RESILIENT

In more detail, the 2-year project (Nov/21-Oct/23) will have 3 work packages (WPs):

WP1 will use existing maternity and mental health records, collected as part of care in south London.

These are accessible via a secure database, the early-LIfe data cross-LInkage in Research (eLIXIR) platform. They include some details of how maternity care changed in the pandemic, such as virtual care, self-monitoring (eg, blood pressure), and acceptance of COVID-19 vaccination. This WP will compare care and the consequences for different groups.

WP2 will collect information across the UK in two ways.

First, interviews with minority ethnic group women, those living with complex social or medical needs, and health service leaders and policymakers, will gather views on care changes that have occurred and their effects.

Second, women who are planning pregnancy, pregnant, or post-birth and using the King’s College London COVID Symptom Study app (ZOE Global Ltd.) will be invited to join the COVID Symptom Study Biobank and share their views on COVID-19 vaccination, pregnancy outcomes, mental health, and early-life parenting.

In WP3, we will hold ‘listening events’ in the four UK nations, and a national ‘Policy Lab’ workshop, to engage maternity service users, health care staff, and health policymakers. We will present the study results and ‘imagine our best future’, then work together to agree recommendations for future policy and action.

A patient and public involvement and engagement advisory group will work with us throughout. We will share our findings locally, regionally, and nationally across the four nations, through webinars, social media, online, and plain-language reports. Our impact will be on women, NHS maternity staff, the NHS Long Term Plan, and wider society.

COVID-related publications from our co-investigator group members:

Women’s experiences of maternity care in the United Kingdom during the COVID-19 pandemic: A follow-up systematic review and qualitative evidence synthesis - ScienceDirect

Antonelli, M., Penfold, R. S., Merino, J., Sudre, C. H., Molteni, E., Berry, S., Canas, L. S., Graham, M. S., Klaser, K., Modat, M., Murray, B., Kerfoot, E., Chen, L., Deng, J., Österdahl, M. F., Cheetham, N. J., Drew, D. A., Nguyen, L. H., Pujol, J. C., Hu, C., Selvachandran, S., Polidori, L., May, A., Wolf, J., Chan, A. T., Hammers, A., Duncan, E. L., Spector, T. D., Ourselin, S., & Steves, C. J. (2022). Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis, 22(1), 43-55. https://doi.org/10.1016/s1473-3099(21)00460-6

Afuwape, I., Parsons, J., Bick, D., Dale, J., & Hillman, S. C. (2021). Vaccines and pregnancy. InnovAiT, 17557380211051765.

Antonelli, M., Capdevila, J., Chaudhari, A., Granerod, J., Canas, L. S., Graham, M. S., Klaser, K., Modat, M., Molteni, E., Murray, B., Sudre, C. H., Davies, R., May, A., Nguyen, L. H., Drew, D. A., Joshi, A., Chan, A. T., Cramer, J. P., Spector, T., Wolf, J., Ourselin, S., Steves, C. J., & Loeliger, A. E. (2021). Optimal symptom combinations to aid COVID-19 case identification: Analysis from a community-based, prospective, observational cohort. J Infect, 82(3), 384-390. https://doi.org/10.1016/j.jinf.2021.02.015

Blakeway, H., Prasad, S., Kalafat, E., Heath, P. T., Ladhani, S. N., Le Doare, K., Magee, L. A., O'Brien, P., Rezvani, A., von Dadelszen, P., & Khalil, A. (2021). COVID-19 vaccination during pregnancy: coverage and safety. Am J Obstet Gynecol, 226(2), 236.e231-236.e214. https://doi.org/10.1016/j.ajog.2021.08.007

Canas, L. S., Österdahl, M. F., Deng, J., Hu, C., Selvachandran, S., Polidori, L., May, A., Molteni, E., Murray, B., Chen, L., Kerfoot, E., Klaser, K., Antonelli, M., Hammers, A., Spector, T., Ourselin, S., Steves, C., Sudre, C. H., Modat, M., & Duncan, E. L. (2021). Disentangling post-vaccination symptoms from early COVID-19. EClinicalMedicine, 42, 101212. https://doi.org/10.1016/j.eclinm.2021.101212

