Royal College of Midwives, London, United Kingdom.
National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom.
Midwifery. 2022 Sep;112:103390. doi: 10.1016/j.midw.2022.103390. Epub 2022 Jun 1.
The COVID-19 pandemic required all healthcare systems to adapt quickly. There is some evidence about the impact of the pandemic on United Kingdom maternity services overall, but little is known about the impact on midwifery-led services, including midwifery units and home birth services.
To describe changes to midwifery-led service provision in the United Kingdom and the Channel Islands during the COVID-19 pandemic.
Three national surveys were circulated using the United Kingdom Midwifery Study System (UKMidSS) and the Royal College of Midwives (RCM) Heads and Directors of Midwifery Network. The UKMidSS surveys took place in wave 1 (April to June 2020) and in wave 2 (February to March 2021). The RCM survey was conducted in April 2020.
The response rate to the UKMidSS surveys was 84% in wave 1 and 70% in wave 2, while 48% of Heads and Directors of Midwifery responded to the RCM survey. Around 60% of midwifery units reported being open as usual in wave 1, with the remainder affected by closures. Fewer unit closures (15%) were reported in the wave 2 survey. Around 40% of services reported some reduction in home birth services in wave 1, compared with 15% in wave 2. The apparent impact of the pandemic varied widely across the four nations of the United Kingdom and within the English regions.
The pandemic led to increased centralisation of maternity care and the disruption of midwifery-led services, especially in the first wave. Further research should focus on the reasons behind closures, the regional variation and the impact on maternity care experience and outcomes.
COVID-19 大流行要求所有医疗保健系统迅速做出调整。有一些证据表明大流行对英国整体产妇服务产生了影响，但对于助产士主导服务（包括助产士单位和家庭分娩服务）的影响知之甚少。
描述 COVID-19 大流行期间英国和海峡群岛的助产士主导服务提供的变化。
使用英国助产士研究系统（UKMidSS）和皇家助产士学院（RCM）的助产士主管和主任网络，分发了三项全国性调查。UKMidSS 调查分别于 2020 年 4 月至 6 月（第 1 波）和 2021 年 2 月至 3 月（第 2 波）进行。RCM 调查于 2020 年 4 月进行。
UKMidSS 第 1 波调查的回复率为 84%，第 2 波为 70%，而 RCM 调查的助产士主管和主任的回复率为 48%。约 60%的助产士单位报告在第 1 波中照常开放，其余单位受到关闭的影响。第 2 波调查报告的单位关闭减少（15%）。在第 1 波调查中，约有 40%的服务报告家庭分娩服务有所减少，而在第 2 波调查中则为 15%。大流行的明显影响在英国的四个国家和英格兰地区之间差异很大。
大流行导致产妇护理的集中化程度提高，并且中断了助产士主导的服务，尤其是在第 1 波。进一步的研究应重点关注关闭的原因、区域差异以及对产妇护理体验和结果的影响。
