The first study looking at women’s perceptions of COVID-19 and their healthcare experiences in the UK was a qualitative thematic analysis published in BMC Pregnancy and Childbirth.
In May 2020, Karavadra et al (2020) developed a questionnaire and advertised it widely, through the BBC website, Twitter and other online media. They were looking to hear from women who were currently pregnant or had already given birth during the pandemic.
So what did they find?
Here is the authors’ summary of the results:
“One thousand four hundred fifty-one participants replied to the online questionnaire. Participants provided significant insight into the perceived barriers to seeking healthcare during this pandemic. These include ‘not wanting to bother anyone’, ‘lack of wider support from allied healthcare workers’ and the influence of the media. Other concerns included the use of virtual clinics antenatally and their acceptability to patients, the presence of birthing partners, and the way in which information is communicated about rapidly changing and evolving services. The influence of the media has also had a significant impact on the way women perceive hospital care in light of COVID-19 and for some, this has shaped whether they would seek help.” Karavadra et al (2020)
Some of these findings deserve to be looked at a bit more closely. Virtual consultations, for instance, were not popular: “whilst participants understood why these measures were in place, 62% felt that this provided ‘impersonal care’ and it affected how much information they disclosed to their healthcare worker.” Karavadra et al (2020).
Even more negative experiences for Black and Brown women
I was particularly concerned to read the authors’ words about the experiences of Black and Brown women.
“Whilst the number of participants from BAME backgrounds was only 6%, the information they provided in terms of barriers to health in particular was striking. They explained the perceived ‘stigma’ they experienced when seeking medical or midwifery experience. For one reason or another, this group of participants detailed negative experiences with healthcare workers and felt they were ‘not taken seriously’.” Karavadra et al (2020)
Care in labour
The findings which relate to intrapartum (in labour) care are also troubling. Although, if you have even glanced at social media over the past months, I doubt you will be surprised by them.
“Partner presence was the most common theme discussed for intrapartum care. Participants explained that they were worried about partners not being allowed to be present at all during labour or during active labour only. They were also worried about ‘being alone’ should there be an intrapartum problem.” Karavadra et al (2020)
Women were also worried about being told they needed more intervention if they were found to have COVID-19. They were worried that they might be denied the opportunity to birth in water and the fear of separation from their baby at birth was also a common theme. A number of women were concerned about going to hospital and sought information about homebirth as an option.
Why this is important
There are a couple of linked reasons why this study was important, although I think it is unlikely that I will have to spell these out to most readers of this website. The first is that, while pretty much anybody working with parents-to-be already knows these things, they need to be kept at the forefront of others’ minds. That is because – despite amazing efforts by some health care practitioners and birth workers – disproportionate COVID-related restrictions remained in place for parents on pregnancy and birth journeys, and some of these were not appropriate or measured, and clearly caused harm.
Karavadra B, Stockl A, Prosser-Snelling E et al. Women’s perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom. BMC Pregnancy Childbirth 20, 600 (2020). You can read the full study here
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