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Vasarri MV, Fernicola F, Arienti F, Carli A, Colciago E, Locatelli A, Trotta M, Procopio A, Zammarchi L, Ornaghi S. Indirect impact of SARS-CoV-2 pandemic on incidence of maternal primary cytomegalovirus and Toxoplasma gondii infection in pregnancy. Int J Gynaecol Obstet 2024; 166:1218-1224. [PMID: 38619337 DOI: 10.1002/ijgo.15534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 03/21/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Public health interventions promoted during the SARS-CoV-2 pandemic to control viral spread have impacted the occurrence of other communicable disease. Yet no studies have focused on perinatal infections with the potential for neonatal sequelae, including cytomegalovirus (CMV) and Toxoplasma gondii (TG). Here we investigate whether incidence rates of maternal primary CMV and TG infection in pregnancy were affected by the implementation of pandemic-related public health measures. METHODS A retrospective study including all pregnant women with confirmed primary CMV or TG infection in pregnancy, managed between 2018 and 2021 at two university centers. The incidence rate was calculated as the number of CMV and TG infections per 100 consultations with a 95% confidence interval (CI). Data were compared between pre-pandemic (2018-2019) and pandemic (2020 and 2021) years. The Newcombe Wilson with Continuity Correction method was employed to compare incidence rates. RESULTS The study population included 215 maternal primary CMV and 192 TG infections. Rate of maternal primary CMV infection decreased in 2021 compared with 2018-2019 (4.49% vs 6.40%, attributable risk [AR] 1.92, P = 0.019). By contrast, the rate of TG infection substantially increased in 2020 (6.95% vs 4.61%, AR 2.34, P = 0.006). Close contact with cats was more common among patients with TG infection in 2020 and 2021 than among pre-pandemic TG-infected women (26.3% and 24.4% vs 13.3%, P = 0.013). CONCLUSION Pandemic-related public health interventions and associated behavioral and lifestyle changes exerted a divergent effect on the incidence of primary CMV and TG infection in pregnancy, likely due to modulation of exposure to risk factors for these infections.
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Affiliation(s)
- Maria Viola Vasarri
- Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- University of Milan-Bicocca School of Medicine and Surgery, Monza, Italy
| | - Federica Fernicola
- Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- University of Milan-Bicocca School of Medicine and Surgery, Monza, Italy
| | - Francesca Arienti
- Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- University of Milan-Bicocca School of Medicine and Surgery, Monza, Italy
| | - Anna Carli
- Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | | | - Anna Locatelli
- Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- University of Milan-Bicocca School of Medicine and Surgery, Monza, Italy
| | - Michele Trotta
- Tuscany Referral Centre for Infectious Diseases in Pregnancy, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Angelica Procopio
- School of Human Health Sciences, Degree Course in Medicine and Surgery, University of Florence, Florence, Italy
| | - Lorenzo Zammarchi
- Tuscany Referral Centre for Infectious Diseases in Pregnancy, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sara Ornaghi
- Department of Obstetrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- University of Milan-Bicocca School of Medicine and Surgery, Monza, Italy
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Ulrich SE, Sugg MM, Desjardins MR, Runkle JD. Disparities in spatiotemporal clustering of maternal mental health conditions before and during the COVID-19 pandemic. Health Place 2024; 89:103307. [PMID: 38954963 DOI: 10.1016/j.healthplace.2024.103307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/15/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
Mounting evidence indicates the worsening of maternal mental health conditions during the COVID-19 pandemic. Mental health conditions are the leading cause of preventable death during the perinatal and postpartum periods. Our study sought to detect space-time patterns in the distribution of maternal mental health conditions in pregnant women before (2016-2019) and during (2020-2021) the COVID-19 pandemic in North Carolina, USA. Using the space-time Poisson model in SaTScan, we performed univariate and multivariate cluster analysis of emergency department (ED) visits for perinatal mood and anxiety disorders (PMAD), severe mental illness (SMI), maternal mental disorders of pregnancy (MDP), suicidal thoughts, and suicide attempts during the pre-pandemic and pandemic periods. Clusters were adjusted for age, race, and insurance type. Significant multivariate and univariate PMAD, SMI, and MDP clustering persisted across both periods in North Carolina, while univariate clustering for both suicide outcomes decreased during the pandemic. Local relative risk (RR) for all conditions increased drastically in select locations. The number of zip code tabulation areas (ZCTAs) included in clusters decreased, while the proportion of urban locations included in clusters increased for non-suicide outcomes. Average yearly case counts for all maternal mental health outcomes increased during the pandemic. Results provide contextual and spatial information concerning at-risk maternal populations with a high burden of perinatal mental health disorders before and during the pandemic and emphasize the necessity of urgent and targeted expansion of mental health resources in select communities.
