Reducing inequalities in perinatal mental health: What does good perinatal mental health support look like for LGBTQIA+ people? (HHS-2026-05)

About the Project

Perinatal mental health (PMH) difficulties affect many parents during pregnancy and the postnatal period, yet access to appropriate, affirming support is uneven across and within communities. LGBTQIA+ parents frequently report exclusionary or distressing experiences within perinatal services, including assumptions about gender, parental roles, and family structure that can exacerbate distress, delay help‑seeking, and compound existing inequalities. Despite increasing recognition of these issues, there remains limited evidence about what good PMH support looks like for LGBTQIA+ people across diverse genders, sexual orientations, sex characteristics and parental roles, and how services can inclusively meet these needs.

The overall aim of this PhD is to contribute to understanding what good PMH support looks like for LGBTQIA+ people and how NHS and community services can better meet their needs. The project responds directly to a national research priority identified through a recent James Lind Alliance consultation.

Using a Realist Evaluation approach, the study will examine what works, for whom, in what circumstances, and why, explicitly attending to intersectional identities and structural inequalities. The project will begin with a realist review to develop initial programme theories about mechanisms of support. These theories will guide empirical work across NHS and voluntary and community sector sites, including interviews with practitioners and LGBTQIA+ parents. Data will be analysed iteratively using realist logic to refine programme theories and identify barriers, facilitators, and mechanisms of inclusive care.

Lived experience consultation will be embedded throughout the project to ensure meaningful involvement and relevance. The study will produce practical, evidence‑based recommendations to support more inclusive, culturally competent, and equitable PMH services. By strengthening understanding of how PMH support operates for LGBTQIA+ people, the project aims to reduce inequalities in access, experience, and outcomes, and to inform policy, practice, and future research.

For subject specific enquiries please contact: z.darwin@hud.ac.uk