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

Objective 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. Design National survey. Setting UK maternity services during the COVID-19 pandemic. Population or sample Healthcare professionals working within maternity services. Methods 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. Main outcome measures Service modifications made during the pandemic. Results 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. Conclusions 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. Tweetable abstract A national survey showed that UK maternity services were modified extensively and heterogeneously in response to COVID-19.

Automated summary

This study investigated the modifications to maternity services in the UK during the COVID-19 pandemic, finding that there were reductions in antenatal and postnatal appointments, with a high percentage utilizing remote consultation methods. Changes in screening pathways for gestational diabetes mellitus and the temporary removal of home births or midwife-led unit births were also reported. Overall, the study highlighted the extensive impact of the pandemic on maternity services.