The social and healthcare professional support drawn upon by women antenatally during the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis

Midwifery, Год журнала: 2024, Номер 133, С. 103995 - 103995

Опубликована: Апрель 9, 2024

To explore antenatal experiences of social and healthcare professional support during different phases distancing restriction implementation in the UK. Semi-structured interviews were conducted via telephone or video-conferencing software between 13 July 2020 – 2 September 2020. Interviews transcribed a recurrent, cross-sectional, thematic analysis was conducted. Twelve women interviewed UK restrictions March (Timepoint 1; T1) separate sample twelve initial easing these May 2; T2). T1 themes were: 'Maternity care as non-essential' 'Pregnancy is cancelled'. T2 'Technology polarised tool' 'Clinically vulnerable, not clinically vulnerable? That question'. At T1, anxieties ascribed to exclusion partners from routine care, perceived insensitivity aggression public. For T2, insufficient Governmental transparency led disillusionment, confusion, anger. Covert workplace discrimination also caused distress at T2. Across timepoints: deteriorated mental wellbeing attributed depleted opportunities interact socially scaled back maternity care. Recommendations are made to: protect maternal autonomy; improve quality health signposting; prioritise parental community re-opening 'non-essential' services; option for face-to-face appointments when safe legal; protecting rights working mothers.

Язык: Английский

---

Post-Pandemic Maternity Care Planning for Vaccination: A Qualitative Study of the Experiences of Women, Partners, Health Care Professionals, and Policy Makers in the United Kingdom

Vaccines, Год журнала: 2024, Номер 12(9), С. 1042 - 1042

Опубликована: Сен. 11, 2024

Maternal vaccination during pregnancy, in general and against COVID-19 infection, offers protection to both mother baby, but uptake remains suboptimal. This study aimed explore the perceptions regarding particularly for marginalised populations those living with social or medical complexity. A total of 96 semi-structured in-depth interviews were conducted 40 women, 15 partners, 21 HCPs, 20 policy makers, across all four nations United Kingdom (UK), discussing their lived experience utilising, delivering, developing pregnancy pandemic. Three themes derived: (1) historical context, (2) communication information guidance, (3) appraisal action. Together these captured participants' legacy mistrust drugs pregnancy; prior positive experiences; concerns about missing information, conflicting false vaccines; confusing guidance pregnant women. The final theme describes behaviour actions undertaken consequent experiences available information. findings suggest efforts improve may be best focused on personalised trusting relationship other vaccines, outside positively influenced vaccination.

Язык: Английский

---

COVID‐19 in pregnancy

The Obstetrician & Gynaecologist, Год журнала: 2025, Номер 27(1), С. 43 - 56

Опубликована: Янв. 1, 2025

Key content COVID‐19 is known to be associated with significant morbidity for pregnant women and their babies. This susceptibility adverse clinical outcomes may the unique physiological characteristics of host. Public health measures recommended management prevention critical in pregnancy lactation evolved during 2020 pandemic; some decisions were controversial. We highlight lessons learnt considerations future pandemic preparedness. Learning objectives To outline pathology pregnancy, including placental involvement. summarise current evidence‐based signpost resources updates. discuss role vaccines reduce mortality existing novel SARS‐CoV‐2 viral strains. Ethical issues Sustained international collaborative strategies are crucial ensure global equity access treatment communicable diseases.

Язык: Английский

---

Implementation of national guidelines on antenatal magnesium sulfate for neonatal neuroprotection: extended evaluation of the effectiveness and cost-effectiveness of the National PReCePT Programme in England

