Table 3 Theme development for women’s views and experiences
Codes (reduced for illustrative purposes) | Descriptive themes | Analytical sub-themes | Analytical theme |
|---|---|---|---|
Virtual care worked well; Virtual care problematic; Virtual care | Providing care virtually | Telehealth | Theme 1 Altered maternity care |
New model of care good; Rushed care; Changed maternity care; Faster appointments; Cancelled appointments; Varied care; Continuity of care; Increased medicalisation; Preparedness for birth hampered; Increased stress/anxiety due to changes in care | Changes to usual care structures, processes and care provision and the impact of these | Altered care structures, processes, provision, and access | |
Feeling sad for partner; partner unable to bond with baby in first few days; partner attendance; partner restrictions; Feeling guilty as partner not present; Feeling angry as partner missing out | Restrictions on partner attendance and impact of this | “It felt cruel” – restricting partners attendance | Theme 2 COVID related restrictions |
Alone or isolated (because of visiting or social distancing restrictions) | Feeling alone and isolated | Restrictions in general: pros and cons | |
Visiting restrictions (in general); Self-restricting contact with others; Separated from baby; Forming close relationships with other women; Feeling cheated; Missing out | General visiting, access, and social restrictions; advantages and disadvantages | ||
Safety prioritised over experience; Staff safety prioritised over woman’s care; Precautions taken by MCPs; COVID testing/diagnosis | HCP precautionary and safety activities to protect against infection | N/A | Theme 3 Infection prevention and risk |
Fear/worry of contracting COVID at visits; Hospital care less safe/as safe; Time of uncertainty; Benefit outweighs risk; Changing place of birth | Women’s thoughts and actions related to contracting/avoid contracting COVID | ||
Reduced support; Access to support; Loss of support; Good support; Seeking support; Sources of support; Breastfeeding support; Postpartum support; Mental health issues undetected | Support systems affected by COVID (mostly negatively) | Psychosocial and information support | Theme 4 “The lived reality” – navigating support systems |
Media reports and influence; Information seeking; Information needs; Conflicting information; Help-seeking negatively affected; First time mother’s unique needs | Information sources and needs | ||
Finding solutions; Changing plans; Exploring alternatives; Being resilient and strong; Being in control; Preparing for birth; Comparing themselves to other women; Self-advocacy; Adapting to changes; Women’s recommendations to MCPs | How women addressed their support and information deficits | Women’s solutioning | |
Advice from MCPs; Guidance expected from MCPs/needing reassurance; Good communication important; Challenges in accessing MCPs or services; Birth options reduced; Care from/communicating with MCPs; MCP more concerned about COVID than pregnancy issues | Good and poor interactions with HCPs and services | N/A | Theme 5 Interactions with maternity services |
Feeling forgotten about; Feeling abandoned; Being cared for stopped; Unmet expectations; Awful experience; Poor care; Compassionate care; Disrespectful care | Care quality |