Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care.

J Jardine,E Morris,T Draycott,A Khalil,S Relph,P Von Dadelszen,M Ross‐Davie,La Magee

doi:10.1111/1471-0528.16547

Abstract

To explore the modifications to maternity services across the UK, in response to the coronavirus disease 2019 (COVID-19) pandemic, in the context of the pandemic guidance issued by the Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM) and NHS England. National survey. UK maternity services during the COVID-19 pandemic. Healthcare professionals working within maternity services. A national electronic survey was developed to investigate local modifications to general and specialist maternity care during the COVID-19 pandemic, in the context of the contemporaneous national pandemic guidance. After a pilot phase, the survey was distributed through professional networks by the RCOG and co-authors. The survey results were presented descriptively in tabular and graphic formats, with proportions compared using chi-square tests. Service modifications made during the pandemic. A total of 81 respondent sites, 42% of the 194 obstetric units in the UK, were included. They reported substantial and heterogeneous maternity service modifications. Seventy percent of units reported a reduction in antenatal appointments and 56% reported a reduction in postnatal appointments; 89% reported using remote consultation methods. A change to screening pathways for gestational diabetes mellitus was reported by 70%, and 59% had temporarily removed the offer of births at home or in a midwife-led unit. A reduction in emergency antenatal presentations was experienced by 86% of units. This national survey documents the extensive impact of the COVID-19 pandemic on maternity services in the UK. More research is needed to understand the impact on maternity outcomes and experience. A national survey showed that UK maternity services were modified extensively and heterogeneously in response to COVID-19.

Highlights

81 respondent sites, 42% of 194 obstetric units in the UK, were included. They reported substantial and heterogeneous maternity service modifications. 70% of units reported a reduction in antenatal appointments and 56% in postnatal appointments; 89% reported using remote consultation methods. 70% reported a change to screening pathways for gestational diabetes mellitus. 59% had temporarily removed the offer of births at home or in a midwife-led unit. 86% of units experienced a reduction in emergency antenatal presentations
This national survey documents the extensive impact of the COVID-19 pandemic on maternity services in the UK
The SARS-CoV-2 coronavirus that causes COVID-19 was first identified in the UK on 29 January 2020.1 2 The ensuing pandemic mandated urgent modifications to the National Health Service (NHS), responding to anticipated staffing shortages,[3,4,5] a possible surge in patients requiring critical care,[6 7] and the need to reduce face-to-face contact to minimise the risk of nosocomial transmission of SARS-CoV-2

Summary

Introduction

The SARS-CoV-2 coronavirus that causes COVID-19 was first identified in the UK on 29 January 2020.1 2 The ensuing pandemic mandated urgent modifications to the National Health Service (NHS), responding to anticipated staffing shortages,[3,4,5] a possible surge in patients requiring critical care,[6 7] and the need to reduce face-to-face contact to minimise the risk of nosocomial transmission of SARS-CoV-2. In response to the SARS-CoV-2 pandemic situation in the UK, the Royal College of Obstetricians and Gynaecologists (RCOG) urgently convened a COVID-19 guidance development team, which included input from the Royal College of Midwives (RCM), Royal College of Paediatrics and Child Health (RCPCH) and Royal College of Anaesthetists (RCoA), on 4 March 2020 This resulted in publication of version 1 of the guidance document ‘Coronavirus (COVID-19) Infection in Pregnancy’ on 9 March 2020, intended to support clinicians providing maternity care for pregnant women during the pandemic; version 10.1 of this document was published 19 June 2020.10 All previous versions are available from the RCOG upon request. There has been a parallel suite of RCOG, RCM and NHS-England guidance and frameworks advising maternity units on suitable modifications to maternity services.[10,11,12]

Methods

Results

Conclusion