Abstract
Antenatal care is critical since it guarantees pregnant women’s good well-being, including their unborn. Antenatal care concentrates on vital body nutrients and illnesses that might put the life of the unborn and that of the mother at risk. However, COVID-19 has increased the risk of giving birth to an unhealthy baby or one with the virus. As a result, the virus outbreak influenced antenatal care services delivery changes. In this respect, this research focused on discovering the ante-natal services accessible during the COVID-19 pandemic while finding out how consistently England women utilized them. The study used thematic analysis in deriving the results, and this involved looking for materials having data relating to antenatal care services provided during the COVID-19 pandemic and critically analyzing them to guarantee the presentation of accurate data. From the analysis of the existing study, the pandemic led to the introduction of online antenatal services, and women in England embraced the new approach.
Introduction
Antenatal care is critical in safeguarding pregnant women and their unborn, considering that it guarantees that the pregnancy does not risk the woman’s well-being and that of the fetus. In this respect, through antenatal care, women learn from skilled healthcare professionals about healthy behaviors and warning signs during pregnancy while receiving psychological, emotional, and social support during this vital time (Ali et al., 2018). This data shows that antenatal care involves educating pregnant women while monitoring their well-being. In this respect, the trained health care professionals include practitioners who have been trained and educated on ways to manage complicated and uncomplicated pregnancies. Additionally, antenatal care ensures that pregnant women access micronutrient supplements and hypertension treatment to prevent eclampsia, including tetanus immunization (WHO, 2020). In this respect, WHO presents that some of the services acquired in antenatal care include HIV testing and medications administration to prevent mother-to-child transmission in case of exposure. Additionally, pregnant women are offered malaria medications and insecticide-treated mosquito nets if they live in malaria-endemic areas.
Antenatal visits present chances of educating and providing interventions to pregnant women, and WHO (2020) recommends a minimum of 4 appointments depending on the effectiveness of contradicting model utilized in antenatal care. During the visits, healthcare practitioners focus on blood pressure, proteinuria and bacteriuria in urine, blood testing to identify severe anemia and syphilis, and height/weight measurements (Ali et al., 2018). It is estimated that 25 % of maternal deaths occur during pregnancy, with variability contradicting depending on diseases, violence, and unsafe abortions prevalent in a region (WHO, 2020). This data justifies the need to focus on antenatal care, considering that its ignorance might contribute to a high death rate among pregnant women, especially those with little knowledge of risky behaviors that pose a significant risk to their lives. Additionally, statistics show that between a third and a half of maternal deaths are attributed to hypertension, especially eclampsia and pre-eclampsia, and antepartum hemorrhage, linked to insufficient care during pregnancy (WHO, 2020). In this context, particular pre-existing conditions become severe throughout the pregnancy period. These conditions contribute to maternal and unborn complications, resulting in miscarriage and even death.
Approximately 900,000 stillbirths occur every year during the last eleven weeks of pregnancy (Lindegren et al., 2021). This data validates the existence of unborn stillbirth, and the causes include pregnancy complications and maternal infections, such as syphilis. In this context, the fetus is prone to problems restricting its growth, and to some extent, they contribute to preterm birth. Antenatal care is critical to a child’s development even after birth since some factors such as fetal alcohol syndrome and congenital infections impact the baby’s growth. The community, family, and social beliefs significantly impact well-being during pregnancy, either negatively or positively (WHO, 2020). In this respect, some communities’ culture promotes rest and exceptional food for pregnant women. However, some communities do not acknowledge pregnant women to the extent they are isolated till they give birth. In instances of traditional taboos, women might deprive of essential nutrients, contributing to deficiencies in vitamins, proteins, and iron, affecting fetus growth.
There is a need to identify and survey pregnant women and their unborn while recognizing and managing pregnancy-related complications, especially pre-eclampsia. This approach guarantees treatment and recognition of concurrent and underlying illnesses associated with pregnancy. During the care, screening for diseases and conditions such as STI, anemia, mental issues, and stress is done to guarantee the unborn well-being and that of their mother (Ali et al., 2018). Additionally, preventive measures including de-worming, tetanus toxoid immunization, and getting folic acid and iron supplements are performed to promote the health of unborn babies. Amid the coronavirus pandemic, some medical officers have argued that expectant women are at high risk of having illnesses attributable to the virus (Coxon et al., 2020). In this context, World Health Organization (WHO) has not yet developed a specific procedure for treating the virus (Coxon et al., 2020). As a result, healthcare professionals deal with the exhibiting symptoms of the virus, influencing pregnant women to be cautious about COVID transmission. Moreover, COVID-19 symptoms endanger the unborn child’s health since the virus affects the mother’s normal body functioning (Coxon et al., 2020). Therefore, it is critical to focus on ante-natal services available to women during the COVID -19 period and how consistently women in England utilize them. In this respect, the research aims to discover the ante-natal services accessible during the COVID-19 pandemic and how consistently England women used them. The objectives of the study will be;
- What are the ante-natal services available during the COVID-19 period?
