Introduction
Aims and objectives
Methods
Participants
Study recruitment
Data collection
Changes to working practices during COVID-19 pandemic |
• Challenges and positives arising from pandemic |
Changes observed for young parents during COVID-19 pandemic |
• Impact on mothers and on fathers |
• Impact of pandemic on parental mental health |
Strategies employed to adapt services and support parents during pandemic |
Data analysis
Reflexivity, research group and context
Ethical considerations
Results
Participants
Professional Role | Number |
---|---|
Health Visitor | 4 |
Family Nurse Partnership Healthcare Professional | 5 |
Perinatal Mental Health Professional | 2 |
Midwife with specific responsibility for teenage parents | 1 |
Midwife | 1 |
Social Worker | 1 |
Specialist Nurse Sonographer | 1 |
Specialist Nurse for Newborn and Infant Examination | 1 |
Youth Worker running community courses and support programmes | 1 |
Themes | Subthemes |
---|---|
1. Perinatal healthcare professionals’ perceptions of how young parents' needs were amplified during the pandemic | A) Working with the challenges faced by young parents B) Specific pandemic-related challenges for young parents |
2. Perceptions of the impact of COVID-19 on delivery of perinatal care | A) Delivery of perinatal care using virtual and remote methods B)Consequences of changes to perinatal care |
Theme 1: Perinatal healthcare professionals’ perceptions of how young parents' needs were amplified during the pandemic
Subtheme A) Working with the challenges faced by young parents
‘I mean we work with young first-time teenaged parents so they are a vulnerable group in any case. A lot of that is based on family issues in the past, a lot of them have got multiple ACEs so there’s been a historical childhood impact on them from family.’ (P008, Family Nurse)
“A lot of our younger women are living with their family, so actually to try and find that space by themselves is, is really hard to do, and some of those younger women struggled a bit with those relationships with their family as well. So, actually, (A) it’s trying to find that space, but then, (B) there is that, always that worry that you’ll be overheard” (P004, Perinatal Mental Health Professional)
“…..if you're the first in your peer group who has become pregnant at the age of 18 or 19. It’s not an experience that your peers, the people that you met to school, university, college with and you’ve grown up with actually have a lived experience of… certainly, in the community there’s a much stronger bridge between the healthcare professionals and new mums coming through.” (P011, Midwife)
Subtheme B) Specific pandemic-related challenges for young parents
“..for some of our younger ladies it felt like, because they’ve not had that level of, of life experience, it was harder for them to ask for what they wanted and they were happy to be guided by, by the team more, I suppose. They were less, they were less likely to say, “This is what I want, this is what I want,” and they were happier to be led” (P004, Perinatal Mental Health Professional)
“They feel they can’t ask for support because they don’t know that they need support” (P015, Health Visitor)
“I think a loss of things like the children’s centres and mum and baby groups …..the more, sort of, voluntary sector, third sector agencies that, that used to do a lot of that valuable work. That’s been really challenging so they’ve not had the drop-in groups, children’s centres to go to, mum and baby things” (P002, Perinatal Mental Health Professional)
“Because if you haven’t got that [trusting relationship], you are not going to get any depth with them much at all. But if you’ve got that and they trust you and they’ve got, if you’ve got that unconditional professional love for them and a professional love but you know what I mean, you’re there whatever. A lot of them haven’t had that and they, yes they will go a long way with you if you can build that up.” (P005, Family Nurse)
Theme 2: Perceptions of the impact of COVID-19 on delivery of perinatal care
Subtheme A) Delivery of perinatal care using virtual and remote methods
“I have a big kit that I carry around in a pillowcase full of tools to demonstrate labour and birth and trying to do that over a camera, yes it’s difficult.” (P006, Teenage Midwife)
“(the service)..it would have been more proactive before. It would have been- Because these mothers would have been coming to the lounge, playgroups, baby massage. They- they would have more visits from us. And we would’ve seen things earlier, you know” (P014, Health Visitor)
“Some [young parents] prefer the digital world and will text you and talk to you on the telephone rather than face to face, others are very anxious about telephone contact…” (P007, Family Nurse)
‘She says, “I can’t do it anymore on the phone.” I say, “Look just wait for me next week”’ (P010, Family Nurse)
“…..especially with the younger mums it’s around what you learn from just laying eyes on them, … having that face-to-face interaction, how they communicate, how they interact……. you learn a lot by the fact of can they get to clinic, bring a child that’s looking reasonably clean and tidy, manage the appointment to get there roughly on time, leave again.” (P002, Perinatal Mental Health Professional)
“we were in constant touch with our mobiles saying we can’t come and visit this week but how would you like to do this, would you like a phone call, would you like an Attend Anywhere so we had maintained that contact all the way through. Like I say we’ve had more contact in actual fact” (P008, Family Nurse)
“So there’s actually more time to make that phone call say for instance with a client. You know 10 min just checking in, seeing how you are.” (P008, Family Nurse)
“So I absolutely love my mobile phone for work. I have mums send me videos on it…. I have a look at it, I give them a lot of help and support around what they need to look for……I think my mums feel very reassured by the fact they can just text me” (P015, Health Visitor)
“So, it was nice in a way that they were home to include them more in the visit and often you know they would be, on the Attend Anywhere, they would be sitting by the… partner and participating and getting the information as well or joining in or saying you know, “It’s tough” or, “It’s great” or whatever.” (P012, Health Visitor)
“When you are just walking side by side with somebody you can have conversations that don’t feel as challenging or as intense as if you were just sat in the room face to face, I think” (P008, Family Nurse)
Subtheme B) Consequences of changes to perinatal care
“all the nurses are coming back to me and saying the contacts have actually increased. So although they’ve not done as many face to face, they’ve done more telephone or virtual contacts to try and alleviate some of those anxieties. Because sometimes in a lot of those cases we are the only professional that’s working with them.” (P008, Family Nurse)
“So then having a group online and some of our ladies were saying the issue was, it’s not the same as being able to just have these little conversations with people.…our younger ladies as well just said that they felt very uncomfortable using online, and that it just wasn’t something that they found helpful.” (P004, Perinatal Mental Health Professional)