Why do we need this research?
Inequalities in social and economic conditions before the COVID-19 pandemic contributed to the unequal experiences and outcomes around healthcare for individuals from different communities, so it is important to understand whether experiences of NHS maternity care are similarly unequal. The pandemic affected the ways in which many people could access and use maternity services, with significant impact for healthcare professionals, pregnant women and their birth partners, and it is unclear whether these changes have increased or decreased inequalities for those using these services.
What are the aims of this study?
The study will examine the impact that the COVID-19 pandemic has had on the way maternity services are delivered and the health and wellbeing of mothers, babies and families relating to these service changes. The overarching aim is to inform policymakers, commissioners and service managers can develop a fairer and more robust maternity service post-pandemic to reduce inequalities in maternity care.
The service changes of particular interest are virtual maternity care conducted by video link or telephone, mothers monitoring their own blood pressure or blood glucose levels and COVID-19 vaccination. Across these three areas, the study will see whether service changes increased or decreased existing inequalities in maternity care, paying particular attention to women and families from minority ethnic groups and those who experienced complicated pregnancies.
What will the researchers do?
The study consists of three different pieces of work (‘work packages’).
Work package 1 will use existing maternity and mental health records, collected as part of care in south London. These include details of how maternity care changed in the pandemic, such as virtual care, mothers monitoring their own blood pressure, and acceptance of COVID-19 vaccination. This will allow researchers to compare changes in care and the consequences of this for different groups.
Work Package 2 will collect more information from across the UK. It will do this in two ways. Firstly, the researchers will undertake interviews with women and families from minority ethnic groups and those who experienced complicated pregnancies, and health service leaders and policymakers, to gather views on the changes to maternity services that have occurred and their effects on maternity care. Secondly, those women who are also using the King’s College London COVID Symptom Study app will be invited to join the COVID Symptom Study Biobank and share their views on COVID-19 vaccination, pregnancy outcomes and mental health.
Lastly, Work Package 3 will consist of ‘listening events’ held in each of the four UK nations, and a national ‘Policy Lab’ workshop, to involve women and families, healthcare professionals and policymakers in developing a plan to shape future maternity services by working together to agree recommendations for future policy and action.
A patient and public involvement advisory group is working with the research team throughout the study. They will help the researchers produce plain-language reports and share the findings locally, regionally, and nationally across the UK, through webinars, social media and online.
What do we expect the study to find?
This work will inform the care of more than 600,000 UK pregnant women each year, and at least as many who are planning pregnancies. The aim is to make improvements in maternity care and services for maternity service-users (including partners and family members), NHS maternity care commissioners and providers, policymakers and implementers of digitally-enabled care and commercial innovation and more cost-effective care and/or lower costs.
Additional information:
Lead researcher – Professor Laura Magee
Institution – King’s College London
Funder – National Institute for Health Research (NIHR)
Duration – November 2021 – October 2023
Find out more on the RESILIENT study website.