- Did women in England utilize the ante-natal services, and how frequently?
Presentation and Evaluation of Data
The COVID-19 pandemic contributed to the advancement in online antenatal services for pregnant mothers, and the approach got a positive response in the U.K, including England. Chatwin et al. (2021) study investigated the experiences of those expectant mothers utilizing the National Health Service (NHS) social media-based antenatal support services at the early COVID-19 stages in the U.K. To achieve the study’s objectives, the authors designed an online survey with an open-ended question and two closed questions administered to pregnant women utilizing online services for the first three weeks after a lockdown in the U.K. The research involved 320 women, and 156 completed the questions relating to ease of contact, relative antenatal care level, information access, and frequency of use (Chatwin et al., 2021). In this case, the study involved information verification and provision, reducing and managing isolation feelings, and the impact of routine care. The authors utilized thematic analysis for analyzing open-ended responses and descriptive statistics in analyzing closed question data. The research findings showed that pregnant women embraced the social media approach in getting antenatal support and care during the coronavirus pandemic.
As a response to the COVID-19 outbreak in 2020, U.K. maternity services have changed service delivery. Stacey et al. (2021) research explored users’, as well as their spouses’, experiences in maternity services utilization during the epidemic in the North of England. The authors involved 606 respondents who completed survey questions in August 2020, and the data collected were analyzed through content analysis and descriptive analysis. The findings showed that the respondent valued support from healthcare professionals, and they felt let down and lost by the new system, in-person contact is not the same as virtual contact, and the need for psychological and emotional well-being. These findings from Stacey et al. (2021) indicated that the changes in maternity services compromised mental well-being during the critical vulnerability period. Therefore, the research implies changes in antenatal services that involved an increment in virtual contact in England due to the COVID-19 outbreak.
The COVID-19 epidemic influenced virtual antenatal care implementation to keep pregnant mothers safe, and the change was embraced by patients in the U.K, including England. Quinn et al.’s (2021) research focused on evaluating professionals’ and patient’s experiences with virtual consultations during the coronavirus epidemic to verify on fulfillment and question the quality and safety of the care received. In this research, the authors engaged 148 women who had taken part in virtual clinical appointments at the U.K. obstetric care center, and 92 people provided feedback. Moreover, the authors involved 37 healthcare professionals (HCPs) who took part in delivering virtual antenatal care clinics. The results indicated that pregnant mothers were delighted with virtual clinics, with the majority of the respondents rating their experience as good and very good. However, 83 women respondents presented that they preferred face-to-face appointments while 65 preferred virtual services. For HCPs, 39 practitioners explained that virtual clinic experiences were better than face-to-face engagements. Besides, 18 HCPs indicated that it is easy to adapt to virtual clinics and said that the approach should be executed long-term. Therefore, the epidemic influenced antenatal care digitalization in the U.K., including England, and pregnant women and healthcare practitioners demonstrated high satisfaction with the new approach.
Additionally, the COVID-19 pandemic has influenced antenatal care services delivery change, including gynecology and obstetrics services across the United Kingdom. In this context, Rimmer et al.’s (2020) study focused on disruptions of health care services due to the coronavirus epidemic. In particular, the case study concentrated on women’s health care among units in U.K.’s National Health Services. The authors’ involved junior doctors in gynecology and obstetrics, and U.K’s Audit and Research members interviewed the participants. The questionnaire included both open-ended comments and closed-ended questions, and thematic framework analysis and quantitative analysis methods were utilized to analyze the data. The results from 148 respondents, where most of the participants were in their 3-7 years of training, showed that they implemented COVID-19 protocols when providing and most units condensed face-to-face antenatal clinics (Rimmer et al., 2020). In this respect, COVID-19 influenced the healthcare sector in the U.K. to change their delivery of services, including gynecology and obstetrics, for the segment to be in line with the virus guidelines. Therefore, the coronavirus pandemic contributed to changes in delivering antenatal care services in the U.K., including England.
Additionally, the COVID-19 epidemic has an insightful blow on health care systems globally, and it is linked with adverse fetal and maternal outcomes. In this context, Townsend et al.’s (2021) research aimed at assessing the changes in maternity healthcare conditions and expectant mothers’ experiences seeking healthcare during the SARS-Cov-2 pandemic. In this respect, the study involved a meta-analysis and systematic review of studies that involved the epidemic’s effects on access, attendance, and provision of maternity services. In this respect, the authors searched information from Embase and MEDLINE per PRISMA protocols from January 2020 to April 2021 for controlled research letters and observational studies reporting primary data that compares healthcare delivery and maternity healthcare-seeking before and after the COVID-19 pandemic. Random-effects meta-analysis, incidence rate ratio (IRR), and risk ratio (R.R.) with 95% confidence intervals were utilized in combining the data. Out of 4743 citations spotted, 21 were included in the meta-analysis, while 56 were incorporated in the systematic review. The research results showed a decrease in antenatal clinic visits and unscheduled visits, although there was an increment in remote and virtual care and unscheduled attendees’ hospitalization (Townsend et al., 2021). This information indicates that there was persistency in ignorance of antenatal care and a reduction in healthcare provision during the coronavirus epidemic. The authors concluded that the findings explain the worsening pregnancy outcomes detected after the pandemic onset. The conclusions included global data implying that the U.K. was involved in the research. Therefore, the COVID-19 epidemic affected the delivery of antenatal care services, which reduced the number of pregnant women seeking prenatal services.
