Equity and Inclusion: A Review of NHS and HSC Online Information for Women in the Early Phase of Labour
Maryam Malekian, Dominique C. M. Mylod, Hina Tariq, Vanora A. HundleyBackground: The early or latent phase of labour (early labour) is a time when women feel unsupported and have limited access to quality midwifery support, often being advised to stay at home. As a result, women seek online information and often turn to hospital websites as a trusted source of this information. Women from underserved and marginalised groups may be particularly reliant on online information. The aim of this study was to systematically evaluate the availability, accessibility, content, and evidence base of online early labour information provided by UK hospitals, with a focus on inclusivity, and equity in information provision. Methods: A systematic search of NHS and HSC maternity websites across the UK (England, Scotland, Wales, and Northern Ireland) was undertaken to identify publicly available guidance on early labour. Eligible materials included webpages, downloadable leaflets, and multimedia resources. The identified guidance was evaluated in terms of availability, accessibility, content, and transparency of evidence. Data were synthesised descriptively and presented using narrative summaries and tables. Results: A total of 146 hospital websites were reviewed, of which 72 (49%) provided guidance specific to early labour or included a dedicated section on the latent phase. There was marked variation in availability, accessibility, and content. Accessibility was often limited, with few multilingual resources, alternative formats, or inclusive visual materials. Most guidance was text-heavy, with minimal use of multimodal or user-friendly formats and limited representation of diverse populations. Clinical content also varied, particularly in definitions of early labour and recommendations for pain management. Only a minority of resources referenced supporting evidence. Conclusions: Online early labour information provided by UK maternity services varies in availability, accessibility, and inclusivity, raising important equity concerns. Limitations in accessibility, consistency, and transparency of evidence may contribute to disparities in understanding and decision-making, particularly among women from disadvantaged or marginalised groups. There is a clear need for standardised, evidence-based, and inclusive information that is accessible to diverse populations to support equitable maternity care during early labour.