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Affiliation(s)
- Sarah E Ulrich
- Department of Geography and Planning, P.O. Box 32066, Appalachian State University, Boone, NC, 28608, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, P.O. Box 32066, Appalachian State University, Boone, NC, 28608, USA.
| | - Michael R Desjardins
- Department of Epidemiology & Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC, 28801, USA
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Abderhalden-Zellweger A, de Labrusse C, Gemperle M, Grylka-Baeschlin S, Pfund A, Mueller AN, Mariani I, Pessa Valente E, Lazzerini M. Women's experiences of disrespect and abuse in Swiss facilities during the COVID-19 pandemic: a qualitative analysis of an open-ended question in the IMAgiNE EURO study. BMC Pregnancy Childbirth 2024; 24:402. [PMID: 38822258 PMCID: PMC11143635 DOI: 10.1186/s12884-024-06598-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/21/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has challenged the provision of maternal care. The IMAgiNE EURO study investigates the Quality of Maternal and Newborn Care during the pandemic in over 20 countries, including Switzerland. AIM This study aims to understand women's experiences of disrespect and abuse in Swiss health facilities during the COVID-19 pandemic. METHODS Data were collected via an anonymous online survey on REDCap®. Women who gave birth between March 2020 and March 2022 and answered an open-ended question in the IMAgiNE EURO questionnaire were included in the study. A qualitative thematic analysis of the women's comments was conducted using the International Confederation of Midwives' RESPECT toolkit as a framework for analysis. FINDINGS The data source for this study consisted of 199 comments provided by women in response to the open-ended question in the IMAgiNE EURO questionnaire. Analysis of these comments revealed clear patterns of disrespect and abuse in health facilities during the COVID-19 pandemic. These patterns include non-consensual care, with disregard for women's choices and birth preferences; undignified care, characterised by disrespectful attitudes and a lack of empathy from healthcare professionals; and feelings of abandonment and neglect, including denial of companionship during childbirth and separation from newborns. Insufficient organisational and human resources in health facilities were identified as contributing factors to disrespectful care. Empathic relationships with healthcare professionals were reported to be the cornerstone of positive experiences. DISCUSSION Swiss healthcare facilities showed shortcomings related to disrespect and abuse in maternal care. The pandemic context may have brought new challenges that compromised certain aspects of respectful care. The COVID-19 crisis also acted as a magnifying glass, potentially revealing and exacerbating pre-existing gaps and structural weaknesses within the healthcare system, including understaffing. CONCLUSIONS These findings should guide advocacy efforts, urging policy makers and health facilities to allocate adequate resources to ensure respectful and high-quality maternal care during pandemics and beyond.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland.
| | - Claire de Labrusse
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| | - Michael Gemperle
- Research Institute of Midwifery and Reproductive Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Susanne Grylka-Baeschlin
- Research Institute of Midwifery and Reproductive Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Anouck Pfund
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| | - Antonia N Mueller
- Research Institute of Midwifery and Reproductive Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Ilaria Mariani
- WHO Collaborating Center for Maternal and Child Health, Institute for Maternaland , Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Emanuelle Pessa Valente
- WHO Collaborating Center for Maternal and Child Health, Institute for Maternaland , Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marzia Lazzerini
- WHO Collaborating Center for Maternal and Child Health, Institute for Maternaland , Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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Tan A, Blair A, Homer CS, Digby R, Vogel JP, Bucknall T. Pregnant and postpartum women's experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis. BMC Pregnancy Childbirth 2024; 24:262. [PMID: 38605319 PMCID: PMC11007880 DOI: 10.1186/s12884-024-06439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/24/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Pregnant and postpartum women's experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic. METHODS A qualitative evidence synthesis of studies relating to women's experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings. RESULTS Sixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment. CONCLUSIONS The findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.
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Affiliation(s)
- Annie Tan
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia.
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Geelong, Australia.
| | - Amanda Blair
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Caroline Se Homer
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Robin Digby
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Geelong, Australia
- Alfred Health, Melbourne, Australia
| | - Joshua P Vogel
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Geelong, Australia
- Alfred Health, Melbourne, Australia
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Mamrath S, Greenfield M, Fernandez Turienzo C, Fallon V, Silverio SA. Experiences of postpartum anxiety during the COVID-19 pandemic: A mixed methods study and demographic analysis. PLoS One 2024; 19:e0297454. [PMID: 38451908 PMCID: PMC10919661 DOI: 10.1371/journal.pone.0297454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/04/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The first wave of the COVID-19 pandemic saw the reconfiguration of perinatal and maternity services, national lockdowns, and social distancing measures which affected the perinatal experiences of new and expectant parents. This study aimed to explore the occurrence of postpartum anxieties in people who gave birth during the pandemic. METHODS An exploratory concurrent mixed-methods design was chosen to collect and analyse the quantitative and qualitative data of an online survey during the first UK lockdown. The survey included the Postpartum Specific Anxiety Scale-Research Short Form-for use in global Crises [PSAS-RSF-C] psychometric tool, and open-ended questions in relation to changes in birth plans and feelings about those changes and giving birth in a pandemic. Differences in measured scores were analysed for the participant's ethnicity, sexual orientation and disability using independent Student's t-tests, and for age, the analysis was completed using Pearson's correlation. Qualitative data from open-ended questions were analysed using a template analysis. RESULTS A total of 1,754 new and expectant parents completed the survey between 10th and 24th April 2020, and 381 eligible postnatal women completed the psychometric test. We found 52.5% of participants reported symptoms consistent with a diagnosis of postnatal anxiety-significantly higher than the rates usually reported. Younger women and sexual minority women were more likely to score highly on the PSAS-RSF-C than their older or heterosexual counterparts (p<0.001). Younger participants reported anxieties in the 'infant safety and welfare' category, whilst lesbian, gay, bisexual, and pansexual participants scored highly in the 'psychosocial adjustment to motherhood' category. DISCUSSION Postpartum anxiety is under-reported, and demographic differences in the rates of postpartum anxiety are under-researched. This research demonstrates for the first time a difference in postpartum anxiety rates amongst sexual minority women.