Additionally, COVID-19 saw ultra-rapid, radical, and universal changes in National Health Service (NHS) in U.K. maternity care. Sanders and Blaylock (2021) argue that the onset of the epidemic contributed to the stripping of various features supporting family-centered care and woman. In particular, the authors argued that services were trimmed to the lowest level required to guarantee that pregnant mothers and their unborn are safe. As a result, Sanders and Blaylock (2021) surveyed to understand the COVID-19 impact on pandemic-related services and public health messaging and changes in motherhood care users in the U.K. during the SARS-Cov-2 epidemic. The authors utilized an online survey to investigate users’ experiences of COVID-19 socially distanced and communal health messaging parenthood care services across the U.K, including England. The participants constituted mothers who had experienced pregnancy after March 2020 and the data was collected between June and September the same year, and the authors’ utilized framework analysis for open-ended answers. The research findings showed that pregnant women were happy with the adoption of a severely social distance and precautionary approach due to the pathogen, especially in an environment of tremendous uncertainty and anxiety (Sanders and Blaylock, 2021). However, the results showed that the majority of the pregnant women were aware of the negative impacts, although the service delivery changes attributed to unintentional negative consequences, including confusion over advice, missing critical clinical care, emotional trauma, and distress for women. Moreover, Sanders and Blaylock discovered that the COVID-19 restrictions had influenced women to feel that both postnatal and antenatal care is inadequate.
However, some research has indicated that the coronavirus epidemic had less effect on antenatal care, especially in the South-West of England. According to Maslin et al. (2022), the restrictive pandemic measures, including lockdowns, had unintended and intended consequences in changes in behavior and activities. As a result, the authors conducted research in South-West England and evaluated neonatal admissions before the COVID-19 pandemic and after the epidemic. The study results indicated a decrease in neonatal unit admittances from 2018 to 2020, considering that live births in 2018 were at 9.48%, while in 2020 was 8.89% (Maslin et al. 2022). Moreover, the research showed no critical difference in gestational groups, and the analysis did not identify whether the decreased rate is attributable to the SARS-Cov-2 pandemic. The study recommends discovering the lockdown effect on behavior change among pregnant women and support services.
Additionally, women have justified changes in antenatal care after the COVID-19 pandemic. In this context, Silverio et al. (2021) explored women’s experiences of motherhood service reconfiguration after the coronavirus epidemic first wave. The study utilized qualitative interviews, and the authors engaged 23 women who had derived from March 2020 to August 2020 in a maternity hospital. Slightly prepared interviews were carried out using video conferencing method. The written interviews were then analyzed ‘manually’ utilizing Microsoft Word. Later, template analysis was utilized in interpreting, analyzing, and encoding the data, and the findings were in line with the lately published national motherhood services for restructuring UK-wide reaction to pandemic. Three main arguments that appeared from the investigation included the disruption of Internal Personal Care and the Expansion of Visual Care Provision. The second involved changes in employee preferences and birth programs, and the third was related to navigation counseling services during the epidemic (Silverio et al., 2021). In the research, women reported differing views on reducing formal consultations. The amplification in remote care, particularly by phone, has not been well approved by women. In addition, women showed less dependence on health care practitioners for support instead of relying on their family.
The COVID-19 pandemic has attributed to the changes in provision of maternity services in the U.K. As a result, Jardine et al. (2021) tested the transformation of antenatal care services in U.K in response to the coronavirus 2019 epidemic. In this case, the study involved healthcare practitioners associated with prenatal services. A nationwide electronic examination was designed to scrutinize changes in specialist and conventional maternity care environments during theSARS-CoV-2 epidemic. The questions were disseminated through expert networks by RCOG and other authors, and the research results are presented in descriptive table and image formats, with comparable scales using the chi-square test (Jardine et al., 2021). The authors reported significant and varied changes to the motherhood service, with 70% of units reporting a decrease in antenatal engagements and 89% said they use remote consultation methods. This national investigation justified the significant impact of the coronavirus epidemic on prenatal services in the U.K. The authors recommended that further research is needed to understand the effects of the changes on pregnancy outcomes.
