Abstract
Introduction Globally, the COVID-19 pandemic has
significantly disrupted the provision of healthcare and
efficiency of healthcare systems and is likely to have
profound implications for pregnant and postpartum
women and their families including those who experience
the tragedy of stillbirth or neonatal death. This study
aims to understand the psychosocial impact of COVID-19
and the experiences of parents who have accessed
maternity, neonatal and bereavement care services
during this time.
Methods and analysis An international, cross-sectional,
online and/or telephone-based/face-to-face survey is
being administered across 15 countries and available
in 11 languages. New, expectant and bereaved parents
during the COVID-19 pandemic will be recruited. Validated
psychometric scales will be used to measure psychosocial
well-being. Data will be analysed descriptively and by
assessing multivariable associations of the outcomes with
explanatory factors. In seven of these countries, bereaved
parents will be recruited to a nested, qualitative interview
study. The data will be analysed using a grounded theory
analysis (for each country) and thematic framework
analysis (for intercountry comparison) to gain further
insights into their experiences.
Ethics and dissemination Ethics approval for
the multicountry online survey, COCOON, has been
granted by the Mater Misericordiae Human Research
Ethics Committee in Australia (reference number: AM/
MML/63526). Ethics approval for the nested qualitative
interview study, PUDDLES, has been granted by the
King’s College London Biomedical & Health Sciences,
Dentistry, Medicine and Natural & Mathematical Sciences
Research Ethics Subcommittee (reference number:
HR-19/20-19455) in the UK. Local ethics committee
approvals were granted in participating countries where
required. Results of the study will be published in
international peer-reviewed journals and through parent
support organisations. Findings will contribute to our
understanding of delivering maternity care services,
particularly bereavement care, in high-income, lower
middle-income and low-income countries during this or
future health crises.
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