3.1.3. Women and families in vulnerable situations
In the documents published during
the first weeks of the pandemic, there was almost no mention of women
and families in vulnerable situations in either country. From the end of
March 2020, the attention on women and families in vulnerable situations
increased, especially in service-user organisation outputs.
On 22 March 2020, the Dutch organisation Birth Movement published an
ethical statement about maternity care during the COVID-19 pandemic, in
which they encouraged healthcare professionals to continue to consider
exceptions in certain situations; for example, if a pregnant woman had
different needs because she was anxious after a previous traumatic birth
or a previous stillbirth (GB_1). In response, several professional
organisations started to offer advice specifically relating to families
in vulnerable situations, e.g., the Royal Dutch Organisation of Midwives
published a document on 1 April 2020 in which the objectives of
post-partum care during COVID-19 included ‘coping with how birth went,
pay attention to the transition to parenthood’ (KNOV_14). In the UK
there were similar changes: service user organisations emphasised the
need to consider women and families in vulnerable situations following
which some professional organisations adjusted their policies.
‘To prevent avoidable suffering – in some cases tragedy – and
reduce the huge economic burden on society, the mental health of
pregnant women and new mums needs to be given equal priority to physical
health, including by mums and families themselves’ (Maternal Mental
Health Alliance, MMHA_1, 5 May 2020).
‘Women with known psycho-social vulnerabilities, operative birth,
preterm/low birth weight baby and/or other medical or neonatal
complexities need to be prioritised for face-to-face care’ (Royal
College of Midwives, RCM_14, 20 May 2020).
In June 2020, a study was published that demonstrated that in the UK,
women from ‘black or minority ethnic groups’ were significantly more
likely to be admitted to the hospital with COVID-19 than other women
[4]. In response to this, several UK documents were produced which
emphasised that women from black or ethnic minority communities were
more vulnerable to COVID-19 infection, were more likely to be
hospitalised for COVID-19, and had an increased risk of adverse
perinatal outcomes during the COVID-19 pandemic (BR_10, _18; MBRR_1;
NHSE_5, _12; NHSR_1; RCM_2, _3, _5, _6, _13, _14, _16, _17,
clarifying the increased risk for women from minority ethnic
backgrounds, many of these documents also provided recommendations for
practice, such as to lower the threshold for admission for women from
these groups where necessary (RCM_1, _32, _37; NHSE_5).
In the NL, no data were published about the percentage of women with a
Black or other minority background that were hospitalised with COVID-19.
In NL documents, there was some emphasis on the increased vulnerability
of migrant women, asylum seekers, and women with Dutch as a second
language during the COVID-19 pandemic (NVOG_1; KNOV_30), but less
attention was placed on vulnerable women in NL documents, compared to
those from the UK.