Moreover, the COVID-19 pandemic influenced the introduction of telehealth services in delivering antenatal care. In this respect, Palmer et al. (2021) intended to evaluate the efficacy and protection of telehealth in antenatal care. As a result, the authors developed and implemented a maternity care program that integrated telehealth into all types of prenatal care. Using a time-series design, the authors analyzed the health data collected regularly for all obstetricians. In addition, they have examined the effect of telehealth incorporation into pre-natal care from March 23, 2020, on all forms of high-risk and low-risk care. The authors evaluated the first three months of integrated telehealthcare from April 20 to July 26, 2020, with general care from January 1, 2018, and March 22, 2020. The main outcomes involved detection and fetal growth restrictions, gestational diabetes, and eclampsia. The second result focused on childbirth, intensive care, and premature birth. The study findings showed that of the 20, 154 maternity consultations were made available during the integrated care period while 10, 731 (53%) were administered through telehealth (Palmer et al., 2021). Overall, compared to the standard of care, no significant difference was observed in the period of integrated care in terms of the number of fetuses with limited fetal development. Therefore, telehealth Combined Care has resulted in a 50% reduction in consultation with a person without compromising the consequences of pregnancy, and this model of care can help reduce interpersonal communication during the COVID-19 epidemic.
Changes in antenatal services after the epidemic outbreak can be justified by altering diabetes management among expectant women before and during the coronavirus epidemic. In this respect, Murphy (2020) assessed before and during the lockdown diabetes treatment in pregnant women. Expectant women visit hospital clinics solely for indispensable ultrasound scans and labor and delivery, with most antenatal obstetric and diabetes visits done remotely. There are online tools for expectant mothers with type 1 diabetes (T1D), for those planning a pregnancy, and for self-management including utilizing continuous or intermittent glucose monitoring (Murphy, 2020). Lockdown effects on maternal glucose control, retinal screening procedures, and intrapartum care are all discussed. Alternative screening approaches for detecting hyperglycemia and gestational diabetes mellitus (GDM) during pregnancy are addressed. In T1D pregnancy, case studies detail the remote commencement of insulin pump analysis and mechanized insulin delivery. Therefore, video consultations are warmly appreciated, and patient experiences for women who require face-to-face encounters have vastly improved. Formal assessment of remote diabetes models, teaching and technology implementation, including women’s perspectives, will be vital even when the pandemic eases.
Moreover, scholars have researched expectant women’s insights about SARS-CoV-2 and their experiences in seeking healthcare services. For instance, Karavadra et al. (2020) invited women who were pregnant or who had given birth during the coronavirus epidemic to participate in a nationwide online study. Through public and private participation, the authors created questionnaires and advertised them through the BBC website and other online media outlets, such as Twitter, in May 2020, and the data collected was analyzed through qualitative thematic analysis. One thousand four hundred fifty-one respondents responded to an online opinion poll and provided important information related to the barriers to searching for health care during the epidemic, and the findings indicated that difficulties included ‘not wanting to bother anyone, ‘adequate support for health care professionals, and media impact (Karavadra et al., 2020). In addition, other apprehensions incorporated the utilization of pre-pregnancy clinics and their acceptance of patients, the presence of maternity partners, and how information is transmitted about changing and emerging services. The manipulation of the media has had a profound effect on the way women view antenatal care due to epidemic, and for some, this has influenced they decisions on whether they should look for help.
Coronavirus has prompted the healthcare industry to consider ways to change its performance as the risk of SARS-CoV-2 infection in health facilities is a problem for new mothers and pregnant women in need of specialist care. As a result, online care for pregnant women may be another preferred option for these women as it can provide long-term clinical consultation and pregnancy (Wu et al., 2020). Additionally, providing antenatal care online can guarantee cost-effective medical services and reduce health care inequalities due to efficiency and cost-effectiveness. However, some pregnant women might question the reliability of such online information. Therefore, it is essential to ensure online services’ quality and safety and establish a stable, mutual trust between pregnant women, obstetricians, and technologists responsible for online programs (Wu et al., 2020). In particular, the authors’ report justifies how the COVID-19 epidemic presents opportunities for the development and popularity of online prenatal care programs and challenges.
Critique of Findings
The sample size utilized in the case study raises questions in most case studies involving changes in antenatal care, how pregnant women used the services, and how frequently. For instance, Chatwin et al.’s (2021) research involved 320 women across the U.K., and only 156 individuals responded to the questions. In this case, the authors conducted research in Scotland, Northern Ireland, England, and Wales; hence, the research findings might not provide accurate data. In the 2011 census, Wales and England had 1.2 million people with a mixed population (Aspinall, 2021). This data implies that U.K. countries have a populace with different ethnic backgrounds, which means people have contradicting beliefs and values relating to social issues, including accessing antenatal care. In this context, collecting data from the U.K. implies the inclusion of many different races, justifying the inaccuracy of the results. Moreover, the U.K. had a population of 66.46 million in 2018 (Aspinall, 2021). This data explains that including 320 women who had experienced pregnancy after the COVID-19 outbreak will likely result in inefficiency in achieving the study results. In this context, 320 women participants represented less than 5 % of pregnant cases across the U.K. Therefore, the sample size of the case study exploring pregnant mothers’ experiences in utilizing social media in acquiring antenatal care services limits the accuracy of the research results.
