Health Literacy for Pregnant Women with Limited English in the UK
- Madeleine Benton
- Sep 18
- 4 min read
A new health literacy programme in East London aims to improve pregnancy experiences for women who don’t speak English.
In the United Kingdom, approximately one-third of births are to mothers who themselves were born overseas. Many of these women face intersecting challenges, including unfamiliarity with the healthcare system, cultural differences, and limited English proficiency. These factors can significantly impact health literacy - the ability to access, understand, and use health information effectively.
As a research psychologist in the field of perinatal mental health, I am very aware of the impact of low-health literacy and language proficiency on women’s psychosocial outcomes (the effects we see in a person’s mental, emotional, and social life), including their mental health and feelings of loneliness.
Low health literacy is associated with missed appointments, poor understanding of medical advice, and reduced engagement with healthcare providers. During pregnancy, these challenges can lead to adverse outcomes for both mother and child, which if not improved will increase the health inequalities they face in the future. Addressing health literacy, particularly among linguistically diverse populations, is therefore essential to promoting equitable maternal care and future healthcare for both mother and child.
Our project set out to address this gap by co-developing a Health Literacy Programme for Bengali-speaking pregnant women in East London.
A Programme Built by and for the Community
The project emerged from concerns raised by women, families, birthing companions and translators about the challenges faced by non-English speaking pregnant women in accessing and understanding healthcare in Tower Hamlets, East London. Tower Hamlets is a London borough where around 69% of residents are from ethnic minority backgrounds and around 20% of adults can’t speak English and are Bengali or Sylheti speakers from Bangladesh. Our group was led by Elly Charity (a Women’s Health Charity which aims to improve the quality of maternal healthcare in the UK and internationally) and included women with lived experience, researchers, community champions, ESOL (English for Speakers of Other Languages) teachers, illustrators, and health professionals. We came together to develop a health literacy programme for this group of women.
The programme was developed over a 24-month period and included focus groups and workshops with local communities and healthcare professionals. The programme includes six, two-hour sessions delivered in-person weekly covering key topics on female anatomy, gestational diabetes, labour and childbirth, and postnatal care. The programme was piloted (tested on a small scale) in Tower Hamlets with women who were pregnant and spoke Bengali with limited English proficiency. The programme was co-facilitated by ESOL teachers, healthcare professionals, and a Bengali-speaking community researchers. The use of visual aids, interactive role-play, and real-life medical tools were also included to further enhance engagement and comprehension.
What Women Said: Confidence and Connection
Sixteen women who took part in the piloting of the programme were interviewed about their experiences, which were overwhelmingly positive. Women reported enhanced confidence in their health knowledge and communication with health professionals. They also reported increased feelings of social connection and peer support through attending the programme with other pregnant women.
One woman said, “Coming to the programme was the best decision… I will carry all the information for life.”Another emphasised how beneficial the programme was for both her and her baby: “It is my first pregnancy and I am new in this country so I had very little knowledge about pregnancy and the health care system. But after doing the programme I have learned so many things about pregnancy and medical terms. I got to know how to take care of myself during pregnancy and…my baby’s health.”
Key Strengths of the Programme
Several features contributed to the programme’s success. These included: 1) Co-design: where women from within the community developed the programme from the beginning alongside health professions, researchers, teachers, and artists. 2) Bilingual delivery: sessions were conducted in both English and Bengali, facilitating understanding while supporting language development. 3) Practical engagement: Role-play, quizzes, and visual materials made learning accessible and engaging. 4) Community researcher: Who played a vital role in recruiting and engaging women throughout the programme delivery and evaluation.
Areas for Improvement and Future Directions
While the programme was well-received, women identified areas for enhancement. Some suggested expanding content on infant care, mental health, and sexual wellbeing. Others expressed a desire for more structured opportunities to practise English, or for scope to tailor sessions to different stages of pregnancy. A key consideration moving forward is balancing empowerment with safety. While many women reported increased confidence in communicating without interpreters, it remains essential to ensure that language support is available when needed to avoid misunderstandings in clinical settings. After the initial piloting of the programme in Tower Hamlets, the programme, has now been adapted for use in other language groups with additional programme components integrated into the material based on women’s feedback.
In terms of our next steps, we will test the new content in South End and other parts of Essex, where there are high levels of child poverty and health inequality within communities with low levels of English language.
Why This Matters Beyond East London
This project offers a compelling model for inclusive, community-driven healthcare education. By centring the voices of women with lived experience, this programme demonstrates how co-designed interventions can bridge communication gaps, reduce health inequalities, and foster trust between patients and providers.
Health Literacy as a Foundation for Equity
Health literacy is a fundamental component of equitable healthcare. This East London project illustrates the transformative potential of culturally sensitive, community-led education in improving maternal health outcomes. This project demonstrates that when women are equipped with the right tools and support, they are empowered to advocate for themselves, their families, and their futures.
Want to dive deeper into the Health Literacy Project? Check out our overview video here: https://www.youtube.com/watch?v=Z5PsxQMudM4
