The changing maternity care study: How has virtual and remote care changed maternity care practices during Covid-19?

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Adopted project
4 August 2020 — adopted June 2020 • completed December 2020

The changing maternity care study: How has virtual and remote care changed maternity care practices during Covid-19?

The Covid-19 pandemic forced dramatic changes to the way routine healthcare services were able to deliver care.

Maternity care was heavily affected, with:

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Reduced face-to-face appointments

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Limited or no homebirth facilities

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Reduced continuity of carer and rise in virtual appointments

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Restrictions on support persons at antenatal appointments, birth, and on postnatal wards

This study aimed to better understand the experiences of women who gave birth during the COVID-19 pandemic and maternity healthcare professionals delivering their care.

Background to the study

The COVID-19 pandemic posed an additional risk factor to maternal morbidity and mortality. The risk for pregnant women infected with COVID-19 remained unknown at the time. Reports included preterm birth and stillbirth associated with severe maternal illness, but effects on the growing foetus were not fully understood. Co-morbidities also remained unexplored — although outside of pregnancy, hypertension was reported to be a risk factor for COVID-19-related morbidity and mortality.

The pandemic also posed additional risk to healthcare professionals who continued to work to deliver routine care in hospital and community settings. Given the nature of maternity care, professionals would usually have regular contact with pregnant women, their partners, and their children — requiring substantial adaptation to new ways of working.

Disproportionate impact on BAME communities

People from Black, Asian, and Minority Ethnic backgrounds were known to be at increased risk of contracting more severe symptoms associated with COVID-19, and more likely to die from the virus. The study was especially interested in how BAME maternity professionals experienced working to deliver maternity care during the pandemic.

Project aims

Understand how COVID-19 may interact with hypertension and other mental and physical co-morbidities during pregnancy

Evaluate the influence of the virus on the risk of adverse maternal and foetal/newborn outcomes

Describe the lived experience of this unique population during the pandemic

Understand how COVID-19 has changed the delivery of maternity care in south London

Describe the lived experience of healthcare professionals working to deliver maternity care during the pandemic

How the research was carried out

This was a cross-sectional qualitative study of women who gave birth in south London during the COVID-19 pandemic (since March 2020 onwards). Two groups were interviewed:

👶‍♀️ Women who gave birth

Interviewed about how their antenatal care changed, what birth was like during the pandemic, and their experiences of the postnatal period and being a new mum.

👔 Maternity healthcare professionals

Interviewed about changes to antenatal care delivery, their experience of delivering babies with PPE, and delivering postnatal care to new mothers during the pandemic.

The study sought to find out what women and healthcare professionals thought was good about maternity care during the pandemic, which procedures might be advisable to keep, and what they did not like about the care they received or delivered.

Meeting the needs of the diverse population of south London

South London is home to one of the UK’s most diverse populations and houses some of the most deprived postcodes in the capital. Previous research had shown Black, Asian, and Minority Ethnic women and babies, and those with high levels of social complexity and/or deprivation, are more likely to have worse outcomes during pregnancy and after birth.

This study built on a programme of work to better understand these outcomes and recommend improvements to health services and care to strive for better outcomes for BAME women and babies, as well as those living with high levels of social complexity.

More information

The study was led by the Department of Women & Children’s Health at King’s College London and was funded by King’s College London via a King’s Together Seed Fund grant. It was adopted by ARC South London in June 2020 and was completed by December 2020.

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Take part in this research

To take part, please email: Maternity-Studies@kcl.ac.uk

Funded by King’s College London via a King’s Together Seed Fund grant. Adopted by ARC South London in June 2020. Completed December 2020.