Quantitative — describe, quantify and explain

For all pregnancies, study the impact on maternity care quality (effectiveness, safety, and acceptability), maternal and offspring outcomes, and costs within the context of service configurations, particularly: virtual consultations; out-of-office monitoring (e.g. patient-reported blood pressure); and Covid-19 vaccination (provision, uptake, and adverse events).

Using routinely-collected, linked maternity, mental health, and offspring data from the eLIXIR platform (~35,000 records) from South London. Segmented and individual-level multivariate regression analysis.

Social science — enrich understanding

In-depth interviews with up to 105 pregnant/postpartum women, partners, care providers and policymakers with lived experience of maternity services during the pandemic, with a focus on those from ethnic minority groups, with medical/mental health co-morbidities, or living with social complexity.

Also questionnaires administered nationally (~43,000 maternity service users) via the Covid Symptom Study (CSS) Biobank to understand vaccine uptake, hesitancy and side effects.

Stakeholder engagement — policy action

Regional listening events (‘Imagining our best future’) in each UK nation to assess WP1 and WP2 findings, brainstorm and prioritise high-impact future actions, and understand barriers to implementation. Followed by a National Policy Lab (‘co-production for action’) to produce an ‘Imagine our best future’ report.

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Service users and south London community

31 South London service users with experience of maternity care during the pandemic joined interviews or focus groups. Minority ethnic group members and those living with social or medical complexity were represented. Concerns about digital poverty prompted inclusion of relevant support in the budget.

Networks and engagement organisations

Collaborative working with voluntary sector organisations, social media networks, individual women, and the ARC South London Maternity and Perinatal Mental Health PPIE Advisory Group.

PPIE Advisory Group

Met every four months to assist information-sharing and facilitate research co-production. Members synthesise PPIE results, write PPIE sections of reports and blogs, and contribute to the design of guides.

Support and learning

Trauma-informed ways of working accomplished through training with Birth Companions Charity. Group pre-meetings and personal follow-up provided for service users’ comfort.

Impact and governance

Core team reported back at each Advisory Group meeting on how feedback influenced the research. PPIE voices appropriately resourced, regularly reviewed and reported on.