Affiliations
1 Amsterdam University Medical Centre, Vrije
Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam
Public Health, Amsterdam, the Netherlands
2 School of Community Health & Midwifery, Faculty of
Health and Care, University of Central Lancashire, Preston, United
Kingdom
The coronavirus (COVID-19) pandemic has resulted in rapid changes in
many areas of health care worldwide.1 Some
organisational and governance controls on innovation have been relaxed,
to enable rapid adaptation to changing circumstances. The speed of
innovation raises a range of ethical, governance and organisational
issues. It is important to assess what changes have been instituted,
which ones should be maintained, and how to encourage effective
innovations in future. Maternity care provides an exemplar case within
the broader health care setting, given the imperative to provide both
safe and personalised care for optimal outcomes. Some pandemic-related
changes in maternity services, such as restricting women’s opportunities
for companionship during ultrasound scans or throughout labour, or
limiting parental visiting to neonatal units, have been associated with
psychological harm.2 Other changes provide more
positive impacts, including reports of more individualised and efficient
care associated with the increased use of
telemedicine.3 We undertook a documentary analysis of
national policy and service-user organisation responses to the pandemic
in the United Kingdom (UK) and the Netherlands (NL), as part of the
Achieving Safe and Personalised Maternity Care In Response to Epidemics
(ASPIRE COVID-19) study. The overall aim of ASPIRE COVID-19 is to
identify ‘what works’ in providing maternity care during the current and
future pandemics, or similar health crises. The NL was chosen as the
comparator to the UK because there were known differences in the
organisation of maternity services during the COVID-19 pandemic between
the two countries, especially for place of birth. Here we report on
activities described as new or expanded innovations in 290 documents
produced by seventeen key professional and service-user organisations in
the NL and the UK between February and December 2020 (see Table 1). We
included strategic papers, guidelines, protocols, and updates for health
care professionals, such as newsletters.
Table 1 Professional and service-user organisations (n=number of
collected documents)