The impact of the Covid-19 pandemic on the health and care of women experiencing mental illness and domestic violence and abuse, during pregnancy

Pregnant women have been uniquely affected by these changes, including advice to ‘shield’ during the initial UK wide social distancing measures, reduced face-to-face contact with healthcare professionals throughout their pregnancy, and restrictions on birth partners attending antenatal appointments and births. While these measures have been necessary for reducing the risk of transmission of COVID-19, there are concerns about the unintended impact on health and social care services to identify and respond to mental illness and domestic violence and abuse (DVA).

This study will help understand the impact of the restrictions in place during the pandemic on the identification and management of mental illness and DVA in south London, by comparing electronic healthcare data from women attending maternity services before the introduction of lockdown, with those receiving care during the lockdown period. In the future, it will help identify the longer-term impact on the health and well-being of these women and their children.

Study aims

This study aims to determine the impact of the service delivery changes during the COVID-19 pandemic on:

• Identification of mental illness and domestic violence and abuse (DVA) during pregnancy
• Referrals to specialist perinatal mental health services during pregnancy
• Rates of spontaneous and iatrogenic preterm birth and low birth weight among women with mental illness or DVA
• Rates of new-onset and relapse of mental illness three months after birth.

How the research will be carried out

This study utilises existing data linkages between maternity and mental health records in south London from the eLIXIR database (early-LIfe data cross-LInkage in Research). Anonymous data related on two cohorts of women will be extracted from healthcare records describing:

1) Pregnancies booked for antenatal care before the start of the UK social-distancing measures in March 2020 and;

2) Pregnancies booked during the imposed social-distancing measures in the UK.

An interrupted time-series design will be conducted to calculate the differences in the rate of perinatal mental illness, DVA and alcohol and substance misuse. We will also compare mental health, pregnancy, and birth outcomes before, during and after birth. The analysis will be adjusted for potential confounding factors and correlations in the data over time.

The findings of this study will help understand the impact of service delivery changes during the pandemic and help inform future recovery of services. We will establish a unique birth cohort of women affected by perinatal mental health during the pandemic, who  we can follow-up in future research to help identify long-term impacts on maternal and child health.

For further information about the project please contact Dr Abigail Easter

abigail.easter@kcl.ac.uk