P13 How have UK maternal health services change in response to the COVID-19 pandemic? – A systematic review

• Published in: Journal of epidemiology and community health (1979) Vol. 75; no. Suppl 1; p. A49
• Main Authors: Beetham, Hannah, Hurt, Lisa, Copeland, Lauren
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.09.2021
• Subjects: Anesthesia; Coronaviruses; COVID-19; Obstetrics; Pandemics; Pregnancy; Systematic review; United Kingdom > UK
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2021-SSMabstracts.103

RationaleMany expectant and new mothers have been impacted by the restructuring of maternal services that has occurred in response to the pandemic. Although there is hopefully an end in sight, restrictions may continue for some months. It is therefore important to assess the changes that have occurred, in order to prevent further harm to mothers, or to realise and implement any positive changes permanently. Aim: To analyse the different ways in which antenatal, obstetric, and postnatal services in the UK have adapted to the COVID-19 pandemic.MethodsKey-word searches were used to systematically scope three databases for papers that reported on any aspect of maternal care or services and COVID-19 until 03/12/2020. In total, 2,299 papers’ titles and abstracts were screened according to pre-set eligibility criteria. Half were double-screened by a second researcher, and discrepancies were discussed between three researchers until resolved. Full-text screening (n=344) excluded papers that weren’t relevant, or didn’t include primary data. Excluded papers and papers that the lead researcher flagged for a second opinion were checked by a second researcher. At this point, the decision was made to focus on UK services, due to the high number of papers. Next steps will be to extract data from the final sample of papers (n=12) and appraise their quality. Narrative synthesis will form a coherent report on how services in the UK have changed.ResultsPreliminary results show that there have been shifts in some maternal services towards virtual delivery. Additionally, there has been a change in the number of antenatal and postnatal appointments, including the number and nature of antenatal emergency presentations. There has also been a reduction in the care choices available to pregnant women, including changes to birth plans. Furthermore, there have been changes to obstetric unit layouts and care delivery, including changes to the rates of C-sections and general anaesthesia. Additional results will be submitted before the June 28th.Population Health RelevanceThis review is expected to highlight some interesting changes that have occurred in UK maternal services since the beginning of the pandemic. Some may have changed maternal services for the better, while others may highlight some difficulties that new mothers have faced, and will be important to address in case of continuing restrictions or future pandemics. Further research will focus on qualitatively assessing the experiences of new mothers during the pandemic, to gain first-hand insights into how they were affected by the changes.