A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Background There is an increasing focus on inequity in healthcare and health outcomes. Early awareness of potential sources of inequity in access to and outcomes from innovative health technologies can support system preparedness and allow implementation of mitigations. They may also be used to improve research inclusion. Objective To explore methods used to integrate equality and equity into horizon scanning for healthcare innovations, focusing on acceptability, polypharmacy, and multiple long-term conditions (MLTC). Design A scoping review followed Joanna Briggs Institute (JBI) guidelines to identify relevant methodologies for integrating equity into horizon scanning. Data sources Searches were conducted in MEDLINE, Embase, ProQuest, and WHO Global Index Medicus up to May 24, 2024. Eligibility criteria Studies were eligible if they presented methodologies for integrating equity and equality considerations into horizon scanning in health and care. Primary outcomes related to equity or equality, and secondary outcomes addressed acceptability, polypharmacy, and MLTC. Data extraction and synthesis Data were extracted on study characteristics, equity frameworks, and the integration of equity-related factors, including socioeconomic status, gender, and geographic location. A narrative synthesis was used to present the findings. Results Out of 951 records screened, three studies were included. The studies used varied horizon scanning methods, including scenario-building and foresight methodologies, and spanned multiple healthcare contexts such as precision oncology and complex paediatric care. Each study incorporated equity/equality by addressing the impact of emerging innovations on clinically vulnerable populations. Acceptability was found to be crucial for equitable implementation, particularly in precision oncology. However, managing complex health needs, especially in disadvantaged groups, is complicated by significant challenges such as polypharmacy and the presence of multiple long-term conditions. Conclusions Limited evidence highlighted a lack of consistent approaches to integrating equity into horizon scanning. While methods such as stakeholder engagement and scenario analysis showed promise, further research is needed to refine frameworks that better detect early indicators of inequity in healthcare innovation.

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Oscillating autonomy: a grounded theory study of women’s experiences of COVID-19 infection during pregnancy, labour and birth, and the early postnatal period

Peterson,

Bridle,

Dasgupta

et al. 2024

BMC Pregnancy Childbirth

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Background Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period.Methods National on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women's experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period. ResultsThe theory of 'Oscillating Autonomy -Losing and Seeking to Regain Control by Striving for Agency' was developed, comprising three main themes: 'Anxious Anticipation: The fear of infection was worse than COVID-19 itself'; 'Fluctuating Agency: What changed when COVID-19 took control'; and 'Reclaiming Control: Seeking reassurance during COVID-19 positivity' . Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation.Conclusions Support was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.

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A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Cited by 6 publications

References 48 publications

The social and healthcare professional support drawn upon by women antenatally during the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis

The social and healthcare professional support drawn upon by women antenatally during the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis

Methods for considering equality and equity implications in horizon scanning for medicines and healthcare innovations: a scoping review

Oscillating autonomy: a grounded theory study of women’s experiences of COVID-19 infection during pregnancy, labour and birth, and the early postnatal period

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