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Dasgupta T, Horgan G, Peterson L, Mistry HD, Balls E, Wilson M, Smith V, Boulding H, Sheen KS, Van Citters A, Nelson EC, Duncan EL, Dadelszen PV, Rayment-Jones H, Silverio SA, Magee LA. Women's experiences of maternity care in the United Kingdom during the COVID-19 pandemic: A follow-up systematic review and qualitative evidence synthesis. Women Birth 2024; 37:101588. [PMID: 38431430 DOI: 10.1016/j.wombi.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Maternity care services in the United Kingdom have undergone drastic changes due to pandemic-related restrictions. Prior research has shown maternity care during the pandemic was negatively experienced by women and led to poor physical and mental health outcomes in pregnancy. A synthesis is required of published research on women's experiences of maternity care during the latter half of the COVID-19 pandemic. AIM To update a previous systematic review of maternity care experiences during the pandemic to June 2021, exploring experiences of maternity care specifically within the United Kingdom and how they may have changed, in order to inform future maternity services. METHODS A systematic review of qualitative literature was conducted using comprehensive searches of five electronic databases and the Cochrane COVID Study Register, published between 1 June 2021 and 13 October 2022, and further updated to 30 September 2023. Thematic Synthesis was utilised for data synthesis. FINDINGS Of 21,860 records identified, 27 studies were identified for inclusion. Findings included 14 descriptive themes across the five core concepts: (1)Care-seeking and experience; (2)Virtual care; (3)Self-monitoring; (4)COVID-19 vaccination; (5)Ethical future of maternity care. DISCUSSION Our findings in the UK are consistent with those globally, and extend those of the previous systematic review, particularly about women's perceptions of the COVID-19 vaccine during pregnancy. CONCLUSION Our findings suggest the following are important to women for future maternity care: personalisation and inclusiveness; clear and evidence-based communication to facilitate informed decision-making; and achieving balance between social commitments and time spent settling into motherhood.
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Affiliation(s)
- Tisha Dasgupta
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Gillian Horgan
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Lili Peterson
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom; Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Hiten D Mistry
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Emily Balls
- The RESILIENT Study Patient & Public Involvement & Engagement Advisory Group, United Kingdom
| | - Milly Wilson
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Valerie Smith
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland; School of Nursing, Midwifery and Health Systems, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Harriet Boulding
- The Policy Institute, Faculty of Social Science & Public Policy, King's College London, London, United Kingdom
| | - Kayleigh S Sheen
- Department of Social Sciences, College of Health, Science and Society, University of the West of England Bristol, Bristol, United Kingdom; The RESILIENT Study Technical Advisory Group, United Kingdom
| | - Aricca Van Citters
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, NH, United States
| | - Eugene C Nelson
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, NH, United States
| | - Emma L Duncan
- Department of Twin Research & Genetic Epidemiology, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Peter von Dadelszen
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Hannah Rayment-Jones
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom; School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Laura A Magee
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, United Kingdom.
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Jackson L, Greenfield M, Payne E, Burgess K, Oza M, Storey C, Davies SM, De Backer K, Kent-Nye FE, Pilav S, Worrall S, Bridle L, Khazaezadeh N, Rajasingam D, Carson LE, De Pascalis L, Fallon V, Hartley JM, Montgomery E, Newburn M, Wilson CA, Harrold JA, Howard LM, Sandall J, Magee LA, Sheen KS, Silverio SA. A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build. Front Glob Womens Health 2024; 5:1347388. [PMID: 38449695 PMCID: PMC10915094 DOI: 10.3389/fgwh.2024.1347388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/08/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered. Methods A consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy. Results The synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice. Discussion The evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision.
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Affiliation(s)
- Leanne Jackson
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Mari Greenfield
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, United Kingdom
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Elana Payne
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Karen Burgess
- Petals: The Baby Loss Counselling Charity, Cambridge, United Kingdom
| | - Munira Oza
- The Ectopic Pregnancy Trust, London, United Kingdom
| | - Claire Storey
- International Stillbirth Alliance, Bristol, United Kingdom
| | - Siân M. Davies
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Kaat De Backer
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Flora E. Kent-Nye
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Sabrina Pilav
- Centre for Research in Psychology and Sport Sciences, Health and Wellbeing Research, The University of Hertfordshire, Hatfield, United Kingdom
| | - Semra Worrall
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Laura Bridle
- HELIX Service, Maternal Mental Health Services, King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Nina Khazaezadeh
- Chief Midwifery Office, NHS England—London Region, London, United Kingdom
| | - Daghni Rajasingam
- Maternity Services, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Lauren E. Carson
- Section of Women’s Mental Health, School of Mental Health & Psychological Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Research Development, UK Biobank, Manchester, United Kingdom
| | - Leonardo De Pascalis
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Julie M. Hartley
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Elsa Montgomery
- Division of Methodologies, Department of Midwifery, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, United Kingdom
| | - Mary Newburn
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Claire A. Wilson
- Section of Women’s Mental Health, School of Mental Health & Psychological Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Joanne A. Harrold
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Louise M. Howard
- Section of Women’s Mental Health, School of Mental Health & Psychological Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jane Sandall
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Laura A. Magee
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Kayleigh S. Sheen
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Social Sciences, College of Health, Science and Society, University of the West of England Bristol, Bristol, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
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France-Ratcliffe M, Hopkins ND, Low DA, Cocks MS, Jones H, Sheen KS, Sprung VS. Perceptions of Antenatal Exercise in Pregnant Females and the Impact of COVID-19. Int J Environ Res Public Health 2022; 19:10635. [PMID: 36078351 PMCID: PMC9518533 DOI: 10.3390/ijerph191710635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/11/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Exercise during pregnancy presents many benefits for the mother and baby. Yet, pregnancy is characterised by a decrease in exercise. Studies have reported barriers to antenatal exercise. The coronavirus (COVID-19) pandemic may have further exacerbated barriers to antenatal exercise as pregnant females faced many challenges. Rich, in-depth exploration into pregnant female's perceived barriers to antenatal exercise during COVID-19 is imperative. Questionnaires reporting physical activity levels were completed by all participants (n = 14). Semi-structured interviews were conducted between November 2020 and May 2021 in the UK. Interviews were analysed using thematic analysis and revealed four main themes: 'Perceptions of being an active person shaping activity levels in pregnancy', 'How do I know what is right? Uncertainty, seeking validation and feeling informed', 'Motivators to antenatal exercise' and 'A process of adaptations and adjustment'. Findings indicate that the COVID-19 pandemic exacerbated barriers to antenatal exercise and highlight the importance of direct psychosocial support and clear, trustworthy information. Findings also support the fundamental need for better education amongst healthcare professionals regarding antenatal exercise.
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Affiliation(s)
- Madeleine France-Ratcliffe
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Nicola D. Hopkins
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - David A. Low
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Matthew S. Cocks
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Helen Jones
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Kayleigh S. Sheen
- Faculty of Health, School of Psychology, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Victoria S. Sprung
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
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