Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic

Abstract

Background The COVID-19 pandemic poses an unprecedented risk to the global population. Maternity care in the UK was subject to many iterations of guidance on how best to reconfigure services to keep women, their families and babies, and healthcare professionals safe. Parents who experience a pregnancy loss or perinatal death require particular care and support. PUDDLES is an international collaboration investigating the experiences of recently bereaved parents who suffered a late miscarriage, stillbirth, or neonatal death during the global COVID-19 pandemic, in seven countries. In this study, we aim to present early findings from qualitative work undertaken with recently bereaved parents in the United Kingdom about how access to healthcare and support services was negotiated during the pandemic. Methods In-depth semi-structured interviews were undertaken with parents (N = 24) who had suffered a late miscarriage (n = 5; all mothers), stillbirth (n = 16; 13 mothers, 1 father, 1 joint interview involving both parents), or neonatal death (n = 3; all mothers). Data were analysed using a template analysis with the aim of investigating bereaved parents’ access to services, care, and networks of support, during the pandemic after their bereavement. Results All parents had experience of utilising reconfigured maternity and/or neonatal, and bereavement care services during the pandemic. The themes utilised in the template analysis were: 1) The Shock & Confusion Associated with Necessary Restrictions to Daily Life; 2) Fragmented Care and Far Away Families; 3) Keeping Safe by Staying Away; and 4) Impersonal Care and Support Through a Screen. Results suggest access to maternity, neonatal, and bereavement care services were all significantly reduced, and parents’ experiences were notably affected by service reconfigurations. Conclusions Our findings, whilst preliminary, are important to document now, to help inform care and service provision as the pandemic continues and to provide learning for ongoing and future health system shocks. We draw conclusions on how to enable development of safe and appropriate services during this pandemic and any future health crises, to best support parents who experience a pregnancy loss or whose babies die.

Precarity and preparedness during the SARS‐CoV‐2 pandemic: A qualitative service evaluation of maternity healthcare professionals

“…The prolonged and cumulative effect of endemic precarity, and the un(der)‐prepared service, and the health system shock was occasionally seen as a chance to innovate and transform, 38 albeit usually with a top‐down or “command and control” style approach, which was not always appraised positively. Furthermore, innovation has often been reported as a proxy term for the reality of time being spent on paring back services and delivering only essential care causing poorer outcomes for women, their families, and their babies; 2 , 39 , 40 , 41 , 42 , 43 , 44 and demoralizing staff who did not believe they were providing the level of care they ought to and were trained to deliver.…”

Supporting Perinatal Mental Health and Wellbeing during COVID-19

“…Maternity services have therefore been subject to repeated service-level reconfiguration [8], rendering many women unhappy with the care they received [38]. Specifically, it has been reported that women (in the general population) in the UK have experienced some of the highest levels of perinatal mental ill health ever recorded empirically [39,40] and were adversely affected by restrictions associated with COVID-19 [41,42], especially with regard to missing out on social and healthcare professional support [43].…”

Navigating uncertainty alone: A grounded theory analysis of women’s psycho-social experiences of pregnancy and childbirth during the COVID-19 pandemic in London

“…Throughout the pandemic, evidence from many countries has consistently suggested pregnant and postpartum women have experienced: increased levels of anxiety [17] , [18] , pregnancy-related stress [19] , anxiety related to fear of contracting the virus [20] , and the lack of social support [21] , [22] . Reduced access to maternity services has been coupled with a reduction in health-seeking behaviours, with poorer outcomes for pregnant women and their babies being noted, such as increased mortality, stillbirth, and ruptured ectopic pregnancies [23] , [24] , [25] . To tailor adequate support and inform maternity service reconfiguration during future public health crises, it is essential to understand the psycho-social experiences of women who were pregnant and gave birth during the COVID-19 pandemic.…”