Beyond COVID-19: Reported clinical practices in maternity care in Victoria during the COVID-19 pandemic and implications for the future - A statewide review.

Abstract

Background: In Australia, during the COVID-19 pandemic many routine pregnancy visits were replaced by telehealth, along with changes to routine screening and visitor policies. Many providers plan to continue these changes.

Aims: Describe changes to maternity care provision across the state of Victoria during the COVID-19 pandemic.

Materials and methods: A population-based cross-sectional design was used. Managers of maternity services (public and private) were invited to complete a questionnaire by telephone or online exploring changes to care delivery, telehealth practices, perceived impact of changes and future telehealth implementation.

Results: Fifty per cent of maternity service managers (34/68; 27 public, six private) responded (March-April 2021). Around 50% of all pregnancy visits became telehealth, with multiple combinations of face-to-face and telehealth visits; 92% conducted the first (booking) appointment via telehealth. No specific gestational visit was conducted face-to-face by all services. Visits most likely to be face-to-face were at 39 and 40 weeks gestation (65%). For telehealth appointments, there was an ad hoc approach to routine screening, eg, measuring blood pressure (11% did not advise at all), fetal growth (26%-no specific strategy) and fetal heart rate (15%-no specific strategy). Over half (52%) would consider maintaining telehealth post-pandemic.

Conclusions: Even in a single state, there was great variation in what constitutes telehealth, when pregnant women should have face-to-face visits, and what routine screening in pregnancy should be maintained. This is concerning given over half the services are planning to continue telehealth post-pandemic, despite the lack of evidence of safety, efficacy and input from women and clinicians.