Making maternity and neonatal care personalised in the COVID-19 pandemic: Results from the Babies Born Better survey in the UK and the Netherlands

  1. Lauri M. M. van den Berg
  2. Naseerah Akooji
  3. Gill Thomson
  4. Ank de Jonge
  5. Marie-Clare Balaam
  6. Anastasia Topalidou
  7. Soo Downe
  8. on behalf of the ASPIRE COVID-19 research team

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Abstract

The COVID-19 pandemic had a severe impact on women’s birth experiences. To date, there are no studies that use both quantitative and qualitative data to compare women’s birth experiences before and during the pandemic, across more than one country.

Aim

To examine women’s birth experiences during the COVID-19 pandemic and to compare the experiences of women who gave birth in the United Kingdom (UK) or the Netherlands (NL) either before or during the pandemic.

Method

This study is based on analyses of quantitative and qualitative data from the online Babies Born Better survey. Responses recorded by women giving birth in the UK and the NL between June and December 2020 have been used, encompassing women who gave birth between 2017 and 2020. Quantitative data were analysed descriptively, and chi-squared tests were performed to compare women who gave birth pre- versus during pandemic and separately by country. Qualitative data was analysed by inductive thematic analysis.

Findings

Respondents in both the UK and the NL who gave birth during the pandemic were as likely, or, if they had a self-reported above average standard of life, more likely to rate their labour and birth experience positively when compared to women who gave birth pre-pandemic. This was despite the fact that those labouring in the pandemic reported a lack of support and limits placed on freedom of choice. Two potential explanatory themes were identified in the qualitative data: respondents had lower expectations of care during the pandemic, and they appreciated the efforts of staff to give individualised care, despite the rules.

Conclusion

Our study implies that many women labouring during the COVID-19 pandemic experienced restrictions, but their experience was mitigated by staff actions. However, personalised care should not be maintained by the good will of care providers, but should be a priority in maternity care policy to benefit all service users equitably.

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  1. Version published to 10.1371/journal.pone.0267415
  2. ScreenIT

    SciScore for 10.1101/2022.04.11.22273702: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethics statement: In the Netherlands the study was submitted to the Medical Ethics Review Committee of the VU University Medical Centre (reference number 2020.255).
    Consent: All the participants gave informed consent before they started the survey.
    Sex as a biological variableData collection: The B3 survey has been run since February 2014, with an overall response to date of over 97,000 women in 25 languages from 86 countries [15-19].
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations of this study: The strengths of our study include the large number of responses to the B3 survey both before and after the pandemic, the ability to compare birth experiences between two European countries with similar social structures, and the use of both quantitative and qualitative data. The combination of methods gave us the opportunity to explain some of the unexpected findings in the quantitative data. As far as we are aware there are no other published studies to date that can make this comparison for women using childbirth services before and after the pandemic. Furthermore, our team consisted of people from a range of different disciplines, which contributed to investigator triangulation and therefore the trustworthiness of the results. However, our study has some limitations. Since the data were downloaded from the survey platform in December 2020, more women who gave birth during COVID-19 responded soon after their birth than women who gave birth pre-pandemic. This might have led to different levels of recall bias between the two groups. Although memory for the actual events of labour and birth is generally stable over time, there is some evidence that affective memories may become less positive, particularly if the labour or birth were difficult [44]. Furthermore, we used a convenience sampling method since we disseminated the survey online. Our results are therefore relevant to women who have similar characteristics to those in our sampl...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.04.11.22273702v1 on medRxiv