Canas, L. S., Sudre, C. H., Capdevila Pujol, J., Polidori, L., Murray, B., Molteni, E., Graham, M. S., Klaser, K., Antonelli, M., Berry, S., Davies, R., Nguyen, L. H., Drew, D. A., Wolf, J., Chan, A. T., Spector, T., Steves, C. J., Ourselin, S., & Modat, M. (2021). Early detection of COVID-19 in the UK using self-reported symptoms: a large-scale, prospective, epidemiological surveillance study. Lancet Digit Health, 3(9), e587-e598. https://doi.org/10.1016/s2589-7500(21)00131-x

Chmielewska, B., Barratt, I., Townsend, R., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., Le Doare, K., Ladhani, S., von Dadelszen, P., Magee, L., & Khalil, A. (2021a). Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob Health, 9(6), e759-e772. https://doi.org/10.1016/s2214-109x(21)00079-6

Fallon, V., Davies, S. M., Silverio, S. A., Jackson, L., De Pascalis, L., & Harrold, J. A. (2021). Psychosocial experiences of postnatal women during the COVID-19 pandemic. A UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety. J Psychiatr Res, 136, 157-166. https://doi.org/10.1016/j.jpsychires.2021.01.048

Fernandez Turienzo, C., Newburn, M., Agyepong, A., Buabeng, R., Dignam, A., Abe, C., Bedward, L., Rayment-Jones, H., Silverio, S. A., Easter, A., Carson, L. E., Howard, L. M., & Sandall, J. (2021). Addressing inequities in maternal health among women living in communities of social disadvantage and ethnic diversity. BMC Public Health, 21(1), 176. https://doi.org/10.1186/s12889-021-10182-4

Flynn, A. C., Kavanagh, K., Smith, A. D., Poston, L., & White, S. L. (2021). The Impact of the COVID-19 Pandemic on Pregnancy Planning Behaviours. Womens Health Rep (New Rochelle), 2(1), 71-77. https://doi.org/10.1089/whr.2021.0005

Graham, M. S., Sudre, C. H., May, A., Antonelli, M., Murray, B., Varsavsky, T., Kläser, K., Canas, L. S., Molteni, E., Modat, M., Drew, D. A., Nguyen, L. H., Polidori, L., Selvachandran, S., Hu, C., Capdevila, J., Hammers, A., Chan, A. T., Wolf, J., Spector, T. D., Steves, C. J., & Ourselin, S. (2021). Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study. Lancet Public Health, 6(5), e335-e345. https://doi.org/10.1016/s2468-2667(21)00055-4

Jackson, L., De Pascalis, L., Harrold, J. A., Fallon, V., & Silverio, S. A. (2021a). Postpartum women's experiences of social and healthcare professional support during the COVID-19 pandemic: A recurrent cross-sectional thematic analysis. Women Birth. https://doi.org/10.1016/j.wombi.2021.10.002

Jackson, L., De Pascalis, L., Harrold, J. A., Fallon, V., & Silverio, S. A. (2021b). Postpartum women's psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis. BMC Pregnancy Childbirth, 21(1), 625. https://doi.org/10.1186/s12884-021-04071-2

Jardine, J., Relph, S., Magee, L. A., von Dadelszen, P., Morris, E., Ross-Davie, M., Draycott, T., & Khalil, A. (2021). Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care. Bjog, 128(5), 880-889. https://doi.org/10.1111/1471-0528.16547

Kalafat, E., Magee, L. A., von Dadelszen, P., O’Brien, P., & Khalil, A. (2021). SARS-CoV-2 vaccination in pregnancy: a unique opportunity for equity. The Lancet, 398(10304), 951.

Kalafat, E., O'Brien, P., Heath, P. T., Le Doare, K., von Dadelszen, P., Magee, L., Ladhani, S., & Khalil, A. (2021). Benefits and potential harms of COVID-19 vaccination during pregnancy: evidence summary for patient counseling. Ultrasound Obstet Gynecol, 57(5), 681-686. https://doi.org/10.1002/uog.23631

