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  • ‘Our COVID-19 cloud silver lining’: the initiation and progress of postnatal contraception services during the COVID-19 pandemic in a UK maternity hospital

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‘Our COVID-19 cloud silver lining’: the initiation and progress of postnatal contraception services during the COVID-19 pandemic in a UK maternity hospital
  1. Kate Johanna Campbell1,2,
  2. Rachel Barlow-Evans1,2,
  3. Suzanne Jewell1,2,
  4. Natalie Woodhead2,
  5. Ruchira Singh2,
  6. Kulsum Jaffer1
  1. 1 Sexual Health Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2 Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Kate Johanna Campbell, Sexual Health Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham B4 6DH, UK; kate.campbell6{at}nhs.net

https://doi.org/10.1136/bmjsrh-2020-200764

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    Key messages

    • Immediate postnatal contraception (PNC) services are convenient and acceptable for postnatal women.

    • Providing immediate PNC is safe and supported by the Faculty of Sexual & Reproductive Healthcare guidance.

    • During the COVID-19 pandemic immediate PNC reduces the need for contact with multiple healthcare providers. This may reduce virus transmission.

    The COVID-19 pandemic presented an opportunity to rapidly improve postnatal contraception (PNC) services at the largest single-site maternity unit in the UK, Birmingham Women’s and Children’s Hospital NHS Trust.

    Why was change needed?

    Prior to March 2020 there was no provision of PNC at the hospital. Midwives would routinely enquire about women’s contraceptive plans and direct them to general practice for advice and initiation. Contraceptive services are free as part of the National Health Service (NHS) to UK residents.

    The demand for and importance of PNC provision is well documented. In the UK almost 1 in 13 women presenting for an abortion or delivery has conceived within a year of a previous birth.1 An interpregnancy interval of less than 12 months increases the risk of complications for both mother and baby.2 A 2017 UK survey showed 47% of women would prefer to have their contraception provided from the postnatal ward before discharge.3 A local service evaluation from 2011 highlighted a gap in access to PNC at our hospital and the desire of women to receive both advice and immediate provision.

    During March 2020 the COVID-19 pandemic evolved in the UK. Routine health services were disrupted and access to contraception in the community became compromised.4 Birmingham Women’s is a tertiary obstetric hospital caring for all women including those with complex medical needs and high-risk pregnancies. Lack of access to PNC for these women could have grave consequences. They are also …

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    Footnotes

    • Contributors KJC: primary author and data collection. RBE: data analysis and data collection. SJ: data collection. NW: proofreading and editing. RS: concept, final proofreading. KJ: concept.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.