Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Warwick Medical School, University of Warwick, University Road, Coventry CV4 7AL, UK.
Women Birth. 2024 Feb;37(1):240-247. doi: 10.1016/j.wombi.2023.10.006. Epub 2023 Oct 29.
COVID-19 impacted negatively on maternity care experiences of women and staff. Understanding the emergency response is key to inform future plans.
Before the COVID-19 pandemic, experts highlighted concerns about UK community postnatal care, and its impact on long-term health, wellbeing, and inequalities. These appear to have been exacerbated by the pandemic.
To explore community postnatal care provision during and since the pandemic across a large diverse UK region.
A descriptive qualitative approach. Virtual semi-structured interviews conducted November 2022-February 2023. All regional midwifery community postnatal care leaders were invited to participate.
11/13 midwifery leaders participated. Three main themes were identified: Changes to postnatal care (strategic response, care on the ground); Impact of postnatal care changes (staff and women's experiences); and Drivers of postnatal care changes (COVID-19, workforce issues).
Changes to postnatal care during the pandemic included introduction of virtual care, increased role of Maternity Support Workers, and moving away from home visits to clinic appointments. This has largely continued without evaluation. The number of care episodes provided for low and high-risk families appears to have changed little. Those requiring additional support but not deemed highest risk appear to have been most impacted. Staffing levels influenced amount and type of care provided. There was little inter-organisation collaboration in the postnatal pandemic response.
Changes to postnatal care provision introduced more efficient working practices. However, evaluation is needed to ensure ongoing safe, equitable and individualised care provision post pandemic within limited resources.
COVID-19 对女性和医护人员的孕产护理体验产生了负面影响。了解应急响应措施对于制定未来计划至关重要。
在 COVID-19 大流行之前，专家就对英国社区产后护理及其对长期健康、幸福感和不平等的影响表示担忧。这些问题似乎因大流行而加剧。
探索在英国一个多样化的大区中，大流行期间及之后的社区产后护理服务提供情况。
采用描述性定性方法。2022 年 11 月至 2023 年 2 月期间进行了虚拟半结构式访谈。邀请所有区域助产士社区产后护理负责人参与。
13 名助产士负责人中的 11 名参与了研究。确定了三个主要主题：产后护理的变化（战略应对、实地护理）；产后护理变化的影响（员工和妇女的体验）；以及产后护理变化的驱动因素（COVID-19、劳动力问题）。
大流行期间产后护理的变化包括引入虚拟护理、增加产妇支持工作者的角色，以及从家访转向诊所预约。这种情况在很大程度上仍在继续，而没有进行评估。为低风险和高风险家庭提供的护理次数似乎变化不大。那些需要额外支持但不属于最高风险的人似乎受到的影响最大。人员配备水平影响了护理的数量和类型。在大流行期间的产后护理响应中，各组织之间几乎没有协作。
产后护理服务提供方式的改变引入了更高效的工作模式。然而，在资源有限的情况下，需要进行评估以确保在大流行后继续提供安全、公平和个性化的护理。