Moreover, Rimmer et al. research focused on gathering data from junior doctors attending to pregnant women across the U.K. The case study involved participants who included gynecology and obstetrics doctors across the U.K. working in National Health Service in women’s healthcare units (Rimmer et al. 2020). In this case, focusing on junior doctors can be perceived as a significant limitation to the research findings, considering that they were a wide variety of healthcare professionals attending to pregnant mothers across the U.K. Moreover, the fact that research results are from 148 units justifies that only a few across the U.K. were engaged in the study. Besides, the research concentrated in all of the U.K, justifying that results might vary if the authors had focused on England specifically.
However, some research focused on a small geographical region, limiting the accuracy of the findings. For instance, Stacey et al. (2021) concentrated their research in the North of England and engaged 606 respondents. In this case, focusing on the North of England solely limits gathering other women’s perceptions across the country, considering that individuals have contradicting opinions on healthcare issues. Research focusing on the relationship between race and COVID-19 found that children from mixed, Asian, and Black ethnic backgrounds had a lower percentage of coronavirus tests, although they experienced a high positivity rate in England (Saatci et al., 2021). This case study justifies that contradicting races have different perceptions concerning utilizing available healthcare services in England. In most scenarios, parents play a significant role in their children’s health, considering making significant decisions for their kids. In this context, Stacey et al.’s (2021) study focusing on North England justifies that only a specific ethnic group participated in the research. Therefore, there is a high likelihood that concentrating on the whole country would have produced different results due to disparity in approaching antenatal care among other races. Therefore, focusing on a limited region in the case study limited accuracy in research findings relating to antenatal services accessible in England.
Additionally, some research focused on hospitals in the U.K., justifying that the results might differ if all healthcare centers are involved. For example, in a U.K. tertiary obstetric care center, Quinn et al.’s (2021) research focused on professional and patient experiences with virtual prenatal clinics during the COVID-19 epidemic. In particular, the case study focused on only one care center, implying that only limited persons qualifying for the research were engaged. Therefore, the results are limited to a particular area, considering that people seek medical attention at nearly accessible health centers. Only pregnant women near the U.K. tertiary obstetric care center accessed prenatal services in this context. Hence, there is a high probability that the research findings are from respondents within the same geographical region who are likely to be sharing the same social and economic status. Therefore, the results from this research might be limited to only one area, and the findings could change if data were collected from a large geographical area.
The majority of the research identified the introduction of virtual antenatal care services in the U.K., including England. For instance, Chatwin et al.’s (2021) research focused on women utilizing online services after three weeks of pandemic onset. The results indicated that the social media-based approach was well positioned in providing antenatal care. In this case, the research justified that the epidemic outbreak contributed to the utilization of social media in delivering antenatal services across the U.K. On the other hand, Stacey et al.’s (2021) case study focusing on change in maternity care services in North England identified the distinction between virtual contact and in-person contact in service delivery. This information justifies that COVID-19 led to the introduction of virtual service delivery, contributing to comparing the new approach of delivering antenatal care with pre-COVID-19 services. Moreover, the Quinn et al. (2021) case study focused on the transition from face-to-face antenatal care services to virtual care services. The research findings showed that 86 % of the participants rated their virtual experience as good and very good. In this case, the coronavirus epidemic influenced the introduction of virtual services in the U.K. Additionally, Palmer et al. (2021) identified that the COVID-19 pandemic influenced the implementation of telehealth services to guarantee antenatal care amid the epidemic. In this research, the authors discovered an increment in the utilization of telehealth conventional care after the coronavirus pandemic outbreak to enhance the safety of pregnant women and the unborn. Therefore, most research identified online services, including social media and telecommunications, in delivering antenatal care during the COVID-19 pandemic.
However, there was a disparity in the utilization of antenatal services available during COVID-19 in England since the research focused on different regions. For instance, Townsend et al. (2021) case study identified a reduction in seeking maternity healthcare globally. In this case, the authors reviewed studies focusing on maternal healthcare seeking and provision by pregnant women worldwide. Therefore, the authors might have come across disparities in responses to antenatal care through the majority of the research pinpointed reduction in maternal services. On the other hand, the changes in service delivery did not comprise pregnancy outcomes in Palmer et al. (2021) research focusing on low-cost telehealth services. In particular, the authors acknowledge the service changes deliver before COVID-19 and after COVID-19. In this respect, Palmer et al. (2021) identified a 50% reduction in in-person appointments due to the adoption of the telehealth service delivery approach. The study focused on one of the U.K. countries, Australia. The findings justify that most pregnant women embraced the new process of seeking antenatal care. Therefore, Palmer et al. (2021) results contradict those of Townsend et al. (2021), considering the latter focused on global data while the former concentrated on a specific region, a health service in Australia.
