“Anxious and traumatised”: Users’ experiences of maternity care in the UK during the COVID-19 pandemic

Abstract

Objective The COVID-19 pandemic saw universal, radical, and ultra-rapid changes to UK National Health Services (NHS) maternity care. At the onset of the pandemic, NHS maternity services were stripped of many of the features which support woman and family centred care. In anticipation of unknown numbers of pregnant women and maternity staff potentially sick with COVID-19, services were pared back to the minimum level considered to be required to keep women and their babies safe. The aim of this survey was to understand the impact of COVID-19 public health messaging and pandemic-related service changes on users of maternity care in the UK during the pandemic. Methods We conducted an online survey to explore user's experiences of COVID-19 public health messaging and ‘socially-distanced’ maternity care across the UK. The study population consisted of women who had experienced pregnancy after the 11th March 2020 (when the WHO declared a pandemic), whether or not they were still pregnant. We collected data between June and September 2020. We used framework analysis for the free-text data and generated descriptive statistics. Findings Women were generally happy to adopt a precautionary approach and stringently social distance in the context of a relatively unknown pathogen and in an environment of extreme anxiety and uncertainty, but were acutely aware of the negative impacts. The survey found that the widespread changes to services caused unintended negative consequences including essential clinical care being missed, confusion over advice, and distress and emotional trauma for women. COVID-19 restrictions have resulted in women feeling their antenatal and postnatal care to be inadequate and has also come at great emotional cost to users. Women reported feeling isolated and sad in the postnatal period, but also frustrated and upset by a lack of staff to help them care for their new baby. Key conclusions With growing evidence of the impact of the virus on pregnant women and an increased understanding of the unintended consequences of unclear public health messaging and overly precautious services, a more nuanced, evidence-based approach to caring for women during a pandemic must be prioritised. Implications for practice All maternity services should ensure they have clear lines of communication with women to keep them updated on changing care and visiting arrangements. Services should ensure that opportunities to provide safe face-to-face care and access for birth partners and visitors are maximised.

Giving birth and becoming a parent during the COVID-19 pandemic: A qualitative analysis of 806 women's responses to three open-ended questions in an online survey

“…Women reported feeling like a bother when they asked for help and felt that the postnatal wards were critically understaffed. Similar findings are presented in a recent study from UK, were women reported feeling isolated and sad in the postnatal period and frustrated and upset by a lack of staff to help them care for the new baby ( Sanders & Blaylock, 2021 ). Our findings indicate that individual breastfeeding support was one of the aspects of early postnatal care that suffered the most.…”

“Never let a good crisis go to waste”: Positives from disrupted maternity care in Australia during COVID-19

“…Despite the emerging evidence that many women have greatly appreciated having fewer visitors in hospital, not all studies into this topic have demonstrated positive results. Recent data from a United Kingdom- based study found that the majority of birthing women surveyed were displeased with COVID-19- related hospital visitor restrictions, with 72% stating that the restrictions had led to increased feelings of loneliness ( Sanders & Blaylock, 2021 ). However, women in this context reported that one of the key elements which caused them to feel negatively about the restrictions was that they had less interaction with the midwives during their hospital stay ( Sanders & Blaylock, 2021 ).…”

Psychological trauma in postpartum women who experienced maternity care during the stringent COVID-19 pandemic restrictions

“…There is a growing body of evidence supporting the emotional, psychological and physical trauma inflicted on women who experienced visitor restrictions while receiving maternity care after 11 March 2020 during the COVID-19 pandemic. 1 The study employed the quantitative and qualitative format to demonstrate the number of women who experienced this trauma from the implementation of visitor's restrictions in the UK maternity ward. 1…”

“…The women reported an escalation of anxiety and sadness particularly in the postpartum period. 1 For some, this emotional state had an impact on their recovery, while others reported a negative impact on their ability to care for their newborns. 1 As this pandemic is approaching to an end, we are left to live in a new normal.…”

“…1 For some, this emotional state had an impact on their recovery, while others reported a negative impact on their ability to care for their newborns. 1 As this pandemic is approaching to an end, we are left to live in a new normal. Continuation of the stringent COVID-19 service restrictions within maternity services may not be warranted in the same measures considering the negative impact on the psychological and physical distress reported by the women and their families.…”