'Our COVID-19 cloud silver lining': the initiation and progress of postnatal contraception services during the COVID-19 pandemic in a UK maternity hospital.

### Key messages The COVID-19 pandemic presented an opportunity to rapidly improve postnatal contraception (PNC) services at the largest single-site maternity unit in the UK, Birmingham Women’s and Children’s Hospital NHS Trust. Prior to March 2020 there was no provision of PNC at the hospital. Midwives would routinely enquire about women’s contraceptive plans and direct them to general practice for advice and initiation. Contraceptive services are free as part of the National Health Service (NHS) to UK residents. The demand for and importance of PNC provision is well documented. In the UK almost 1 in 13 women presenting for an abortion or delivery has conceived within a year of a previous birth.1 An interpregnancy interval of less than 12 months increases the risk of complications for both mother and baby.2 A 2017 UK survey showed 47% of women would prefer to have their contraception provided from the postnatal ward before discharge.3 A local service evaluation from 2011 highlighted a gap in access to PNC at our hospital and the desire of women to receive both advice and immediate provision. During March 2020 the COVID-19 pandemic evolved in the UK. Routine health services were disrupted and access to contraception in the community became compromised.4 Birmingham Women’s is a tertiary obstetric hospital caring for all women including those with complex medical needs and high-risk pregnancies. Lack of access to PNC for these women could have grave consequences. They are also at …