Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study
IntroductionAustralian antenatal care includes specific screening and service provision for domestic and family violence (DFV) and mental health. However, the COVID-19 pandemic resulted in major care changes, including greatly expanded telehealth. Given difficulties in a safe assessment and manageme...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Global Women's Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgwh.2022.819953/full |
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| author | Amanda Henry Amanda Henry Amanda Henry Jennifer Yang Sarah Grattan Lynne Roberts Lynne Roberts Anne Lainchbury Janani Shanthosh Janani Shanthosh Patricia Cullen Patricia Cullen Louise Everitt Louise Everitt |
| author_facet | Amanda Henry Amanda Henry Amanda Henry Jennifer Yang Sarah Grattan Lynne Roberts Lynne Roberts Anne Lainchbury Janani Shanthosh Janani Shanthosh Patricia Cullen Patricia Cullen Louise Everitt Louise Everitt |
| author_sort | Amanda Henry |
| collection | DOAJ |
| description | IntroductionAustralian antenatal care includes specific screening and service provision for domestic and family violence (DFV) and mental health. However, the COVID-19 pandemic resulted in major care changes, including greatly expanded telehealth. Given difficulties in a safe assessment and management of disclosures via telehealth, DFV and mental health service provision might be substantially impacted. This study therefore aimed to assess COVID-19 effects on DFV and mental health screening, as well as broader service provision from the perspective of local maternity service providers.MethodsMixed-methods study of staff surveys and interviews of staff directly involved in pregnancy care (doctors, midwives, and allied health) in three Sydney (Australia) maternity units, from October 2020 to March 2021. Surveys and interviews interrogated perceived effects of the COVID-19 pandemic on delivery (ensuring required services occurred), timeliness, and quality of (a) overall maternity care and (b) DFV and mental health screening and care; and also advantages and disadvantages of telehealth. Surveys were descriptively analyzed. Interviews were conducted online, recorded, and transcribed verbatim prior to thematic analysis.ResultsIn total, 17 interviews were conducted and 109 survey responses were received. Breakdown of survey respondents was 67% of midwives, 21% of doctors, and 10% of allied health. Over half of survey respondents felt the pandemic had a negative effect on delivery, timeliness, and quality of overall pregnancy care, and DFV and mental health screening and management. Perceived telehealth positives included convenience for women (73%) and reducing women's travel times (69%). Negative features included no physical examination (90%), difficulty regarding non-verbal cues (84%), difficulty if interpreter required (71%), and unsure if safe to ask some questions (62%). About 50% felt telehealth should continue post-pandemic, but for <25% of visits. Those perceived suitable for telehealth were low-risk and multiparous women, whereas those unsuited were high-risk pregnancy, non-English speaking, and/or mental health/psychosocial/DFV concerns. “Change to delivery of care” was the central interview theme, with subthemes of impact on mental health/DFV screening, telehealth (both positive and negative), staff impact (e.g., continuity of care disruption), and perceived impact on women and partners.DiscussionWhile telehealth may have an ongoing, post-pandemic role in Australian maternity care, staff believe that this should be limited in scope, mostly for low-risk pregnancies. Women with high risk due to physical health or mental health, DFV, and/or other social concerns were considered unsuited to telehealth. |
| first_indexed | 2024-04-13T16:53:03Z |
| format | Article |
| id | doaj.art-6e360e8a24c644aeb763d4a5cd147153 |
| institution | Directory Open Access Journal |
| issn | 2673-5059 |
| language | English |
| last_indexed | 2024-04-13T16:53:03Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Global Women's Health |
| spelling | doaj.art-6e360e8a24c644aeb763d4a5cd1471532022-12-22T02:38:53ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592022-06-01310.3389/fgwh.2022.819953819953Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods StudyAmanda Henry0Amanda Henry1Amanda Henry2Jennifer Yang3Sarah Grattan4Lynne Roberts5Lynne Roberts6Anne Lainchbury7Janani Shanthosh8Janani Shanthosh9Patricia Cullen10Patricia Cullen11Louise Everitt12Louise Everitt13Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, AustraliaDepartment of Women's and Children's Health, St George Hospital, Sydney, NSW, AustraliaThe George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, AustraliaDiscipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, AustraliaThe