Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: A qualitative study

Sergio A. Silverio; Rhiannon George-Carey; Maria Memtsa; Flora E. Kent-Nye; Laura Magee; Kayleigh S. Sheen; Karen Burgess; Munira Oza; Claire Storey; Jane Sandall; The PUDDLES UK Collaboration; Abigail Easter; Peter von Dadelszen; Davor Jurković

doi:10.1186/s12884-024-06721-7

Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: A qualitative study

Sergio A. Silverio^*, Rhiannon George-Carey, Maria Memtsa, Flora E. Kent-Nye, Laura Magee, Kayleigh S. Sheen, Karen Burgess, Munira Oza, Claire Storey, Jane Sandall, The PUDDLES UK Collaboration, Abigail Easter, Peter von Dadelszen, Davor Jurković

^*Corresponding author for this work

Women & Children's Health

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic’s impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported.

Methods: In-keeping with a qualitative research design, In-depth semi-structured interviews were undertaken with an opportunity sample of women (N=32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women’s access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic.

Results: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal.

Conclusions: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.

Original language	English
Article number	522
Pages (from-to)	1-16
Number of pages	1
Journal	BMC Pregnancy and Childbirth
Volume	24
Issue number	522
DOIs	https://doi.org/10.1186/s12884-024-06721-7
Publication status	Published - 9 Aug 2024

Keywords

Early pregnancy
Pregnancy loss
miscarriage
ectopic pregnancy
molar pregnancy
pregnancy of unknown location
termination of pregnancy
abortion
qualitative research
COVID-19
SARS-CoV-2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Silverio et al., (2024) - PUDDLES-EPL Experiences of EarlyPregnancy Loss Care - BMC Pregnancy and ChildbirthFinal published version, 1.08 MBLicence: CC BY

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Silverio, S. A., George-Carey, R., Memtsa, M., Kent-Nye, F. E., Magee, L., Sheen, K. S., Burgess, K., Oza, M., Storey, C., Sandall, J., The PUDDLES UK Collaboration, Easter, A., von Dadelszen, P., & Jurković, D. (2024). Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: A qualitative study. BMC Pregnancy and Childbirth, 24(522), 1-16. Article 522. https://doi.org/10.1186/s12884-024-06721-7

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title = "Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: A qualitative study",

abstract = "Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic{\textquoteright}s impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported.Methods: In-keeping with a qualitative research design, In-depth semi-structured interviews were undertaken with an opportunity sample of women (N=32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women{\textquoteright}s access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic.Results: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal.Conclusions: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.",

keywords = "Early pregnancy, Pregnancy loss, miscarriage, ectopic pregnancy, molar pregnancy, pregnancy of unknown location, termination of pregnancy, abortion, qualitative research, COVID-19, SARS-CoV-2",

author = "Silverio, {Sergio A.} and Rhiannon George-Carey and Maria Memtsa and Kent-Nye, {Flora E.} and Laura Magee and Sheen, {Kayleigh S.} and Karen Burgess and Munira Oza and Claire Storey and Jane Sandall and {The PUDDLES UK Collaboration} and Amy Sampson and Leonie Haddad and Elana Payne and Laura Sambrook and Venetia Goodhart and Abigail Easter and {von Dadelszen}, Peter and Davor Jurkovi{\'c}",

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year = "2024",

month = aug,

day = "9",

doi = "10.1186/s12884-024-06721-7",

language = "English",

volume = "24",

pages = "1--16",

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Silverio, SA, George-Carey, R, Memtsa, M, Kent-Nye, FE, Magee, L, Sheen, KS, Burgess, K, Oza, M, Storey, C, Sandall, J, The PUDDLES UK Collaboration, Easter, A , von Dadelszen, P & Jurković, D 2024, 'Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: A qualitative study', BMC Pregnancy and Childbirth, vol. 24, no. 522, 522, pp. 1-16. https://doi.org/10.1186/s12884-024-06721-7

TY - JOUR

T1 - Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic

T2 - A qualitative study

AU - Silverio, Sergio A.

AU - George-Carey, Rhiannon

AU - Memtsa, Maria

AU - Kent-Nye, Flora E.

AU - Magee, Laura

AU - Sheen, Kayleigh S.

AU - Burgess, Karen

AU - Oza, Munira

AU - Storey, Claire

AU - Sandall, Jane

AU - The PUDDLES UK Collaboration

AU - Sampson, Amy

AU - Haddad, Leonie

AU - Payne, Elana

AU - Sambrook, Laura

AU - Goodhart, Venetia

AU - Easter, Abigail

AU - von Dadelszen, Peter

AU - Jurković, Davor

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/8/9

Y1 - 2024/8/9

N2 - Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic’s impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported.Methods: In-keeping with a qualitative research design, In-depth semi-structured interviews were undertaken with an opportunity sample of women (N=32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women’s access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic.Results: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal.Conclusions: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.

AB - Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic’s impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported.Methods: In-keeping with a qualitative research design, In-depth semi-structured interviews were undertaken with an opportunity sample of women (N=32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women’s access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic.Results: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal.Conclusions: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.

KW - Early pregnancy

KW - Pregnancy loss

KW - miscarriage

KW - ectopic pregnancy

KW - molar pregnancy

KW - pregnancy of unknown location

KW - termination of pregnancy

KW - abortion

KW - qualitative research

KW - COVID-19

KW - SARS-CoV-2

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U2 - 10.1186/s12884-024-06721-7

DO - 10.1186/s12884-024-06721-7

M3 - Article

SN - 1471-2393

VL - 24

SP - 1

EP - 16

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

IS - 522

M1 - 522

ER -

Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: A qualitative study

Abstract

Keywords

UN SDGs

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Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic

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