Sustaining quality midwifery care in a pandemic and beyond

Renfrew, Mary J; Cheyne, Helen; Craig, Justine; Duff, Elizabeth; Dykes, Fiona; Hunter, Billie; Lavender, Tina; Page, Lesley; Ross‐Davie, Mary; Spiby, Helen; Downe, Soo

doi:10.1016/j.midw.2020.102759

Cited by 112 publications

(146 citation statements)

References 28 publications

(30 reference statements)

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“…Explicit discussions about birth plans, what providers and health systems can do to keep women and their babies safe, and the cost-benefit analysis of hospital-based versus home births will be extremely valuable in maximizing positive outcomes and minimizing maternal anxiety. Further research exploring flexible options for delivery care are also warranted (Renfrew et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women

Moyer

Compton

Kaselitz

et al. 2020

Arch Womens Ment Health

280

275

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The aim of this study is to explore the impact of the COVID-19 pandemic on pregnant women's anxiety and identify factors most strongly associated with greater changes in anxiety. An anonymous, online, survey of pregnant women (distributed April 3-24, 2020) included a modified pregnancy-related anxiety scale (PRAS) reflecting respondents' perception of pregnancy anxiety before COVID-19 and a current assessment of pregnancy-related anxiety. The difference between these scores was used as the outcome variable. Data were analyzed using bivariate and multivariate linear regression analyses. Two thousand seven hundred forty pregnant women from 47 states completed the survey. 25.8% (N = 706) stopped in-person visits, 15.2% used video visits (N = 415), and 31.8% (N = 817) used phone visits for prenatal care as a result of COVID-19. Those planning a hospital birth dropped from 2641 (96.4%) to 2400 (87.7%) following COVID-19. More than half of women reported increased stress about food running out (59.2%, N = 1622), losing a job or household income (63.7%, N = 1745), or loss of childcare (56.3%, N = 1543). More than a third reported increasing stress about conflict between household members (37.5%, N = 1028), and 93% (N = 2556) reported increased stress about getting infected with COVID-19. Slightly less than half of respondents (either selves or family members) were healthcare workers (41.4%, N = 1133) or worked in essential services (45.5%, N = 1246). In multivariate analysis, those reporting higher agreement with COVID-19-related stressors had greater changes in pre-to post-COVID-19 pregnancy-related anxiety. The COVID-19 pandemic is profoundly affecting pregnant women's mental health, and factors independent of pregnancy appear to be driving changes in pregnancy-specific anxiety.

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Section: Discussionmentioning

confidence: 99%

Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women

Moyer

Compton

Kaselitz

et al. 2020

Arch Womens Ment Health

280

275

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“…Outside USA, European countries have had the highest number of COVID-19 cases and deaths; UK, Italy, Spain, France, Belgium and Netherlands are all amongst the top ten affected countries in the world ( John Hopkins University 2020 ). In this context, concern about what constitutes safe care of pregnant women and newborns has increased, and in many settings, risk averse decisions have been taken in maternity care provision which, it is argued, may increase unnecessary medical interventions, put women at risk of being infected with COVID-19 by reducing provision of community or home based care, and reduce or reverse progression towards high quality maternity care ( Renfrew et al, 2020 ).…”

mentioning

confidence: 99%

The impact of the coronavirus (COVID-19) pandemic on maternity care in Europe

et al. 2020

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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“…For expectant parents and parents with a newborn, this included limited access to maternity services. For example, partners not able to attend antenatal or scanning appointments, only one birthing partner able to be present and only for established labour and birth, partners not permitted to join on the postnatal ward, 1 restrictions on births at home and in freestanding midwifery units in certain areas, 2 a decrease in antenatal and postnatal appointments, 3 as well as having some of these appointments via telephone or video instead of face-to-face. 1 Community services, such as breastfeeding support and some health visiting appointments, as well as antenatal and postnatal groups were moved remotely.…”

Section: Introductionmentioning

confidence: 99%

“…1 Community services, such as breastfeeding support and some health visiting appointments, as well as antenatal and postnatal groups were moved remotely. 3 However, these guidelines are continuously under review. From March 23 rd to May 11 th 2020, UK Government guidance was for people to stay at home, except for very limited purposes (e.g.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to mood and confidence in pregnancy and early parenthood during COVID-19 in the UK: A mixed-methods synthesis survey

Perez¹,

Panagiotopoulou²,

Curtis³

et al. 2020

Preprint

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Background: Parents’ well-being during pregnancy and early parenthood is critical for children’s development. Environmental stressors can significantly challenge parents’ well-being.Aims: To investigate how COVID-19 and associated restrictions influence mood and parenting confidence of expectant parents and those in early parenthood, identifying barriers and facilitators.Methods: We used a cross-sectional online survey to collect data from 590 expectant parents and parents of infants (564 females) during the most restrictive phase of the lockdown in the UK. Survey included a mixture of forced-choice and open-ended questions pertaining to mood, perceived social support, media use, online interactions, and parenting expectations. Quantitative data were analysed using multiple linear regression and proportional odds models, while an inductive thematic analysis was employed for qualitative data. Quantitative and qualitative data were qualitatively synthesised.Results: A decrease in mood and parenting confidence were found. Barriers included practical difficulties (finding essentials, reliable health information), social difficulties (loss of physical contact, decreased support), and uncertainty during pregnancy. Facilitators included support from others and for first-time parents, loss of childcare resulting in greater parenting confidence. While online resources and communication were not preferable to face-to-face interactions, technology was a helpful tool for communicating, getting support, and finding essentials and information during lockdown.Conclusion: By mid-May 2020, mood and parenting confidence among expectant and parents of newborns in the UK were significantly reduced. Consideration of barriers and facilitators in healthcare and psychological support provided is likely to play an important part in promoting parental mental health and healthy parent-child relationships.

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Sustaining quality midwifery care in a pandemic and beyond

Cited by 112 publications

References 28 publications

Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women

Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women

The impact of the coronavirus (COVID-19) pandemic on maternity care in Europe

Barriers and facilitators to mood and confidence in pregnancy and early parenthood during COVID-19 in the UK: A mixed-methods synthesis survey

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