Kalafat, E., Prasad, S., Birol, P., Tekin, A. B., Kunt, A., Di Fabrizio, C., Alatas, C., Celik, E., Bagci, H., Binder, J., Le Doare, K., Magee, L. A., Mutlu, M. A., Yassa, M., Tug, N., Sahin, O., Krokos, P., O'Brien, P., von Dadelszen, P., Palmrich, P., Papaioannou, G., Ayaz, R., Ladhani, S. N., Kalantaridou, S., Mihmanli, V., & Khalil, A. (2021). An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women. Am J Obstet Gynecol. https://doi.org/10.1016/j.ajog.2021.09.024

Khalil, A., von Dadelszen, P., Kalafat, E., Sebghati, M., Ladhani, S., Ugwumadu, A., Draycott, T., O'Brien, P., & Magee, L. (2021). Change in obstetric attendance and activities during the COVID-19 pandemic. Lancet Infect Dis, 21(5), e115. https://doi.org/10.1016/s1473-3099(20)30779-9

Khalil, A., von Dadelszen, P., Ugwumadu, A., Draycott, T., & Magee, L. A. (2021). Effect of COVID-19 on maternal and neonatal services. Lancet Glob Health, 9(2), e112. https://doi.org/10.1016/s2214-109x(20)30483-6

Klaser, K., Thompson, E. J., Nguyen, L. H., Sudre, C. H., Antonelli, M., Murray, B., Canas, L. S., Molteni, E., Graham, M. S., Kerfoot, E., Chen, L., Deng, J., May, A., Hu, C., Guest, A., Selvachandran, S., Drew, D. A., Modat, M., Chan, A. T., Wolf, J., Spector, T. D., Hammers, A., Duncan, E. L., Ourselin, S., & Steves, C. J. (2021). Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app. J Neurol Neurosurg Psychiatry, 92(12), 1254-1258. https://doi.org/10.1136/jnnp-2021-327565

Magee, L. A., von Dadelszen, P., Kalafat, E., Duncan, E. L., O'Brien, P., Morris, E., Heath, P., & Khalil, A. (2021). COVID-19 vaccination in pregnancy-number needed to vaccinate to avoid harm. Lancet Infect Dis, 21(12), 1627. https://doi.org/10.1016/s1473-3099(21)00691-5

Magee, L. A., von Dadelszen, P., & Khalil, A. (2021). COVID-19 and preterm birth. Lancet Glob Health, 9(2), e117. https://doi.org/10.1016/s2214-109x(20)30457-5

Menni, C., Klaser, K., May, A., Polidori, L., Capdevila, J., Louca, P., Sudre, C. H., Nguyen, L. H., Drew, D. A., Merino, J., Hu, C., Selvachandran, S., Antonelli, M., Murray, B., Canas, L. S., Molteni, E., Graham, M. S., Modat, M., Joshi, A. D., Mangino, M., Hammers, A., Goodman, A. L., Chan, A. T., Wolf, J., Steves, C. J., Valdes, A. M., Ourselin, S., & Spector, T. D. (2021). Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. Lancet Infect Dis, 21(7), 939-949. https://doi.org/10.1016/s1473-3099(21)00224-3

Molteni, E., Astley, C. M., Ma, W., Sudre, C. H., Magee, L. A., Murray, B., Fall, T., Gomez, M. F., Tsereteli, N., Franks, P. W., Brownstein, J. S., Davies, R., Wolf, J., Spector, T. D., Ourselin, S., Steves, C. J., Chan, A. T., & Modat, M. (2021). Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts. Sci Rep, 11(1), 6928. https://doi.org/10.1038/s41598-021-86452-3

Molteni, E., Sudre, C. H., Canas, L. S., Bhopal, S. S., Hughes, R. C., Antonelli, M., Murray, B., Kläser, K., Kerfoot, E., Chen, L., Deng, J., Hu, C., Selvachandran, S., Read, K., Capdevila Pujol, J., Hammers, A., Spector, T. D., Ourselin, S., Steves, C. J., Modat, M., Absoud, M., & Duncan, E. L. (2021). Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health, 5(10), 708-718. https://doi.org/10.1016/s2352-4642(21)00198-x

Molteni, E., Sudre, C. H., Canas, L. S., Bhopal, S. S., Hughes, R. C., Chen, L., Deng, J., Murray, B., Kerfoot, E., & Antonelli, M. S. (2021). Illness characteristics of COVID-19 in children infected with the SARS-CoV-2 Delta variant. Medrxiv.

