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The study will be conducted in two phases.

In phase 1, we will conduct a retrospective cohort study using routinely collected anonymous data of live births over a 12-year period from April 2007-March 2019 from Luton and Dunstable ÌìÃÀ´«Ã½ Hospital, situated in an ethnically dense socially deprived town with approximately 55% of the population being of Black and Minority Ethnic Origin.

We will conduct analyses with respect to the following outcome measures:

1. Late initiation of antenatal care defined as first antenatal appointment attended at >12 weeks of gestation and further classified into moderately late initiation (13-19 weeks) and extremely late initiation (≥20 weeks of gestation);
2. Low uptake of antenatal care defined as having <8 antenatal visits and further classified into moderately low uptake (4-7 visits) and extremely low uptake (<4 visits)
3. Preterm birth defined as births at <37 weeks of gestation);
4. Low Birth Weight defined as birth weight of an infant of <2500 g. We will apply univariate and multivariate regression models to examine the association between the main exposure variables (maternal ethnicity, area deprivation) and late antenatal care initiation and low uptake, and the link between late initiation and low uptake to preterm birth and low birth weight.

In phase 2, we will develop a tailored community based intervention co-produced with maternity service users and provider stakeholders.

We will conduct two facilitated interactive workshops to enable the co-production of the intervention: one with approximately 30 parents (mothers/fathers/couples), and another one with 20 maternity care provider stakeholders.

The intervention will be implemented in four postcode districts where late antenatal care initiation is most prevalent.

We will also conduct a preliminary evaluation to assess the feasibility, acceptability and the effectiveness of the intervention