Maternal and Infant Nutrition & Nurture group, School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
Research in Childbirth and Health group, School of Community Health and Midwifery, University of Central Lancashire, Preston, UK.
BMJ Open. 2022 Jan 11;12(1):e051965. doi: 10.1136/bmjopen-2021-051965.
To explore stakeholders' and national organisational perspectives on companionship for women/birthing people using antenatal and intrapartum care in England during COVID-19, as part of the Achieving Safe and Personalised maternity care In Response to Epidemics (ASPIRE) COVID-19 UK study.
Maternity care provision in England.
Interviews were held with 26 national governmental, professional and service-user organisation leads (July-December 2020). Other data included public-facing outputs logged from 25 maternity Trusts (September/October 2020) and data extracted from 78 documents from eight key governmental, professional and service-user organisations that informed national maternity care guidance and policy (February-December 2020).
Six themes emerged: 'Postcode lottery of care' highlights variations in companionship and visiting practices between trusts/locations, 'Confusion and stress around 'rules'' relates to a lack of and variable information concerning companionship/visiting, 'Unintended consequences' concerns the negative impacts of restricted companionship or visiting on women/birthing people and staff, 'Need for flexibility' highlights concerns about applying companionship and visiting policies irrespective of need, ''Acceptable' time for support' highlights variations in when and if companionship was 'allowed' antenatally and intrapartum and 'Loss of human rights for gain in infection control' emphasises how a predominant focus on infection control was at a cost to psychological safety and human rights.
Policies concerning companionship and visiting have been inconsistently applied within English maternity services during the COVID-19 pandemic. In some cases, policies were not justified by the level of risk, and were applied indiscriminately regardless of need. There is an urgent need to determine how to sensitively and flexibly balance risks and benefits and optimise outcomes during the current and future crisis situations.
作为 Achieving Safe and Personalised maternity care In Response to Epidemics (ASPIRE) COVID-19 UK 研究的一部分，探讨利益相关者和英国国家组织对 COVID-19 期间使用产前和产时护理的女性/分娩者陪伴的看法。
英格兰的产妇护理服务提供。
2020 年 7 月至 12 月，对 26 名国家政府、专业和服务用户组织领导进行了访谈。其他数据包括 25 家产科信托机构记录的面向公众的产出（2020 年 9 月/10 月）和从 8 个关键政府、专业和服务用户组织提取的 78 份文件的数据，这些文件为国家产妇护理指南和政策提供了信息（2020 年 2 月至 12 月）。
出现了六个主题：“护理的邮政编码彩票”突出了信托/地点之间陪伴和探视做法的差异，“规则周围的困惑和压力”涉及陪伴/探视缺乏和可变信息，“意外后果”涉及限制陪伴或探视对妇女/分娩者和工作人员的负面影响，“灵活性的必要性”强调了不顾需要而应用陪伴和探视政策的问题，“支持的可接受时间”突出了陪伴是否“允许”在产前和产时的差异，“为控制感染而丧失人权”强调了主要关注感染控制如何以牺牲心理安全和人权为代价。
在 COVID-19 大流行期间，英国产妇服务中的陪伴和探视政策应用不一致。在某些情况下，政策没有得到风险水平的证明，并且不论需要如何，不加区分地应用。目前迫切需要确定如何在当前和未来的危机情况下，敏感而灵活地平衡风险和收益，优化结果。
