Social Justice and the City: The New ‘Liberal Formulation’

INTRODUCTION: Pregnancy is a crucial period which ultimately directly impacts two individuals health and wellbeing. Within the UK, a standardised pattern of care is established with collaborations across disciplines to the benefit of women and babies. During the COVID19 pandemic, this pattern of care was disrupted to align with protective protocols which until now, has not been formally reported. METHODS: A retrospective, mixed methods study of UK based women pregnant between the years 2012 and 2022 inclusive with no known complications was conducted to collate opinions and experiences of pregnancy with and without the impact of COVID19 restrictions. Quantitative results were analysed using the statistical package GraphPad Prism 9.2.0 and presented as mean values +/- standard deviation were appropriate. In addition, we used a phased approach to open ended questions. RESULTS: Our results showed no significant difference in either the number of appointments or the time of first appointment however an increased percentage of women reported the use of private services during the COVID pandemic. There was no change in the number of midwife appointments during the postnatal period during COVID but there was a significant reduction in the number of health visitor appointments. Overall, the COVID pandemic led to women feeling less satisfied with their care both during their pregnancy and postnatally, but they reported that they continued to be listened to and remained feeling in control of their pregnancy. DISCUSSION: Generally, the changes implemented during the COVID pandemic did not impact women’s pregnancy journey substantially although we have no evidence of the long-term impact on child health and development. Clear themes have been established which can be used to further improve services in maternity and there are key elements to focus on for the future of UK maternity services.