George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, AustraliaDepartment of Women's and Children's Health, St George Hospital, Sydney, NSW, AustraliaSt George and Sutherland Clinical School, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, AustraliaRoyal Hospital for Women, Randwick, NSW, AustraliaThe George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, AustraliaAustralian Human Rights Institute, UNSW Sydney, Kensington, NSW, AustraliaSchool of Population Health, UNSW Sydney, Kensington, NSW, AustraliaNgarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, AustraliaDepartment of Women's and Children's Health, St George Hospital, Sydney, NSW, AustraliaSchool of Nursing and Midwifery, Western Sydney University, Penrith, NSW, AustraliaIntroductionAustralian antenatal care includes specific screening and service provision for domestic and family violence (DFV) and mental health. However, the COVID-19 pandemic resulted in major care changes, including greatly expanded telehealth. Given difficulties in a safe assessment and management of disclosures via telehealth, DFV and mental health service provision might be substantially impacted. This study therefore aimed to assess COVID-19 effects on DFV and mental health screening, as well as broader service provision from the perspective of local maternity service providers.MethodsMixed-methods study of staff surveys and interviews of staff directly involved in pregnancy care (doctors, midwives, and allied health) in three Sydney (Australia) maternity units, from October 2020 to March 2021. Surveys and interviews interrogated perceived effects of the COVID-19 pandemic on delivery (ensuring required services occurred), timeliness, and quality of (a) overall maternity care and (b) DFV and mental health screening and care; and also advantages and disadvantages of telehealth. Surveys were descriptively analyzed. Interviews were conducted online, recorded, and transcribed verbatim prior to thematic analysis.ResultsIn total, 17 interviews were conducted and 109 survey responses were received. Breakdown of survey respondents was 67% of midwives, 21% of doctors, and 10% of allied health. Over half of survey respondents felt the pandemic had a negative effect on delivery, timeliness, and quality of overall pregnancy care, and DFV and mental health screening and management. Perceived telehealth positives included convenience for women (73%) and reducing women's travel times (69%). Negative features included no physical examination (90%), difficulty regarding non-verbal cues (84%), difficulty if interpreter required (71%), and unsure if safe to ask some questions (62%). About 50% felt telehealth should continue post-pandemic, but for <25% of visits. Those perceived suitable for telehealth were low-risk and multiparous women, whereas those unsuited were high-risk pregnancy, non-English speaking, and/or mental health/psychosocial/DFV concerns. “Change to delivery of care” was the central interview theme, with subthemes of impact on mental health/DFV screening, telehealth (both positive and negative), staff impact (e.g., continuity of care disruption), and perceived impact on women and partners.DiscussionWhile telehealth may have an ongoing, post-pandemic role in Australian maternity care, staff believe that this should be limited in scope, mostly for low-risk pregnancies. Women with high risk due to physical health or mental health, DFV, and/or other social concerns were considered unsuited to telehealth.https://www.frontiersin.org/articles/10.3389/fgwh.2022.819953/fullpregnancymental healthdomestic and family violenceCOVID-19telehealthpregnancy care |
| spellingShingle | Amanda Henry Amanda Henry Amanda Henry Jennifer Yang Sarah Grattan Lynne Roberts Lynne Roberts Anne Lainchbury Janani Shanthosh Janani Shanthosh Patricia Cullen Patricia Cullen Louise Everitt Louise Everitt Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study Frontiers in Global Women's Health pregnancy mental health domestic and family violence COVID-19 telehealth pregnancy care |
| title | Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study |
| title_full | Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study |
| title_fullStr | Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study |
| title_full_unstemmed | Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study |
| title_short | Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study |
| title_sort | effects of the covid 19 pandemic and telehealth on antenatal screening and services including for mental health and domestic violence an australian mixed methods study |
| topic | pregnancy mental health domestic and family violence COVID-19 telehealth pregnancy care |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2022.819953/full |
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