Moreover, individual contradicting personalities, cultural backgrounds, and economic statuses contributed to different findings in research relating to the adoption of the new approach to delivering antenatal care. For instance, Chatwin et al.’s (2021) research results showed that pregnant women support a social media-based approach to providing antenatal care. This research is supported by Quinn et al. (2021), which identified that 86 % of participants support virtual clinics. These respondents rated their experience with the new approach as good and very good in this case. However, Stacey et al.’s (2021) case study argues that changes in delivering maternity services comprised well-being and mental health. In this case, participants linked virtual services delivery to negative effects on health especially relating to psychological issues. Therefore, women are unlikely to adopt the changes attributed to COVID-19 due to its depressing effects. This case study is supported by Silverio et al.’s (2021) research that found that pregnant women did not endorse remote care, especially services provided through the telephone. Therefore, pregnant women have mixed reactions to adopting a new approach amid the COVID-1 crisis. The contradictions in embracement justify that people had different beliefs and perceptions of virtual services. Moreover, the economic status might have created a disparity in accessing virtual care, considering that people have some online services that require access to the internet and smartphones, which might not be easily accessible to some individuals. Therefore, differences in values, beliefs, and financial position have contributed to contradicting results relating to endorsing the new approach to delivering antenatal care across England.
Discussion
The studies involved in this research aided in achieving the aim of the research, discovering the antenatal service provided during the COVID-19 pandemic. The various analyses show that the COVID-19 pandemic influenced the introduction of telecommunication in administering health care. According to Palmer et al. (2021), out of the 20 154 consultations after the pandemic, 10 731 were delivered through telehealth. In this case, COVID-19 influenced nations to develop guidelines and restrictions to curb virus spread, such as lockdowns and curfews. In this respect, according to the UKOSS report, five women had died from COVID-19 by the end of March 2020 and approximately 5 women of 1000 maternities were being admitted to hospitals due to the virus, and from the admitted women 9% required respiratory support (Coxon et al., 2020). This research justifies that COVID-19 puts pregnant mothers at risk of caring for their unborn, considering that the virus affects normal body functioning. As a result, the healthcare sector had to develop ways of ensuring that pregnant women acquire antenatal services without contracting the virus. The SARS-CoV- 2 is transmitted mainly through interactions since an individual encounter contaminated air particles and surfaces. Therefore, the changes relating to antenatal care related to changing service delivery to minimize exposure of pregnant women to COVID-19. Palmer et al. (2021) focused on the impact of the adoption of telehealth in delivering antenatal care. The research findings showed that telehealth had reduced face-to-face consultation to 50%. Telehealth depicts the utilization of communication and digital information technologies such as mobile devices and computers to access health care services, manage health, and access health care services. Therefore, the COVID-19 pandemic contributed to the utilization of telehealth services in providing antenatal care in England.
Additionally, virtual antenatal care services, including social media services, were available to pregnant women during the COVID-19 pandemic. Quinn et al. (2021) research concentrated on telephone services in providing antenatal care, and the findings showed endorsement of the virtual services by both pregnant women and healthcare professionals. This case study justifies the provision of virtual antenatal services during the pandemic. Moreover, Chatwin et al. (2021) focused on pregnant women’s views on the social media approach to delivering antennal services. In this case, the authors found that most participants embraced the use of social media in receiving ante-natal care. Therefore, social media and virtual antenatal care services were available for pregnant women during the COVID-19 pandemic.
Moreover, the purpose of the research was to identify England’s pregnant women embracing and utilizing available antenatal services during the COVID-19 pandemic. The majority of the study showed that women in England embraced and frequently used telehealth, virtual, and social media approach services, though the frequencies since some women do not consider using the new changes. According to Jardine et al. (2020), 89% of pregnant women utilized remote consultation methods in the U.K., including England. This result justifies that most individuals preferred virtual and telehealth approaches when seeking antenatal care. In this context, those who did not like remote consultation approaches reported that they did not endorse remote care through the telephone (Silverio et al., 2021). This data demonstrates that not all pregnant women in England utilize virtual services induced during the COVID-19 pandemic. In this context, Quinn et al.’s (2021) research results showed satisfaction with antenatal telephone clinics. Therefore, most England pregnant women utilized online antenatal services developed during the COVID-19 pandemic.
