Leads: Dr Beck Taylor, Prof Sara Kenyon, Dr Laura Quinn (Meths)

Throughout the project, the team are working in partnership with public contributors linked to ARC WM's Maternity theme.

Dates: September 2022 - January 2024

Background:

Prior to the COVID-19 pandemic, experts had highlighted gaps and concerns about postnatal care provision, and its impact on long term health and wellbeing, and health inequalities [Bick et al. Better Births - But why not better postnatal care? Link opens in a new windowLink opens in a new window Midwifery. 2020; 80: 102574]. COVID-19 infection control measures have resulted in significant changes to the way postnatal care is delivered in the NHS (e.g. fewer face to face contacts with health professionals), and less support for women and babies in the community [Jardine J et al. Maternity services in the UK during the COVID‐19 pandemic: a national survey of modifications to standard care. Link opens in a new windowLink opens in a new window. BJOG. 2020]. There is a risk that these changes in care may reduce the quality or quantity of care, and fail to detect and treat problems, and there is concern that some of the changes to care will be continued post-pandemic without evidence of their effect [Bick D, et al. Maternal postnatal health during the COVID-19 pandemic: Vigilance is needed. Link opens in a new windowLink opens in a new window. Midwifery. 2020; 88: 102781]. To our knowledge this is the first and only study in the UK that is focused on the impact of the COVID-19 pandemic on the immediate postnatal clinical care period.

There are three programmes of work incorporated into this project including:

1. A multisite retrospective cohort study using routine national data in England (Hospital Episode Statistics) to explore maternal and neonatal postnatal readmissions during Covid-19

2. A multisite retrospective cohort study of maternal and neonatal outcomes using routine data from selected maternity units in the West Midlands using the BadgerNet electronic patient record (EPR)

3. Qualitative interviews with midwifery leaders.

Policy and Practice Partners:

Routine data collected by Hospital Episode Statistics (HES) - NHS Digital in England and Information Services Division in Scotland.

Clevermed: Five maternity units who use the electronic patient record system BadgerNet and agree for their data to be included.

Aims:

Programme 1:

To explore whether there were changes in the rates of unplanned maternal and neonatal readmissions in the 30 days post birth during the Covid-19 pandemic.

To explore changes in clinical severity of cases for maternal and neonatal readmissions in the 30 days post birth during the Covid-19 pandemic.

Programmes 2 & 3:

To identify how COVID-19 has impacted on postnatal care processes and selected outcomes.

Methods:

Programme 1:

A retrospective cohort design using routine clinical data obtained from electronic patient records to undertake a service evaluation. Data from de-identified electronic patient records from maternity services (mothers and neonates) will be used for this study. We will specifically look at the postnatal period (birth to 30 days post-partum) prior to (March 2015-March 2020) and during the Covid-19 pandemic (March 2020-March 2022). Data will be obtained from NHS England.

Programme 2:

A retrospective cohort design using routine clinical data obtained from electronic patient records on Badgernet maternity in selected maternity units.

De-identified data will be obtained from mothers and babies who give birth in five regional maternity units in the West Midlands who use BadgerNet Maternity (Clevermed) as their Electronic Patient Record (EPR) system. We will specifically look at community care during the postnatal period (birth to maximum 28 days post-partum) prior to (October 2018-March 2020) and during the Covid-19 pandemic (March 2020-March 2022).

Programme 3:

Qualitative interviews with community midwifery matrons from each of the 13 NHS trusts across the West Midlands.

Main Results:

Project underway.

Conclusions:

Forthcoming.

Implications for Implementation:

We will feedback findings to practice, to inform future changes in postnatal care.