The United Kingdom and the Netherlands maternity care responses to COVID-19: A comparative study |
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| Affiliation: | 5. University of Central Lancashire, UK;6. Newcastle upon Tyne Hospitals NHS Foundation Trust, UK;7. University of Manchester, UK;8. Amsterdam University Medical Center, UK;9. University of Southampton, UK;10. NHS England and NHS Improvement North West, UK;11. Royal Free Teaching Hospital in London, UK;12. Birthrights, UK;13. Kings College London, UK;14. The University of Nottingham, UK;15. East Lancashire Hospitals NHS Trust, UK;p. FivexMore, UK;q. MVP BAME Group, UK;r. The Miscarriage Association, UK;s. RCM, UK;t. International Confederation of Midwives (ICM), UK;u. Postnatal Care, UK;v. Royal College of Obstetricians and Gynaecologists (RCOG), UK;w. Fathers Included/Family Included/The Family Initiative, UK;x. Neighbourhood Midwives, UK;y. University of Liverpool, UK;z. National Maternity Voices, UK;11. SANDS, UK;12. Burnet Institute, Australia;13. National Perinatal Epidemiology Unit (NPEU), UK;14. University College London, UK;15. London Ambulance Service Trust, UK;16. NHS England, UK;17. Grace in Action, UK;18. Twins Trust, UK;19. UCL & City University, UK;110. Midwifery Unit Network, UK;111. RCM Scotland, UK;112. BirthWise NI, UK;113. British Maternal and Fetal Medicine Society, UK;114. Birth Trauma Association, Australia;1. Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, The Netherlands;2. School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, UK;3. Research Centre of Midwifery Science Maastricht, Zuyd University, The Netherlands;4. Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Reproduction and Development, The Netherlands |
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| Abstract: | BackgroundThe national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom (UK) and the Netherlands (NL) have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how similarities and differences occurred in these two contexts could inform optimal care in normal circumstances, and during future crises.AimTo compare the UK and Dutch COVID-19 maternity and neonatal care responses in three key domains: choice of birthplace, companionship, and families in vulnerable situations.MethodA multi-method study, including documentary analysis of national organisation policy and guidance on COVID-19, and interviews with national and regional stakeholders.FindingsBoth countries had an infection control focus, with less emphasis on the impact of restrictions, especially for families in vulnerable situations. Differences included care providers’ fear of contracting COVID-19; the extent to which community- and personalised care was embedded in the care system before the pandemic; and how far multidisciplinary collaboration and service-user involvement were prioritised.ConclusionWe recommend that countries should 1) make a systematic plan for crisis decision-making before a serious event occurs, and that this must include authentic service-user involvement, multidisciplinary collaboration, and protection of staff wellbeing 2) integrate women’s and families’ values into the maternity and neonatal care system, ensuring equitable inclusion of the most vulnerable and 3) strengthen community provision to ensure system wide resilience to future shocks from pandemics, or other unexpected large-scale events. |
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| Keywords: | COVID-19 Maternal Health Services Newborn Care Infection Control United Kingdom Netherlands Policy Drivers |
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