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Learning from a crisis: a qualitative study of the impact on mothers' emotional wellbeing of changes to maternity care during the COVID-19 pandemic in England, using the National Maternity Survey 2020.
McLeish, Jenny; Harrison, Sian; Quigley, Maria; Alderdice, Fiona.
  • McLeish J; NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. jenny.mcleish@npeu.ox.ac.uk.
  • Harrison S; NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
  • Quigley M; NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
  • Alderdice F; NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
BMC Pregnancy Childbirth ; 22(1): 868, 2022 Nov 23.
Article in English | MEDLINE | ID: covidwho-2139188
ABSTRACT

BACKGROUND:

Pregnancy and the postnatal period can be times of psychosocial stress and insecurity, but high quality maternity care and social support can help mothers cope with stress and feel more secure. The COVID-19 pandemic and associated social and economic disruption increased rates of antenatal and postnatal stress, anxiety and depression, and also had profound impacts on the organisation of maternity services in England.

METHODS:

This was a qualitative descriptive study of the impact of pandemic-related changes to maternity care on mothers' emotional wellbeing, using inductive thematic analysis of open text responses to the National Maternity Survey (NMS) 2020 in England. A random sample of 16,050 mothers who gave birth 11-24th May 2020 were invited to take part in the survey, and 4,611 responded, with 4,384 answering at least one open text question.

RESULTS:

There were three themes 'Chaos impact of uncertainty', 'Abandoned impact of reduction in care', and 'Alone impact of loss of social support'. Mothers valued maternity care and many experienced additional stress from chaotic changes and reduction in care during the pandemic; from health professionals' own uncertainty and anxiety; and from restrictions on essential social support during pregnancy, labour and birth. Others felt that health professionals had communicated and cared for them well despite the changes and restrictions, and these mothers felt psychologically safe.

CONCLUSIONS:

Planning for future crises should include considering how necessary adaptations to care can be implemented and communicated to minimise distress; ensuring that mothers are not deprived of social support at the time when they are at their most vulnerable; and supporting the psychological welfare of staff at a time of enormous pressure. There are also lessons for maternity care in 'normal' times that care is highly valued, but trust is easily lost; that some mothers come into the maternity system with vulnerabilities that can be ameliorated or intensified by the attitudes of staff; that every effort should be made to welcome a mother's partner or chosen companion into maternity care; and that high quality postnatal care can make a real difference to mothers' wellbeing.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Maternal Health Services Type of study: Experimental Studies / Observational study / Qualitative research / Randomized controlled trials Limits: Female / Humans / Pregnancy Country/Region as subject: Europa Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2022 Document Type: Article Affiliation country: S12884-022-05208-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Maternal Health Services Type of study: Experimental Studies / Observational study / Qualitative research / Randomized controlled trials Limits: Female / Humans / Pregnancy Country/Region as subject: Europa Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2022 Document Type: Article Affiliation country: S12884-022-05208-7