MATERNITY STAFF PERCEPTIONS OF EFFECTS ON ANTENATAL SCREENING AND SERVICES FOR MENTAL HEALTH AND DOMESTIC VIOLENCE DURING THE COVID-19 PANDEMIC: A SURVEY STUDY

ABSTRACT

Background: Domestic and family violence (DFV) and mental health screening are core components of antenatal care. However, the COVID-19 pandemic both increased the prevalence of DFV and mental health issues and resulted in many antenatal visits becoming telehealth. DFV and mental health screening were consequently often delayed, potentially resulting in insufficient time to establish support systems before birth. This study assessed pandemic effects on DFV and mental health screening from the perspective of local maternity service providers. Methods: Maternity staff (midwives, doctors, allied health) at three Sydney metropolitan hospitals were surveyed regarding perceived impact of COVID-19 on the delivery, timeliness, and quality of overall pregnancy care, DFV and mental health screening and care, and their telehealth perceptions. Responses by hospital and maternity care provider subtype were compared. Results: Of 109 respondents, most felt the pandemic negatively impacted overall pregnancy care (60%), DFV screening/care (57%), and mental health screening/care (57%), significantly more believing COVID-19 'extremely' negatively impacted DFV screening (p = 0.02). Staff at the hospital with highest sociodemographic diversity were significantly more concerned about DFV screening/ care. Nominated telehealth advantages e.g. reduced travel (69%) and clinic overcrowding (62%) were fewer than disadvantages including no physical examinations (90%), difficulties picking up non-verbal cues (84%), and certain questions unsafe (62%). Fiftysix percent believed telehealth should be used for some antenatal care for select women (low-risk, multiparous). Conclusions: Telehealth may have an ongoing limited role in maternity care in Australia for low-risk women. Staff considered those high-risk for physical and/or psychosocial reasons unsuited to telehealth care.