These findings are relevant and realistic since they can be utilized by healthcare professionals in designing schedules that are convenient for pregnant women. Moreover, the results are suitable for service users since they become aware of the existing changes. Online antenatal care is economical, diminishing healthcare inequalities and cost-effectiveness (Wu et al., 2020). This information justifies that virtual antenatal services not only take part in guaranteeing pregnant women’s safety but also ensure that they acquire cost-effective quality services. Moreover, online antenatal services have reduced in-person consultations, reducing overcrowding in hospitals (Rimmer and Wattar, 2020). In this respect, the research findings will help healthcare professionals make critical decisions relating to the implementation of online services in the sector. The majority of research presented in the report focused on pregnant women’s reactions and perceptions relating to changes in delivering antenatal care. Therefore, the results will also help understand pregnant women seeking healthcare services. Additionally, the research will be helpful for service users since it includes the implications of utilizing online services. In this context, the confirmation of the effectiveness of using online services guarantee will play a significant role as they decide to use the new approach.
Recommendations
- Research focusing on disparity in endorsing online antenatal changes in England should be conducted. Research findings indicate that some people do not embrace virtual care services. As a result, there is a need to evaluate what causes them to be reluctant to welcome England’s changes.
- Research should be conducted to determine whether there is any difference in the child born by mothers utilizing online antenatal services and those who used face-to-face consultations. This case study will aid in determining the effectiveness of using virtual prenatal services amid the COVID-19 pandemic.
- More research concentrating on perceptions and beliefs in embracing online antenatal care services in England. The country has people from different ethnic communities; hence, the study will determine whether socialization establishes trust in virtual antenatal care services.
Conclusion
Pregnancy is a valuable time for pregnant women, full of anticipation and excitement; thus, they need to know about various pregnancy events. During pregnancy, women should focus on how the fetus grows and develop in the maternal womb (Uwambaye et al., 2020, p.16). Pregnant women have questions about their expected birth date, recommendations about exercise and diet, and linked information on the well-being of their unborn babies. In this context, good pregnancy-related care is essential for the well-being of pregnant women and the normal development of the fetus. Additionally, during pregnancy, it is also a time to develop the skills of raising normal children with healthy behaviors. However, adverse changes may occur during pregnancy due to changes in body composition contributing to issues such as abnormal bleeding, diabetes, high blood pressure, loss of sleep, fatigue, back pain, constipation, heartburn, vomiting, and nausea (Uwambaye et al., 2020, p.16). As a result, there is a need to look into antenatal care, considering that many pregnant women require awareness of body changes and need regular check-ups to guarantee the healthy development and growth of the fetus. There is insufficient information on whether pregnant women are at higher risk for COVID-19-related illnesses, although pregnant women are at greater risk for COVID-19-related respiratory diseases. Therefore, the potential risk of COVID-19 during pregnancy in maternal and child health requires carefully designed studies to prevent premature births during this epidemic. Some studies have shown that some babies born to mothers with COVID-19 tested positive for the virus, even though it was not present in the placenta or amniotic fluid. As a result, the study focused on providing antenatal services during the COVID-19 pandemic.
The majority of research findings showed the adoption of virtual antenatal care to avoid the COVID-19 transmission rate among pregnant women. According to Townsend et al. (2021), COVID-19 influenced the introduction of virtual antenatal care services, and most expectant mothers were satisfied with the new approach. These results indicate that online was available for pregnant women, and the majority embraced the new technique of delivering antenatal services. However, some women had contradicting views on the telehealth approach utilized during the COVID-19 pandemic.
Reference List
Ali, S.A., Dero, A.A., Ali, S.A. and Ali, G.B. (2018) ‘Factors affecting the utilization of antenatal care among pregnant women: a literature review’, J Preg Neonatal Med, 2(2). pp. 41-46.
Aspinall, P.J., (2018) ‘What kind of mixed race/ethnicity data is needed for the 2020/21 global population census round: The cases of the UK, USA, and Canada’, Ethnic and Racial Studies, 41(11), pp.1990-2008. doi:10.1080/01419870.2017.1346267.
Chatwin, J., Butler, D., Jones, J., James, L., Choucri, L. and McCarthy, R. (2021) ‘Experiences of pregnant mothers using a social media based antenatal support service during the COVID-19 lockdown in the UK: findings from a user survey’, BMJ, 11(1), p.e040649. doi:10.1136/bmjopen-2020-040649.
Coxon, K., Turienzo, C.F., Kweekel, L., Goodarzi, B., Brigante, L., Simon, A. and Lanau, M.M. (2020) ‘The impact of the coronavirus (COVID-19) pandemic on maternity care in Europe’, Midwifery, 88, p.102779. doi:10.1016%2Fj.midw.2020.102779.
Jardine, J., Relph, S., Magee, L.A., von Dadelszen, P., Morris, E., Ross‐Davie, M., Draycott, T. and Khalil, A. (2021) ‘Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care’, BJOG: An International Journal of Obstetrics & Gynaecology, 128(5), pp.880-889. doi:10.1111/1471-0528.16547.
