The effect of the COVID-19 pandemic on UK parent experiences of pregnancy ultrasound scans and parent-fetal bonding: A mixed methods analysis.

INTRODUCTION: Companionship in antenatal care is important for facilitating positive parental experiences. During the COVID-19 pandemic, restrictions on partner attendance at fetal ultrasound scans were introduced nationally to minimise transmission of the virus. This study aimed to explore the effect of these restrictions on maternal and paternal experiences of pregnancy scans and evaluate their potential effect on parent-fetal bonding. METHODS: A UK-wide, anonymous cross-sectional survey was completed by new and expectant parents (n = 714) who had, or were awaiting a pregnancy scan during the COVID-19 pandemic. The CORE-10 and an adapted version of the Prenatal Attachment Inventory were used to evaluate psychological distress and prenatal bonding. Additional survey questions captured parental experiences of scans. Separate statistical and thematic analyses of the data were undertaken. A joint display matrix was used to facilitate integration of quantitative and qualitative claims to generate a comprehensive interpretation of study findings. FINDINGS: When fathers did not attend the scan, feelings of excitement and satisfaction were significantly reduced (p<0.001) and feelings of anxiety increased (p<0.001) in both parents. Mothers were concerned about receiving unexpected news alone and fathers felt excluded from the scan. Mean paternal bonding (38.22, SD 10.73) was significantly lower compared to mothers (47.01, SD 7.67) although no difference was demonstrated between those who had attended the scan and those who had not. CORE-10 scores suggested low-to-mild levels of psychological distress, although the mean difference between mothers and fathers was not significant. Key themes described both parents' sense of loss for their desired pregnancy scan experience and reflected on sonographers' central role in providing parent-centred care during scans. CONCLUSION: Restrictions on partner attendance at scans during the COVID-19 pandemic had a negative effect on parental experiences of antenatal imaging. Provision of parent-centred care, which is inclusive of partners, is essential for improved parental experiences.

"It has been the most difficult time in my career”: A qualitative exploration of UK obstetric sonographers' experiences during the COVID-19 pandemic

Introduction Substantial changes were made to the provision of pregnancy ultrasound services during the COVID-19 pandemic with the intention of minimising virus transmission and maintaining service continuity. Published literature describing the impact of the pandemic on obstetric sonographers is predominantly quantitative in nature, however statistics cannot fully convey sonographers' voices. This study aimed to gain a deeper understanding of the lived experiences of UK obstetric sonographers performing pregnancy ultrasound scans during the pandemic. Methods A UK-wide, online, anonymous cross-sectional survey on Qualtrics XMTM was open to responses between 9th March and 6th May 2021. Whilst this survey contained some quantitative elements, open questions were included to capture additional qualitative detail from respondents about their perceptions and experiences of scanning during the pandemic. Key themes were generated from free text responses using thematic analysis. Results Written responses were received from 111/138 sonographers participating in the survey. Five themes were generated, depicting the impact of the pandemic on obstetric sonographers: 1) continuity in a crisis;2) decisions about me, without me;3) battle scars – the lasting damage of COVID-19;4) what people think I do vs. what I really do;and 5) the human touch. A cross-cutting theme was sonographers' feelings of disconnection from senior figures and expectant parents which created a sense of abandonment and distrust. Conclusion Survey respondents' self-reported experiences of ineffective leadership and management, and perceived lack of understanding of the complexity of the sonographer role are potential contributory factors in the high levels of moral injury and occupational burnout reported within the workforce during the pandemic. Implications for practice Moral injury support and healing must be prioritised to enable the recovery of the obstetric ultrasound workforce in the post-pandemic era.

The impact of the COVID-19 pandemic on clinical guidance and risk assessments, and the importance of effective leadership to support UK obstetric sonographers.

INTRODUCTION: The COVID-19 pandemic had a profound impact on the provision of obstetric ultrasound services, leading to the publication of new guidance and requirement for individual departmental risk assessments in the UK. The impact of these changes on clinical practice for UK obstetric sonographers is not currently well reported in published literature. METHODS: Obstetric sonographers working in the UK (n = 138) used the Qualtrics XMTM platform to complete an anonymous, online questionnaire about their experiences during the pandemic. Participants responded to closed-type questions about national guidance, risk assessment and their perception of support, and provided additional detail about their experiences in these areas through free-text response options. RESULTS: Over 90% of respondents were aware of or had read guidance issued by professional organisations, although challenges for its implementation in departments were identified. These were commonly related to the clinical working environment and included limitations on physical space (76.3%), time constraints (67.5%) and ventilation (61.3%). Sonographers felt most supported by their ultrasound colleagues (83.5%) and line managers (41.2%). They felt least supported by senior management and leadership personnel (60.8%), other antenatal colleagues (51.5%) and professional organisations (41.2%). CONCLUSION: Obstetric sonographers will need support from the wider service team and professional organisations to facilitate post-pandemic recovery of the workforce. Formal clinical supervision programmes may be beneficial in facilitating a more holistic approach to peer-support, although there is currently limited evidence of their use in sonographic practice.

UK obstetric sonographers' experiences of the COVID-19 pandemic: Burnout, role satisfaction and impact on clinical practice.

Introduction: The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker's well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers' experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice. Methods: An online, anonymous cross-sectional survey was created to capture sonographers' experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress. Results: Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory (n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice (p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic (p < 0.001), which was associated with higher scores for burnout and psychological distress (p < 0.001). Change in role satisfaction was correlated with sonographers' perception of safety while scanning during the pandemic (R 2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years. Conclusion: Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic.