Balancing restrictions and access to maternity care for women and birthing partners during the COVID‐19 pandemic: the psychosocial impact of suboptimal care

Abstract

 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based. While these changes were introduced to keep women, babies, and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care.  A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and that there were significant deviations from the recommendations of authoritative bodies. Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families, but in particular, may impact on the long-term health of babies. When practice changes deviate from evidence-based frameworks that underpin quality care they must be monitored, appraised and evaluated to minimize unintended iatrogenic effects.

Factors affecting the mental health of pregnant women using UK maternity services during the COVID-19 pandemic: a qualitative interview study

“…Since the start of the COVID-19 pandemic, some of the social distancing restrictions implemented in maternity services have now been critiqued for lacking evidence [ 42 ] and conflicting with human rights, [ 43 ] such as the separation of parents and new-borns. In this study, we explored how social distancing restrictions affected the mental health and wellbeing of women experiencing a pregnancy and accessing UK maternity services during the COVID-19 pandemic.…”

“…Participants in our research described the psychosocial impact of restricted interactions with maternity care staff because of the pandemic, including staff being prevented from delivering “hands-on” care around their new-born babies. When significant practice changes such as these are implemented as they have been during the COVID-19 pandemic, [ 42 ] midwives and other maternity care professionals could be at risk of moral injury from having to uphold changes in care that conflict with their ethical values [ 49 , 50 ]. Additionally, participants in this study described feeling a lack of connection between themselves and their midwives due to social distancing requirements, which is important because this can prevent feelings of mutual trust and empowerment [ 51 ].…”

The impact of perinatal healthcare changes on birth trauma during COVID-19

“…This would additionally extend to any support person(s) present throughout the birth. Indeed, recommendations remain across professional organizations for those who are pregnant to follow general guidelines for wearing face coverings, regardless of vaccination status [ 37 , 38 ]; however, there is recognition of the physiological and psychological state that a person is in while giving birth. That is, this practical recommendation for the active phases of labor and birth may mitigate rates of spread, as mask mandates intend, while improving symptoms of trauma for people giving birth during the pandemic.…”

The United Kingdom and the Netherlands maternity care responses to COVID-19: A comparative study

“…These changes included switching to online and telephone consultations, limiting birth partner companionship, and ensuring extra hygiene precautions during breastfeeding for COVID-19 positive mothers [5] . While it can be considered acceptable to limit some rights to contribute to security, safety, and emergency resource management [6] , some of the changes have raised fierce opposition [7] . Complaints have been made about restrictions in women’s birth choices, and about women being alone during labour or while attending potentially highly sensitive appointments (i.e.…”