Companionship for women/birthing people using antenatal and intrapartum care in England during COVID-19: a mixed-methods analysis of national and organisational responses and perspectives. Issue 1 (11th January 2022)

• Record Type: Journal Article
• Authors: Thomson, Gill; Balaam, Marie-Claire; Nowland (Harris), Rebecca; Crossland, Nicola; Moncrieff, Gill; Heys, Stephanie; Sarian, Arni; Cull, Joanne; Topalidou, Anastasia; Downe, Soo
• Other Names: author non-byline.; Downe Soo author non-byline.; Ellison George author non-byline.; Fenton Alan author non-byline.; Heazell Alexander author non-byline.; Jonge Ank de author non-byline.; Kingdon Carol author non-byline.; Matthews Zoe author non-byline.; Severns Alexandra author non-byline.; Thomson Gill author non-byline.; Topalidou Anastasia author non-byline.; Wright Alison author non-byline.; Akooji Naseerah author non-byline.; Balaam Marie-Clare author non-byline.; Cull Joanne author non-byline.; Berg Lauri van den author non-byline.; Crossland Nicola author non-byline.; Feeley Claire author non-byline.; Franso Beata author non-byline.; Heys Steph author non-byline.; Moncrieff Gill author non-byline.; Nowland Rebecca author non-byline.; Sarian Arni author non-byline.; Booker Maria author non-byline.; Sandall Jane author non-byline.; Thornton Jim author non-byline.; Lynskey-Wilkie Tisian author non-byline.; Wilson Vanessa author non-byline.; Abe Rebecca author non-byline.; Awe Tinuke author non-byline.; Adeyinka Toyin author non-byline.; Bender-Atik Ruth author non-byline.; Brigante Lia author non-byline.; Brione Rebecca author non-byline.; Cadée Franka author non-byline.; Duff Elizabeth author non-byline.; Draycott Tim author non-byline.; Fisher Duncan author non-byline.; Francis Annie author non-byline.; Franx Arie author non-byline.; Frith Lucy author non-byline.; Griew Louise author non-byline.; Harmer Clea author non-byline.; Homer Caroline author non-byline.; Knight Marian author non-byline.; Lokugamage Amali author non-byline.; Mansfield Amanda author non-byline.; Marlow Neil author non-byline.; Mcaree Trixie author non-byline.; Monteith David author non-byline.; Reed Keith author non-byline.; Richens Yana author non-byline.; Rocca-Ihenacho Lucia author non-byline.; Ross-Davie Mary author non-byline.; Talbot Seana author non-byline.; Taylor Myles author non-byline.; Treadwell Maureen author non-byline.;
• Is Part Of: BMJ open. Volume 12:Issue 1(2022)
• Publication Date: 2022-01-11
• Subjects: gynaecology -- organisational development -- risk management -- public health -- qualitative research; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-051965
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To explore stakeholders' and national organisational perspectives on companionship for women/birthing people using antenatal and intrapartum care in England during COVID-19, as part of the Achieving Safe and Personalised maternity care In Response to Epidemics (ASPIRE) COVID-19 UK study. Setting: Maternity care provision in England. Participants: Interviews were held with 26 national governmental, professional and service-user organisation leads (July–December 2020). Other data included public-facing outputs logged from 25 maternity Trusts (September/October 2020) and data extracted from 78 documents from eight key governmental, professional and service-user organisations that informed national maternity care guidance and policy (February–December 2020). Results: Six themes emerged: 'Postcode lottery of care' highlights variations in companionship and visiting practices between trusts/locations, 'Confusion and stress around 'rules'' relates to a lack of and variable information concerning companionship/visiting, 'Unintended consequences' concerns the negative impacts of restricted companionship or visiting on women/birthing people and staff, 'Need for flexibility' highlights concerns about applying companionship and visiting policies irrespective of need, ''Acceptable' time for support' highlights variations in when and if companionship was 'allowed' antenatally and intrapartum and 'Loss of human rights for gain in infection control' emphasises how a predominant focus on infection control was at a cost to psychological safety and human rights. Conclusions: Policies concerning companionship and visiting have been inconsistently applied within English maternity services during the COVID-19 pandemic. In some cases, policies were not justified by the level of risk, and were applied indiscriminately regardless of need. There is an urgent need to determine how to sensitively and flexibly balance risks and benefits and optimise outcomes during the current and future crisis situations.