When the COVID-19 pandemic was declared back in March of 2020, we anticipated that those who were pregnant or planning for a baby were going to be disproportionately impacted. Pregnant women were advised to ‘stringently’ social distance, and maternity services were rapidly reconfigured to accommodate social distancing and infection control measures. Our report, based on an online survey, explores users’ experiences and the emotional consequences of COVID-19 risk messaging and ‘socially-distanced’ maternity care.
- All 524 participants had experience of maternity care during COVID-19 restrictions and appreciated the need for service changes and the pressures placed on NHS services.
- Communication between NHS organisations and individuals was generally regarded as poor and confusing.
- The majority of respondents agreed that those who are pregnant should practice stringent social distancing but recognised the impracticality of advice and the impact it had on their mental health. Many respondents over-interpreted advice to mean ‘shielding’, which had far reaching impacts.
- Virtual antenatal appointments were fully meeting the needs of just a few users.
- Restrictions placed on partner involvement in maternity care, particularly during scans, emergency attendances, and during labour assessments, caused widespread distress and anxiety.
- Removal of the home birth service and concentration of labour care in obstetric units was largely viewed as placing women at increased risk of viral exposure, and necessitated women with other children to breach government advice on household mixing.
- Women with complex pregnancies were concerned that deterioration in their physical health or the wellbeing of their baby could go unnoticed within a system of reduced antenatal and postnatal checks. For participants with previous or ongoing poor mental health there was concern that the pandemic would result in a re-occurrence or deterioration in their condition.
- COVID-19 restrictions compounded existing failures in hospital based postnatal care to meet the needs of new mothers. On postnatal wards women described being lonely, sad, and struggling physically without visitors or sufficient staff to support and help them. Once home, the combination of reduced professional, family, and social support resulted in women feeling isolated and concerned that early signs of ill health may be overlooked.
Whilst a small number of women were unphased by COVID-19 maternity restrictions, for most, the rigorous implementation of changes has resulted in feelings of distress, anxiety, and isolation. The role of maternity services is to meet the emotional and physical needs of women and users. Both were found to have been sacrificed to some extent during the acute phase of the pandemic.
Recent recommendations to relax birth partner and visitor restrictions are welcomed, but allowing local interpretation risks the continued use of stringent measures by organisations and individuals reluctant to adopt more sustainable and person-centred service configurations. We are concerned that this will lead to a continued ‘patchwork’ of restrictions in maternity services across the UK.