Continuing care in Covid-19 outbreak: A global survey of new and expectant parent experiences [COCOON]
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28 July 2020 — adopted June 2020 • completed 2022
Continuing care in Covid-19 outbreak: A global survey of new and expectant parent experiences
The experiences of pregnancy and parenthood during the COVID-19 pandemic were very different to how they were before. Significant changes were made to the way maternity care was delivered to ensure pregnancy, birth, and the postpartum period were managed safely with minimal risk of viral transmission.
What was not yet known was the psycho-social impact of COVID-19 on new parents through pregnancy, into parenthood — and also on parents whose babies were stillborn or died in the immediate days after birth.
This study aimed to better understand the experiences of these parents during the COVID-19 pandemic, and to inform strategies to improve care for women and their families during this or any future similar outbreak.
The death of a baby before or soon after birth is a highly distressing outcome for parents, families and healthcare providers. The quality of bereavement care can have lasting consequences for parents’ wellbeing.
Background to the study
This research study is a global initiative to investigate the experiences of pregnant and postpartum women, and their partners, accessing maternity care during the global COVID-19 pandemic. King’s College London led the UK arm of the study. It was led internationally by the Centre of Research Excellence in Stillbirth, Australia.
Preliminary research found pregnant women were:
Concerned with their birth plan given urban and quarantine constraints
Avoiding visiting healthcare providers due to concerns about coronavirus exposure
Worried about postpartum care such as breastfeeding, vaccinations and neonatal screening
Given the rapid progressive spread of COVID-19, it was important to address the potential outcomes for both mothers and partners, and to identify areas where care could be improved.
Project aims
To understand the impact of COVID-19 on pregnant and postpartum women and their partners in order to identify areas where care can be improved during the current COVID-19 outbreak and if such outbreaks happen in the future
To undertake an online global survey to identify the main concerns, experiences, and psychosocial responses of pregnant and postpartum women and their partners during the COVID-19 outbreak
How the research was carried out
This was a cross-sectional study of women and partners who were pregnant or in the postpartum period during the COVID-19 pandemic outbreak (from 30 January 2020 onwards). Eight parent surveys were delivered online via Qualtrics software:
| Survey A | Pregnant women |
| Survey B | Postpartum women |
| Survey C | Partners during pregnancy |
| Survey D | Partners during postpartum period |
| Survey E | Bereaved mothers — stillbirth |
| Survey F | Bereaved partners — stillbirth |
| Survey G | Bereaved mothers — neonatal death |
| Survey H | Bereaved partners — neonatal death |
More information
The study was led by the Centre of Research Excellence in Stillbirth, Australia, with King’s College London as a collaborating partner. It was adopted by ARC South London in June 2020 and was completed in 2022.
Complete the global COCOON survey to share your experiences of maternity care during the pandemic.
Meet the team
 Professor Jane Sandall CBE Theme lead; professor of social science and women’s health, King’s College London; midwife and NIHR Senior Investigator |
 Sergio A. Silverio Research associate in social science of women’s health, King’s College London |
If you have been affected by pregnancy loss or the death of a baby, support is available from:
- Sands — stillbirth and neonatal death charity
- The Miscarriage Association
- Tommy’s — pregnancy complication research and support
Related content
- →
The experiences of parents who suffer pregnancy loss and whose babies die during the pandemic (PUDDLES) - →
The changing maternity care study: How has virtual and remote care changed maternity care practices during Covid-19? - →
Post-pandemic planning for maternity care across the four nations (RESILIENT study) - →
Maternity and perinatal mental health research at ARC South London
Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.