Murray, B., Kerfoot, E., Chen, L., Deng, J., Graham, M. S., Sudre, C. H., Molteni, E., Canas, L. S., Antonelli, M., Klaser, K., Visconti, A., Hammers, A., Chan, A. T., Franks, P. W., Davies, R., Wolf, J., Spector, T. D., Steves, C. J., Modat, M., & Ourselin, S. (2021). Accessible data curation and analytics for international-scale citizen science datasets. Sci Data, 8(1), 297. https://doi.org/10.1038/s41597-021-01071-x

Oliver, B. J., Schmidt, P., Tomlin, S., Kraft, S. A., Fisher, E., & Nelson, E. C. (2021). A 'COVID Compass' for navigating the pandemic. Int J Qual Health Care, 33(Supplement_2), ii78-ii80. https://doi.org/10.1093/intqhc/mzab053

Relph, S., Jardine, J., Magee, L. A., von Dadelszen, P., Morris, E., Ross-Davie, M., Draycott, T., & Khalil, A. (2021). Authors' reply re: Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care. Bjog, 128(5), 937-938. https://doi.org/10.1111/1471-0528.16639

Schmidt, P., Nelson, E. C., Kearney, G., Kraft, S., & Oliver, B. J. (2021). International, national and local trends in the spread of COVID-19: a geographic view of COVID-19 spread and the role to be played by coproduction. Int J Qual Health Care, 33(Supplement_2), ii71-ii77. https://doi.org/10.1093/intqhc/mzab074

Silverio, S. A., Davies, S. M., Christiansen, P., Aparicio-García, M. E., Bramante, A., Chen, P., Costas-Ramón, N., de Weerth, C., Della Vedova, A. M., Infante Gil, L., Lustermans, H., Wendland, J., Xu, J., Halford, J. C. G., Harrold, J. A., & Fallon, V. (2021). A validation of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises with five translations. BMC Pregnancy Childbirth, 21(1), 112. https://doi.org/10.1186/s12884-021-03597-9

Silverio, S. A., De Backer, K., Easter, A., von Dadelszen, P., Magee, L. A., & Sandall, J. (2021). Women's experiences of maternity service reconfiguration during the COVID-19 pandemic: A qualitative investigation. Midwifery, 102, 103116. https://doi.org/10.1016/j.midw.2021.103116

Silverio, S. A., Easter, A., Storey, C., Jurković, D., & Sandall, J. (2021). Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic. BMC Pregnancy Childbirth, 21(1), 840. https://doi.org/10.1186/s12884-021-04292-5

Sudre, C. H., Keshet, A., Graham, M. S., Joshi, A. D., Shilo, S., Rossman, H., Murray, B., Molteni, E., Klaser, K., Canas, L. D., Antonelli, M., Nguyen, L. H., Drew, D. A., Modat, M., Pujol, J. C., Ganesh, S., Wolf, J., Meir, T., Chan, A. T., Steves, C. J., Spector, T. D., Brownstein, J. S., Segal, E., Ourselin, S., & Astley, C. M. (2021). Anosmia, ageusia, and other COVID-19-like symptoms in association with a positive SARS-CoV-2 test, across six national digital surveillance platforms: an observational study. Lancet Digit Health, 3(9), e577-e586. https://doi.org/10.1016/s2589-7500(21)00115-1

Sudre, C. H., Murray, B., Varsavsky, T., Graham, M. S., Penfold, R. S., Bowyer, R. C., Pujol, J. C., Klaser, K., Antonelli, M., Canas, L. S., Molteni, E., Modat, M., Jorge Cardoso, M., May, A., Ganesh, S., Davies, R., Nguyen, L. H., Drew, D. A., Astley, C. M., Joshi, A. D., Merino, J., Tsereteli, N., Fall, T., Gomez, M. F., Duncan, E. L., Menni, C., Williams, F. M. K., Franks, P. W., Chan, A. T., Wolf, J., Ourselin, S., Spector, T., & Steves, C. J. (2021). Attributes and predictors of long COVID. Nat Med, 27(4), 626-631. https://doi.org/10.1038/s41591-021-01292-y

