PONE-D-21-05490

Experiences of maternity care professionals during the first wave of COVID-19 in a community based maternity care system

PLOS ONE

Dear Dr. van Manen,

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Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review this paper.

The paper is interesting as it looks at a community-based focus. I have a few comments and suggestions.

In the title or abstract it would be helpful to have the country in which the study was conducted. There are literally hundreds of studies now globally about the experiences of care and given countries each had different trajectories of the pandemic, context is essential.

It is hard to see this paper in isolation to the outcomes for women. For example, did attending less for decreased fetal movements make a difference to the rates of stillbirth? I know the woman’s experiences are reported separately but understanding the implications of these changes is difficult. Can the authors report any data that highlights the implications?

I was surprised to see the high numbers of recommended antenatal visits (13). In most countries in high income countries, the recommended number is 7-10 (certainly in Australia this is the case). Could it be that COVID-19 restrictions have just brought the number of antenatal visits down to what is more evidence-based anyway?

I was also surprised that no human ethical approval was required. Was this the same for the women’s survey?

The model of care in The Netherlands was described. Are women receiving community-based care more likely to have continuity of carer, that is a known midwife, than in the hospital setting? If so, this probably made a difference and it could be the continuity that explains the differences rather than the place of care.

How was social disadvantage addressed during the pandemic? For example, when care shifted to the phone or online, how did women without ready access to these modalities receive care? How did language needs get addressed?

Reviewer #2: Thank you for the opportunity to review this interesting and relevant manuscript. I have found the manuscript to be well written and I have a few comments for review.

1. Methods / Study design - It is written that ethical approval was not deemed necessary by the medical ethics committee. I think further information is needed regarding this. Was it because this was part of a larger study that had an umbrella approved ethics application and that this part didn't need a separate ethics?

2. Analysis - line 152 - you mention 'free text fields were either recorded into existing categories or new categories. I think further clarification is required here to add these free text fields were from the 'other' option given in a list and then the answer from the 'other' option was recorded as an existing or new category. When I first read this I thought you had open ended questions and then you were doing a content analysis until I viewed the survey questions at the end.

3. Discussion - line 345 - What data are you referring to when you mention the 'data on perinatal complications', is this data you have collected in the wider study or national perinatal data?

4. Lines 390-382 - Is the qualitative follow up study you mention part of the wider study? This needs clarification.

5. Strengths and limitations line 385-386 - This sentence could be reworded to be clearer. A suggestion is: The speed of initiation of the study after the beginning of the COVID-19 pandemic is a strength of this study.

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Reviewer #1: Yes: Caroline Homer

Reviewer #2: Yes: Hazel Keedle

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Experiences of Dutch maternity care professionals during the first wave of COVID-19 in a community based maternity care system

PONE-D-21-05490R1

Dear Dr. van Manen,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Hannah Dahlen, RN, RM, BN (Hons), MCommN, PhD FACM

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for completing the changes. I am still concerned about the lack of ethical approval but I guess that was out of your hands.

Reviewer #2: Thank you for addressing the comments made in the previous review and I feel this is now acceptable for publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No