‘Never waste a crisis’: a commentary on the COVID‐19 pandemic as a driver for innovation in maternity care

The coronavirus (COVID-19) pandemic has resulted in rapid changes in many areas of healthcare worldwide.1 Some organisational and governance controls on innovation have been relaxed, to enable rapid adaptation to changing circumstances. The speed of innovation raises a range of ethical, governance and organisational issues. It is important to assess what changes have been instituted, which ones should be maintained, and how to encourage effective innovations in future. Maternity care provides an exemplar case within the broader healthcare setting, given the imperative to provide both safe and personalised care for optimal outcomes. Some pandemic-related changes in maternity services, such as restricting women's opportunities for companionship during ultrasound scans or throughout labour, or limiting parental visiting to neonatal units, have been associated with psychological harm.2 Other changes provide more positive impacts, including reports of more individualised and efficient care associated with the increased use of telemedicine.3 We undertook a documentary analysis of national policy and service-user organisation responses to the pandemic in the United Kingdom (UK) and the Netherlands (NL), as part of the Achieving Safe and Personalised maternity care In Response to Epidemics (ASPIRE COVID-19) study. The overall aim of ASPIRE COVID-19 is to identify ‘what works’ in providing maternity care during the current and future pandemics, or similar health crises. The NL was chosen as the comparator for the UK because there were known differences in the organisation of maternity services during the COVID-19 pandemic between the two countries, especially for place of birth. Here we report on activities described as new or expanded innovations in 290 documents produced by 17 key professional and service-user organisations in the NL and the UK between February and December 2020 (Table 1). We included strategic papers, guidelines, protocols and updates for healthcare professionals, such as newsletters