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

Abortion COVID-19 Early pregnancy Ectopic pregnancy Miscarriage Molar pregnancy Pregnancy loss Pregnancy of unknown location Qualitative research SARS-CoV-2 Termination of pregnancy

Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
09 Aug 2024
Historique:
received: 10 11 2023
accepted: 26 07 2024
medline: 10 8 2024
pubmed: 10 8 2024
entrez: 9 8 2024
Statut: epublish

Résumé

Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic's impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported. In-keeping with a qualitative research design, in-depth semi-structured interviews were undertaken with an opportunity sample of women (N = 32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women's access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic. All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal. These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.

Sections du résumé

BACKGROUND BACKGROUND
Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic's impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported.
METHODS METHODS
In-keeping with a qualitative research design, in-depth semi-structured interviews were undertaken with an opportunity sample of women (N = 32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women's access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic.
RESULTS RESULTS
All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal.
CONCLUSIONS CONCLUSIONS
These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.

Identifiants

pubmed: 39123186
doi: 10.1186/s12884-024-06721-7
pii: 10.1186/s12884-024-06721-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

522

Investigateurs

Amy Sampson (A)
Leonie Haddad (L)
Elana Payne (E)
Laura Sambrook (L)
Venetia Goodhart (V)

Informations de copyright

© 2024. The Author(s).

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Auteurs

Sergio A Silverio (SA)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. Sergio.Silverio@kcl.ac.uk.

Rhiannon George-Carey (R)

Gynaecology Services, Royal London Hospital, Barts Health NHS Trust, London, UK.

Maria Memtsa (M)

Gynaecology Service, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK.
Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, School of Life and Medical Sciences, University College London, London, United Kingdom.

Flora E Kent-Nye (FE)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Laura A Magee (LA)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Kayleigh S Sheen (KS)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
Department of Social Sciences, College of Health, Science & Society, University of the West of England Bristol, Bristol, UK.

Karen Burgess (K)

Petals: The Baby Loss Counselling Charity, Cambridge, UK.

Munira Oza (M)

The Ectopic Pregnancy Trust, London, UK.

Claire Storey (C)

Patient and Public Involvement and Engagement Group for Perinatal Bereavement, Trauma, & Loss, King's College London, London, UK.

Jane Sandall (J)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Abigail Easter (A)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Peter von Dadelszen (P)

Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Davor Jurković (D)

Gynaecology Diagnostic and Treatment Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals NHS Foundation Trust, London, UK.
Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, School of Life and Medical Sciences, University College London, London, United Kingdom.

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