BMJ Quality & Safety, Год журнала: 2025, Номер unknown, С. bmjqs - 017763

Опубликована: Апрель 27, 2025

Background Since 2015, the National Institute for Health and Care Excellence (NICE) guidelines have recommended antenatal magnesium sulfate (MgSO 4 ) mothers in preterm labour (<30 weeks’ gestation) to reduce risk of cerebral palsy (CP) baby. However, implementation this guideline clinical practice was slow, MgSO use varied between maternity units. In 2018, PRrevention Cerebral PreTerm (PReCePT) programme, an evidence-based quality improvement (QI) intervention improve , rolled out across England. Earlier evaluation found programme be effective cost-effective over first 12 months. We extended original determine programme’s longer-term impact years, its later births, COVID-19 pandemic, compare England (where PReCePT implemented) Scotland Wales it not). Methods Quasi-experimental longitudinal study using data from Neonatal Research Database on babies born <30 gestation admitted a Service neonatal unit. Primary outcome percentage eligible receiving aggregated national level. Impact estimated multivariable linear regression. The net monetary benefit (NMB) estimated. Results administration rose 65.8% 2017 85.5% 2022 associated with 5.8 points uptake (95% CI 2.69 8.86, p<0.001). Improvement greater when including older births (<34 gestation, 8.67 points, 95% 6.38 10.96, Most gains occurred 2 years following implementation. had NMB £597 000 89% probability being cost-effective. Following implementation, English appeared accelerate compared Wales. There some decline coinciding onset pandemic. Conclusions QI cost-effectively improved anticipated benefits who been protected CP.

Язык: Английский

---

Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: a qualitative study

BMC Pregnancy and Childbirth, Год журнала: 2024, Номер 24(1)

Опубликована: Авг. 9, 2024

Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, management of complications, including is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed way in which maternity gynaecological care was delivered, as health systems moved to rapidly reconfigure re-organise services, aiming reduce risk spread SARS-CoV-2 infection. PUDDLES international collaboration investigating pandemic's impact on for people suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women losses during pandemic, about how they navigated healthcare system its restrictions, were supported.

Язык: Английский

---

Healthcare providers’ experiences of maternity care service delivery during the COVID-19 pandemic in the United Kingdom: a follow-up systematic review and qualitative evidence synthesis

Frontiers in Global Women s Health, Год журнала: 2024, Номер 5

Опубликована: Ноя. 28, 2024

During the COVID-19 pandemic, there was substantial reconfiguration of maternity care services, affecting both users and healthcare providers (HCPs), in United Kingdom (UK) globally.

Язык: Английский

---

Implementation of national guidelines on antenatal magnesium sulfate for neonatal neuroprotection in England, Scotland and Wales: Extended evaluation of the effectiveness and cost-effectiveness of the National PReCePT Programme

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2024, Номер unknown

Опубликована: Июль 16, 2024

ABSTRACT Background Since 2015, UK national guidelines have recommended antenatal magnesium sulfate (MgSO 4 ) for mothers in preterm labour (<30 weeks’ gestation) to reduce the risk of cerebral palsy baby. However, implementation this guideline clinical practice was slow, and MgSO use varied between maternity units. In 2018, PReCePT programme, an evidence-based Quality Improvement intervention improve , rolled-out across England. Earlier evaluation found programme be effective cost-effective over first 12 months. We extended original determine programme’s longer-term impact four years, its later births, COVID-19 pandemic, compare England, Scotland, Wales. Methods Quasi-experimental longitudinal study using data from National Neonatal Research Database on babies born <30 gestation admitted NHS neonatal unit. Primary outcome proportion eligible receiving aggregated level. Impact estimated multivariable linear regression. The net monetary benefit (NMB) estimated. Results administration rose 65.8% 2017 85.5% 2022 associated with 5.8 percentage points improvement uptake (95%CI 2.69 8.86, p<0.001). greater when including older births (<34 gestation, 8.67 points, 95%CI 6.38 10.96, Most gains occurred two years following implementation. had a NMB £597,000 89% probability being cost-effective. Following implementation, English appeared accelerate compared Scotland There some decline coinciding onset pandemic. Conclusions cost-effectively improved benefits who been protected palsy. What is already known topic Antenatal sulphate reduces preterm. Programme (NPP) effectively England months but sustaining quality improvements time often challenging. adds Using quasi-experimental design routinely collected, longitudinal, patient-level data, that NPP sustained effectiveness cost-effectiveness may accelerated Wales, where not formally implemented. How might affect research, or policy This demonstrates dedicated programmes can achieve perinatal care. model could used as blueprint other initiatives

