Reflections of maternity service users and midwives' on the co-creation of interventions to support midwives addressing alcohol during antenatal care

There are divergent perspectives between midwives and pregnant women on how alcohol consumption during pregnancy could be addressed. Co-creation is an approach where lay people and professionals work together as equal partners, offering the opportunity to bridge the gap. Our aim was to evaluate how well we carried out authentic co-creation of an intervention to support midwives have a dialogue about alcohol consumption with pregnant women. Recent maternity service users including women with experience of harm due to alcohol during pregnancy provided feedback on the design, conduct and dissemination of the study. An iterative co-creation approach rooted in participatory research methods was used. Five online workshops were carried out with thirteen midwives and six maternity service users via Zoom July-August 2021. Data were analysed using the core values of co-create as a framework: equality, inclusivity, holistic, resource, positivity, transparency, iterative, and sustainability. The co-creation process was productive and rewarding to midwives and maternity service users. There were positive experiences across the co-creation framework with some unintended positive consequences for maternity-service users. This evaluation provides new knowledge on how well the co-creation process worked in relation to research involving a sensitive topic that can invite stigma. Co-creation projects require generous time and financial resources to ensure a high-quality process and robust outcome for all. Co-creation of strategies involving both service providers and service users have potential to facilitate evidence-based practice. This research is funded by the National Institute for Health Research (Reference: NIHR201128) •Theory-informed implementation strategies can facilitate evidence-based healthcare practice•Co-creation of strategies and healthcare interventions should involve both service providers and service users to maximise their effectiveness and acceptability in practice•Our co-creation process was productive and rewarding to midwives and maternity service users with unexpected positive benefits for maternity service users