Townsend, R., Chmielewska, B., Barratt, I., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., Doare, K. L., Ladhani, S., Dadelszen, P. V., Magee, L. A., & Khalil, A. (2021). Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine, 37, 100947. https://doi.org/10.1016/j.eclinm.2021.100947

2020

Bick, D. (2020). COVID-19: 2020 is the International Year of the Midwife. Midwifery, 85, 102719. https://doi.org/10.1016/j.midw.2020.102719

Bick, D., Cheyne, H., Chang, Y. S., & Fisher, J. (2020). Maternal postnatal health during the COVID-19 pandemic: Vigilance is needed. Midwifery, 88, 102781. https://doi.org/10.1016/j.midw.2020.102781

Etti, M., Sekikubo, M., Nankabirwa, V., Sommerfelt, H., Freyne, B., Kawaza, K., Gadama, G., Jambo, K., Sevene, E., Temmerman, M., Magee, L. A., von Dadelszen, P., Khalil, A., & Doare, K. L. (2020). SARS-CoV-2 Infection in Pregnant Women and Their Newborns. Ann Glob Health, 86(1), 132. https://doi.org/10.5334/aogh.3072

Khalil, A., Kalafat, E., Benlioglu, C., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., Le Doare, K., Heath, P., Ladhani, S., von Dadelszen, P., & Magee, L. A. (2020). SARS-CoV-2 infection in pregnancy: A systematic review and meta-analysis of clinical features and pregnancy outcomes. EClinicalMedicine, 25, 100446. https://doi.org/10.1016/j.eclinm.2020.100446

Khalil, A., von Dadelszen, P., Draycott, T., Ugwumadu, A., O'Brien, P., & Magee, L. (2020). Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic. Jama, 324(7), 705-706. https://doi.org/10.1001/jama.2020.12746

MacGregor, R., Hillman, S., & Bick, D. (2020). Falling through the cracks: the impact of COVID-19 on postnatal care in primary care. Br J Gen Pract, 70(701), 578-579. https://doi.org/10.3399/bjgp20X713573

Magee, L. A., Khalil, A., & von Dadelszen, P. (2020a). Covid-19: UK Obstetric Surveillance System (UKOSS) study in context. BMJ, 370, m2915. https://doi.org/10.1136/bmj.m2915

Magee, L. A., Khalil, A., & von Dadelszen, P. (2020b). Pregnancy hypertension diagnosis and care in COVID-19 era and beyond. Ultrasound Obstet Gynecol, 56(1), 7-10. https://doi.org/10.1002/uog.22115

Von Dadelszen, P., Khalil, A., Wolfe, I., Kametas, N. A., O’Brien, P., & Magee, L. A. (2020). “Women and children last”—effects of the covid-19 pandemic on reproductive, perinatal, and paediatric health. BMJ, 369.

Patient and Public Involvement and Engagement (PPIE) Advisory Group

Purpose

The study has a Patient and Public Involvement and Engagement (PPIE) Advisory Group. This group brings in the perspectives, lived experiences, and insights of many different parents and public representatives to ensure that our study is as relevant as it can be for women who are contemplating pregnancy, pregnant, or have recently had a baby, and their partners. We have maternity voices partnership chairs from England, Scotland and Northern Ireland, and a service user from Wales. We have charities and community networks represented and have invited participation to be diverse and inclusive.

We work as critical friends to the research team – guiding, challenging, and advocating for the project. Researchers ask us for advice on the relevance and acceptability of the study, and on issues of different groups’ experiences, attitudes, and ideas for the future development of services. 

PPIE framework

The study will report on PPIE using the GRIPP2 framework. This has five domains: 1) PPIE aim, 2) methods, 3) study results, 4) discussion and conclusions, 5) reflections/critical perspective.

Meetings

These are held online, for 90 minutes, three times per year, for two years. 

Reciprocity principle

There will be opportunities to shape the research throughout the project, and the way that messages about post-pandemic planning for maternity care are conveyed to policymakers, maternity services commissioners, clinicians, and the public.  Being on the group provides an opportunity to develop knowledge about the way research is conducted, and how lived experiences and interest groups can influence research to make it as relevant as possible, particularly for those who have a history of discrimination, disadvantage and/or poorer health outcomes.

 
Tania Sutedja, an Indonesian mother of one who gave birth during the pandemic, experiencing an emotional & life-enhancing maternity journey.