Язык: Английский

---

Oscillating autonomy: a grounded theory study of women’s experiences of COVID-19 infection during pregnancy, labour and birth, and the early postnatal period

BMC Pregnancy and Childbirth, Год журнала: 2024, Номер 24(1)

Опубликована: Июль 29, 2024

Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The pandemic caused unprecedented disruption to everyday life. This included major reconfiguration maternal, child, perinatal mental care services provision. study aimed investigate the experiences those who tested during pregnancy, labour birth, or early postnatal period. National on-line recruitment from across United Kingdom resulted in sixteen mothers being invited qualitative semi-structured interviews understand had been infected by Interviews were conducted, recorded, transcribed using video-conferencing software. A Grounded Theory approach used analyse data gathered pertaining women's their diagnosis theory 'Oscillating Autonomy – Losing Seeking Regain Control Striving Agency' developed, comprising three main themes: 'Anxious Anticipation: fear infection worse than itself'; 'Fluctuating Agency: What changed when took control'; 'Reclaiming Control: reassurance positivity'. whilst pregnant, period a perceived loss control. Those able regain that control felt more secure situation. Support paramount manage increased vulnerability, as achieved information seeking action including monitoring vaccination.

Язык: Английский

---

The RESILIENT Study of post-pandemic maternity care planning: A qualitative research protocol for in-depth interview with women, partners, healthcare professionals, and policy makers.

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Июль 29, 2024

Maternity care is a core service provision of any healthcare system, delivering for women and birthing people, their wider family units. During the SARS-CoV-2 pandemic, much maternity was reconfigured with aim continuing which could not otherwise be re-scheduled or delayed, but in-line infection control measures instituted through social physical distancing. The RESILIENT Study designed to investigate impact COVID-19 pandemic pandemic-related reconfigurations delivery. It particularly concerned experiences minority ethnic groups those medical complexity. One our specific objectives during from perspective people; fathers, partners, non-gestational parents; professionals; policy makers use in-depth interviews. We will analyse data on virtual care, self-monitoring, vaccination (each using thematic framework analysis); care-seeking experience (using template building an ethical future grounded theory analysis). This focus this protocol. Our findings about receipt, provision, planning complement existing literature broad, on: individual patients, NHS providers, policies, society.

Язык: Английский

---

Freedom for some, but not for Mum: the reproductive injustice associated with pandemic ‘Freedom Day’ for perinatal women in the United Kingdom

Frontiers in Public Health, Год журнала: 2024, Номер 12

Опубликована: Авг. 7, 2024

Introduction Healthcare services for pregnant and postpartum (‘perinatal’) women were reconfigured significantly at the advent duration of SARS-CoV-2 pandemic, despite United Kingdom announcing ‘Freedom Day’ on 19 July 2021 (whereafter all legal lockdown-related restrictions lifted), to maternity (antenatal, intrapartum, postnatal) remained. This study presents data from eight perinatal about their experiences psychosocial wellbeing care in post-‘Freedom epoch. Methods Semi-structured interviews conducted virtually, with recorded, transcribed, analysed by hand. Grounded theory analysis was employed final assessing reproductive injustice pandemic Day’. Results Analysing iteratively inductively led four emergent themes: ‘A Failing System, Women’; ‘Harm Caused a State Difference’; ‘The Privileges (Not Rights) Reproductive Autonomy, Agency, Advocacy’; ‘Worried Women Marginalised Mothers’. Together, these themes form some, but not Mum’. Discussion experienced lack high-quality reliable information vaccination against virus, changes to, decision-making surrounding, care. recognised healthcare professionals stretched that failing often reported hostility staff abandonment times when they unsure how navigate The most singular disparity between having accept continuing freedom whilst receiving (reckless) being enacted general public.

Язык: Английский

---