Silverio, SA, George-Carey, R, Memtsa, M, Kent-Nye, FE, Magee, LA, Sheen, KS, Burgess, K, Oza, M, Storey, C, Sandall, J, Easter, A, von Dadelszen, P, Jurković, D, Sampson, A, Haddad, L, Payne, E, Sambrook, L and Goodhart, V (2024) 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, 24 (1). pp. 1-16. ISSN 1471-2393

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Abstract

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: 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: 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: 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.

Item Type:	Article
Uncontrolled Keywords:	Early pregnancy; Pregnancy loss; Miscarriage; Ectopic pregnancy; Molar pregnancy; Pregnancy of unknown location; Termination of pregnancy; Abortion; Qualitative research; COVID-19; SARS-CoV-2; PUDDLES UK Collaboration; Humans; Abortion, Spontaneous; Bereavement; Pregnancy; Qualitative Research; Adult; Maternal Health Services; Health Services Accessibility; Female; Young Adult; United Kingdom; COVID-19; SARS-CoV-2; Abortion; COVID-19; Early pregnancy; Ectopic pregnancy; Miscarriage; Molar pregnancy; Pregnancy loss; Pregnancy of unknown location; Qualitative research; SARS-CoV-2; Termination of pregnancy; Humans; Female; COVID-19; Pregnancy; Qualitative Research; Adult; Abortion, Spontaneous; United Kingdom; SARS-CoV-2; Health Services Accessibility; Maternal Health Services; Bereavement; Young Adult; Health Services; Conditions Affecting the Embryonic and Fetal Periods; Infectious Diseases; Infertility; Coronaviruses Disparities and At-Risk Populations; Emerging Infectious Diseases; Pregnancy; Pediatric; Women's Health; Coronaviruses; Clinical Research; Contraception/Reproduction; Maternal Health; 8.1 Organisation and delivery of services; Infection; Reproductive health and childbirth; 3 Good Health and Well Being; Humans; Female; COVID-19; Pregnancy; Qualitative Research; Adult; Abortion, Spontaneous; United Kingdom; SARS-CoV-2; Health Services Accessibility; Maternal Health Services; Bereavement; Young Adult; 1110 Nursing; 1114 Paediatrics and Reproductive Medicine; 1117 Public Health and Health Services; Obstetrics & Reproductive Medicine
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RG Gynecology and obstetrics
Divisions:	Psychology (from Sep 2019)
Publisher:	BioMed Central
SWORD Depositor:	A Symplectic
Date Deposited:	17 Jan 2025 13:52
Last Modified:	17 Jan 2025 14:00
DOI or ID number:	10.1186/s12884-024-06721-7
URI:	https://researchonline.ljmu.ac.uk/id/eprint/25314

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