 
Abigail Mensah, a lecturer, a mother of one, and gave birth in the pandemic. Passionate about all stages within pregnancy.

 
Caitlin Steege -  "I am a type 1 diabetic and joined the study to help improve care and outcomes for women like me." 

 
Emily Balls is co-chair of the Moray and Banff Maternity Voices Partnership and is interested in supporting women to make informed choices about birth.

 
Scott Mair, father of seven. Lived experience of traumatic births and near-miss events led to campaigning for paternal mental health, providing peer support and parenting education.  

 
Meg Hill is passionate about public health and maternity care. She owns a perinatal business, is Stockport MVP Chair and an AIMS trustee.

 
Neelam Heera, a Tedx Speaker, founded charity Cysters. After facing battles around diagnosis and care, she wanted to address health inequalities in marginalised groups.

 
Kirsty Kitchen works for Birth Companions, a charity focused on the needs and experiences of women experiencing disadvantage during pregnancy and early motherhood.

 
Leah Bedward is passionate about mindfulness and reflexive practices that challenge institutional inequality leading to improved outcomes and safer spaces for BIPOC women who access maternity services.

Rachael Buabeng, multi-award winning mumpreneuer, founder of Mummy’s Day Out, Author and Maternal Health advocate. A mother, wife and Hyperemesis Gravidarum survivor and advocate. Passionate improving experiences for women within the perinatal period and beyond.

Sarah Wall, mum of 3 soon to be 4, I have worked with maternity transformation teams across the country for the last 4 ¹/₂ years to represent pregnant women, other pregnant people and their families. I believe that everyone deserves a positive birth experience as well as outcome.

Tannice Hemming, writer and former MVP Chair, gave birth during the pandemic. Tannice is passionate about informed birth choices, breastfeeding, neurodiversity and mental health.

 
Cathy McCusker

Emily Hubbard supports research into the development and delivery of innovative public services, and became a first-time Mom during the pandemic.

This study received support from ARC South London

Further information can be found through the link below: https://arc-sl.nihr.ac.uk/research-and-implementation/our-research-areas/maternity-and-perinatal-mental-health/post-pandemic

Trauma-awareness training for RESILIENT researchers and public involvement advisers

Knowing that past trauma affects pregnant women’s interactions with care providers, and that the COVID-19 pandemic has had negative effects for many, we commissioned the charity Birth Companions to deliver a short, online, training course for the RESILIENT researchers and members of the Patient and Public Involvement and Engagement (PPIE) Advisory Group.

We want to reach and interview a wide range of people during the study, and to analysis routinely collected data in appropriate ways, thinking about the social determinants of health. This training brought us together as a group, across continents (Canada and the UK), so was helpful for team building. It was co-developed and participatory.

Eleven RESILIENT researchers and three PPIE representatives attended. We all brought our lived and professional experiences to considering how to be trauma-aware in our research (and other) work. The presentations and outputs of our group discussions are available in the attached files. Attendance certificates were provided.

Feedback from participants included:

‘This is the start of a discussion with colleagues, easier to continue now we have common language and this shared event to reflect on’

‘Loved the talks about Birth Companions and about trauma-informed ways of working. Loved the small group discussion’

‘importance of offering pre- and post-meeting meetings with service users, sandwiching of larger multi-stakeholder meetings, to hear and address any anxieties or concerns’

And some main take-aways:

‘(We must) continue to keep trauma-informed thinking at the forefront of our activities — but also to keep it aligned with strengths-based thinking’

‘It’s important to work from an assumption that many of these women will be traumatised but that does not define them. Ask and build relationships!’

‘Being mindful not to re-traumatize, being mindful of language, and focusing on reciprocity, trust, and empowerment’

‘I'll be incorporating more tenets of a trauma informed approach’

The trainers said: the trainers;

‘We were pleased to be offered the opportunity to design and deliver a bespoke training to the RESILIENT project members. It was fantastic to work with such an engaged and interested group. The breakout rooms provided an opportunity for different strands of conversations to be brought to the wider group and we enjoyed some rich and diverse discussions. It was a pleasure to meet the attendees and spend the afternoon raising awareness of the impact of trauma and thinking about how the principles of a trauma informed approach can support the RESILIENT research.’