Karavadra, B., Stockl, A., Prosser-Snelling, E., Simpson, P. and Morris, E. (2020) ‘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 and Childbirth, 20(1), pp.1-8. doi:10.1186/s12884-020-03283-2.
Maslin, K., McKeon-Carter, R., Hosking, J., Stockley, L., Southby, C., Shawe, J. and Latour, J.M. (2022) ‘Preterm births in South-West England before and during the COVID-19 pandemic: an audit of retrospective data’, European Journal of Pediatrics, 181(2), pp.859-863. doi: 10.1007/s00431-021-04265-y.
Murphy, H.R. (2020) ‘Managing diabetes in pregnancy before, during, and after COVID-19’, Diabetes Technology & Therapeutics, 22(6), pp.454-461. doi:10.1089/dia.2020.0223.
Palmer, K.R., Tanner, M., Davies-Tuck, M., Rindt, A., Papacostas, K., Giles, M.L., Brown, K., Diamandis, H., Fradkin, R., Stewart, A.E. and Rolnik, D.L. (2021) ‘Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis’, The Lancet, 398(10294), pp.41-52. doi.org: 10.1016/S0140-6736(21)00668-1.
Quinn, L.M., Olajide, O., Green, M., Sayed, H. and Ansar, H. (2021) ‘Patient and Professional Experiences With Virtual Antenatal Clinics During the COVID-19 Pandemic in a UK Tertiary Obstetric Hospital: Questionnaire Study’, Journal of medical Internet research, 23(8), p.e25549. doi:10.2196/25549.
Rimmer, M.P., Al Wattar, B.H., UKARCOG members, Barlow, C., Black, N., Carpenter, C., Conti‐Ramsden, F., Dalton, J.A., Davies, R., Davies, R. and Dunlop, C. (2020) ‘Provision of obstetrics and gynaecology services during the COVID‐19 pandemic: a survey of junior doctors in the UK National Health Service’, BJOG: An International Journal of Obstetrics & Gynaecology, 127(9), pp.1123-1128. doi:10.1111/1471-0528.16313.
Saatci, D., Ranger, T.A., Garriga, C., Clift, A.K., Zaccardi, F., San Tan, P., Patone, M., Coupland, C., Harnden, A., Griffin, S.J. and Khunti, K. (2021) ‘Association between race and COVID-19 outcomes among 2.6 million children in England’, JAMA pediatrics, 175(9), pp.928-938. doi:10.1001/jamapediatrics.2021.1685.
Sanders, J. and Blaylock, R. (2021) ‘“Anxious and traumatised”: Users’ experiences of maternity care in the UK during the COVID-19 pandemic’, Midwifery, 102, p.103069. doi: 10.1016/j.midw.2021.103069.
Silverio, S.A., De Backer, K., Easter, A., von Dadelszen, P., Magee, L.A. and Sandall, J. (2021) ‘Women’s experiences of maternity service reconfiguration during the COVID-19 pandemic: A qualitative investigation’, Midwifery, 102, p.103116. doi:10.1016/j.midw.2021.103116.
Stacey, T., Darwin, Z., Keely, A., Smith, A., Farmer, D. and Heighway, K. (2021) ‘Experiences of maternity care during the COVID-19 pandemic in the North of England’, British Journal of Midwifery, 29(9), pp.516-523. doi:10.12968/bjom.2021.29.9.516.
Townsend, R., Chmielewska, B., Barratt, I., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O’Brien, P., Morris, E., Draycott, T., Thangaratinam, S. and Le Doare, K. (2021) ‘Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis’, EClinicalMedicine, 37, p.100947. doi: 10.1016/j.eclinm.2021.100947.
Uwambaye, P., Nyiringango, G., Musabwasoni, S.M.G., Husain, A., Nessa, K. and Razzaque, M.S. (2020) ‘COVID-19 pandemic: adaptation in antenatal care for better pregnancy outcomes’, Frontiers in Global Women’s Health, p.16. doi:10.3389/fgwh.2020.599327.
World Health Organization, (2020) WHO antenatal care recommendations for a positive pregnancy experience: nutritional interventions update: multiple micronutrient supplements during pregnancy. Lindegren, L., Stuart, A., Herbst, A. and Källén, K. (2021) ‘Stillbirth or neonatal death before 45 post‐menstrual weeks in relation to gestational duration in pregnancies at 39 weeks of gestation or beyond: the impact of parity and body mass index. A national cohort study’, BJOG: An International Journal of Obstetrics & Gynaecology. doi:10.1111/1471-0528.16964.
Wu, H., Sun, W., Huang, X., Yu, S., Wang, H., Bi, X., Sheng, J., Chen, S., Akinwunmi, B., Zhang, C.J. and Ming, W.K. (2020) ‘Online antenatal care during the COVID-19 pandemic: opportunities and challenges’, Journal of Medical Internet Research, 22(7), p.e19916. doi:10.2196/19916.
write