Almost nine in ten maternity services experienced a decline in emergency pregnancy appointments during the pandemic due to women avoiding healthcare providers amid coronavirus chaos, a study has found.
The Royal College of Obstetricians and Gynaecologists, who carried out the research, said women refrained from attending appointments due to anxiety around going into a hospital and fears of overwhelming the NHS, as well as not being clear if the appointments were essential.
Researchers found 70 per cent of maternity services reported a reduction in antenatal appointments, while 60 per cent of units stopped the option of giving birth at home or in a midwife-led unit. Over half of services said postnatal appointments after childbirth had been reduced.
The findings come as maternity services warn staff must not be sent to work in other parts of the hospital in the wake of a second wave of coronavirus.
Royal College of Obstetricians & Gynaecologists and the Royal College of Midwives, who together represent the overwhelming bulk of maternity staff, say there must not be a repeat of the acute and widespread maternity staff shortages which played out during the health emergency’s peak.
Professor Asma Khalil, consultant obstetrician at St George’s University Hospitals NHS Foundation Trust who is the report’s lead author, said: “We don’t yet know what the full impact of these emergency service modifications has been on women and their families but this data will be invaluable in understanding the potential indirect effects of Covid-19 on pregnancy outcomes, over and above any direct impact from the virus itself, including potential delays in accessing care because of concerns of transmission.”
The latest research, published in BJOG: An International Journal of Obstetrics and Gynaecology, is based on a poll of 81 obstetric units, which constitutes 42 per cent of the 194 units in the UK. Those polled were asked about their experiences of using services during April when the country was at the peak of the coronavirus crisis.
Dr Edward Morris, president of the Royal College of Obstetricians & Gynaecologists, said: “Maternity services are ‘front door’, essential services. Inpatient maternity services provide care that is largely unscheduled or urgent, with workloads difficult to anticipate in advance. Maternity staff cannot be replaced by other staff groups due to their specialist skillset and protecting this workforce is, therefore, crucial to ensure that maternity care can be sustained.
“We are acutely aware how difficult restrictions on birth partners attending maternity services have been for women and families throughout the pandemic.
“With increasing prevalence of the virus in many areas and a growing number of local lockdowns and restrictions, services are likely to reluctantly need to maintain some of these restrictions for some time to come. However, we know that all services are prioritising enabling birth partners to attend labour and birth and as many key appointments, including scans, as possible.”
A poll of senior midwives previously found the shortage of midwives on NHS maternity units has doubled since the Covid-19 crisis erupted.
Tara Kaufmann, of national pregnancy charity, Maternity Action, told The Independent: “The Covid pandemic has been hard for everyone, and not least women undergoing pregnancy with reduced NHS services, and sometimes labour and birth without the support of their partners.”
Maria Booker, of Birthrights, which campaigns for respectful pregnancy care, told The Independent they strongly backed the call for maternity staff not to be redeployed to other parts of healthcare services as coronavirus cases rise.
She said: “It was a call made by Birthrights back in March. We also welcome the recognition by the Royal Colleges of how crucial it is for individuals to give birth in the best place for them including at home, or in a midwifery-led unit. The last six months have shown that pregnant women make their own judgements about what they feel is safe and disengage if services can't meet their needs.
“Maternity services rightly want women to trust them and feel safe in their care. However, women and birthing people need reassurance that services will listen to then, and meet their individual needs, including welcoming partners/supporters unless there is a compelling reason not to.”
It comes after The Independent recently reported nine in 10 women say their maternity choices were changed due to the Covid-19 emergency.
Make Birth Better, a campaign group which polled 458 pregnant women for a new study they shared exclusively, said mothers-to-be have been forced to give birth without partners and have had less access to pain relief in the wake of the public health crisis. While almost half of women who were dependant on support from a specialist mental health midwife said help had stopped.
Gill Walton, chief executive of the Royal College of Midwives, said: “Maternity services are open, and have been throughout the pandemic, and midwives are ready to support the women in their care in the most appropriate way. It is so important that if women have any worries at all about themselves or their baby, day or night, whatever day of the week and whatever is going on with Covid, that they contact their maternity services.”