Soma Gregory

Background: Woman/person‐centred care is a key policy objective for maternity services in many high‐income countries, both strategically and in terms of service delivery. This approach to care prioritises the individual woman's needs and aspirations over those of professionals or institutions. However, the concept remains ambiguous and practical implementation guidelines are lacking, leading to concerns that it is being practised tokenistically. Aim: To explore how woman‐centred care in maternity services in high‐income countries is experienced and understood by women and professionals. Methods: A rapid review was conducted to synthesise evidence on woman‐centred care from women's and clinicians' perspectives. Five bibliographic databases, CINAHL, Maternity and Infant Care, MEDLINE, PsycINFO and Web of Science, were searched systematically in December 2023. Citations eligible for inclusion were peer‐reviewed quantitative, qualitative and mixed‐methods empirical studies conducted in high‐income countries and literature reviews reporting on studies conducted in high‐income countries. Title and abstract screening, full‐text screening, data extraction and quality appraisal were performed, with 10% of records double‐screened to ensure consistency and minimise bias. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Extracted data were synthesised thematically. Findings: In total, 5295 records were retrieved; after deduplication, 2707 records were screened, and 24 studies met the inclusion criteria. The review identified inconsistencies in how woman‐centred care was experienced and understood at all levels of service provision, from policy directives to institutional practices. Diverse understandings of woman‐centred care among stakeholders were found to influence interactions. Several studies revealed that professionals' varying interpretations affected their attitudes and approaches to care, while some women were found to hold differing expectations about woman‐centred care provision. Conclusion: To realise the policy intention of woman‐centred care, further context‐specific investigations are needed to provide evidence and evaluation to inform implementation strategies.

Purpose: This article addresses a gap in empirical knowledge on post-separation contact in the context of domestic violence and abuse (DVA) for children with disabilities. The intersection of disability and DVA is explored through the mother’s perspective and brings to the fore the unique experiences of children with disabilities in the post-separation contact space. Methods: Known to be a difficult to reach population, the experience of disabled children were captured through in-depth qualitative interviews with a sample of eight victim/survivor mothers. Mothers were recruited through gatekeepers from a voluntary children’s organization and specialist DVA services. Autism spectrum disorder (ASD) was the most common disability occurring in the sample. Results: Three major themes relating to the disabled child’s experience were identified: (i) Courts’ (lack of) consideration of children’s disability in post-separation child contact decision-making; (ii) Disruption to routine; and (iii) Quality of contact. Participating mothers reported that these experiences caused serious emotional distress for the children; distress that was heightened and compounded by their disability status. Conclusion: Applying an intersectional lens to the experiences of children with a disability who live with DVA, this study simultaneously illuminates children’s vulnerability and marginalization in this context, whilst also identifying gaps in policy and practice responses to identify and address the individual needs of these children. Lastly, given the nascent evidence base on this topic, research which directly elicits the voice of the child is urgently needed.

When the COVID-19 pandemic manifested urgent concerns were raised around the globe about the increased risk that public health restrictions could pose for victims of domestic abuse. Governments, NGOs and community services swiftly responded to convey the message that services for victims were operational and restrictions did not apply to those fleeing harm. This paper reports on the various approaches used to communicate this public health messaging during COVID-19, further highlighting strengths and learning which could inform future crises messaging. It utilises data gathered through a rapid review and mapping of policy and practice initiatives across 4 high-middle income countries: UK, Australia, South Africa and Ireland. Four themes were identified: (1) Top-down: National media messaging; (2) Top-down: Political leadership; (3) Traditional media vs. social media and (4) Bottom-up messaging: Localised, community-based messaging. It was found that a strong, clear top-down stance on domestic abuse was perceived as beneficial during COVID-19. However, a stronger focus on evaluation, reach and impact, particularly for minority groups may be required. Newer forms of media were shown to have potential in conveying messaging to minority groups. Community and grassroots organizations demonstrated their experiential knowledge in reaching target audiences. Harnessing this expertise for future crises messaging may be valuable.