent care and inequities during pregnancy and early motherhood, underscoring the need for clearer guidance, workforce training, and improved cross-sector coordination. The resulting realist programme theory will inform co-designed, evidence-based guidance and training relevant to public health systems supporting migrant populations.