Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care

BJOG. 2021 Apr;128(5):880-889. doi: 10.1111/1471-0528.16547. Epub 2020 Nov 5.


Objective: To explore the modifications to maternity services across the UK, in response to the coronavirus disease 2019 (COVID-19) pandemic, in the context of the pandemic guidance issued by the Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM) and NHS England.

Design: National survey.

Setting: UK maternity services during the COVID-19 pandemic.

Population or sample: Healthcare professionals working within maternity services.

Methods: A national electronic survey was developed to investigate local modifications to general and specialist maternity care during the COVID-19 pandemic, in the context of the contemporaneous national pandemic guidance. After a pilot phase, the survey was distributed through professional networks by the RCOG and co-authors. The survey results were presented descriptively in tabular and graphic formats, with proportions compared using chi-square tests.

Main outcome measures: Service modifications made during the pandemic.

Results: A total of 81 respondent sites, 42% of the 194 obstetric units in the UK, were included. They reported substantial and heterogeneous maternity service modifications. Seventy percent of units reported a reduction in antenatal appointments and 56% reported a reduction in postnatal appointments; 89% reported using remote consultation methods. A change to screening pathways for gestational diabetes mellitus was reported by 70%, and 59% had temporarily removed the offer of births at home or in a midwife-led unit. A reduction in emergency antenatal presentations was experienced by 86% of units.

Conclusions: This national survey documents the extensive impact of the COVID-19 pandemic on maternity services in the UK. More research is needed to understand the impact on maternity outcomes and experience.

Tweetable abstract: A national survey showed that UK maternity services were modified extensively and heterogeneously in response to COVID-19.

Keywords: Coronavirus disease 2019; maternity; service modifications; workforce survey.

MeSH terms

  • Appointments and Schedules
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Female
  • Health Care Surveys
  • Health Workforce
  • Hospitalization / statistics & numerical data
  • Humans
  • Maternal Health Services* / organization & administration
  • Maternal Health Services* / standards
  • Maternal Health Services* / trends
  • Organizational Innovation*
  • Practice Guidelines as Topic
  • Pregnancy
  • Remote Consultation / statistics & numerical data
  • SARS-CoV-2
  • State Medicine / trends
  • United Kingdom / epidemiology