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Affiliation(s)
- Simran Mamrath
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Mari Greenfield
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Health, Wellbeing and Social Care, Department of Wellbeing, Education, Languages and Social Care, The Open University, Milton Keynes, United Kingdom
| | - Cristina Fernandez Turienzo
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
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Bute JJ, Brann M, Scott SF, Johnson NL. Expectancy violations and boundary management when giving birth during a pandemic: implications for supporting women. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024; 17:92-100. [PMID: 37818744 DOI: 10.1080/17538068.2023.2267844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND Few life events are as profound as the birth of a child. Yet for those who gave birth during the COVID-19 pandemic, the birth experience and the care of their newborn child were altered in significant ways. METHOD In this study, we examined the stories of women who gave birth during the COVID-19 pandemic using expectations violations theory and communication privacy management theory. RESULTS Based on focus group interviews with 65 women from 19 states across the U.S., we found that policies imposed by institutions and visitation rules negotiated by women were prominent in women's birth stories. Policies that affect territorial access to mothers and babies shaped communication to manage health and safety, resulted in intense emotional responses, and affected relationships with women's partners and families. CONCLUSIONS Our findings offer practical implications for both health care systems and health care providers. Systems must communicate proactively to offer compassionate patient care, and physicians should offer guidance to help new parents manage visitors.
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Affiliation(s)
- Jennifer J Bute
- Department of Communication Studies, IUPUI, Indianapolis, IN, USA
| | - Maria Brann
- Department of Communication Studies, IUPUI, Indianapolis, IN, USA
| | | | - Nicole L Johnson
- Center for Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, VA, USA
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Mohd Ujang IR, Hamidi N, Ab Hamid J, Awang S, Zulkifli NW, Supadi R, Mohamed NE, Sooryanarayana R. The COVID-19 pandemic and disruptions to maternal and child health services in public primary care Malaysia: a retrospective time-series analysis. BMJ Glob Health 2023; 8:e013397. [PMID: 37949498 PMCID: PMC10649372 DOI: 10.1136/bmjgh-2023-013397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide. Maintaining essential health services, including maternal and child health (MCH), while addressing the pandemic is an enormous task. This study aimed to assess the impact of the COVID-19 pandemic on the utilisation of MCH services in Malaysian public primary care. METHODS A retrospective analysis was conducted using national administrative data from 1124 public primary care clinics. Eight indicators were selected to measure service utilisation covering antenatal, postnatal, women's health, child health, and immunisation services. Interrupted time-series analysis was used to evaluate changes in levels and trends of indicators during four different periods: pre-pandemic (January 2019-February 2020), during pandemic and first lockdown (March-May 2020), after the first lockdown was lifted (June-December 2020) and after the second lockdown was implemented (January-June 2021). RESULTS Most indicators showed no significant trend in monthly utilisation prior to the pandemic. The onset of the pandemic and first lockdown implementation were associated with significant decreasing trends in child health (-19.23%), women's health (-10.12%), antenatal care (-8.10%), contraception (-6.50%), postnatal care (-4.85%) and postnatal care 1-week (-3.52%) indicators. These indicators showed varying degrees of recovery after the first lockdown was lifted. The implementation of the second lockdown caused transient reduction ranging from -11.29% to -25.92% in women's health, contraception, child and two postnatal indicators, but no sustained reducing trend was seen afterwards. Two immunisation indicators appeared unaffected throughout the study period. CONCLUSION The COVID-19 pandemic significantly impacted MCH services utilisation in Malaysia. While most MCH services were negatively affected by the lockdown implementation with varying degrees of recovery, infant immunisation showed resilience throughout. This highlights the need for a targeted preparedness plan to ensure the resilience of MCH services in future crises.
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Affiliation(s)
- Izzatur Rahmi Mohd Ujang
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Normaizira Hamidi
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Jabrullah Ab Hamid
- Centre for Health Equity Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Samsiah Awang
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | | | - Roslina Supadi
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Nur Ezdiani Mohamed
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Rajini Sooryanarayana
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
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Loezar-Hernández M, Briones-Vozmediano E, Gea-Sánchez M, Robledo-Martin J, Otero-García L. Primary health care midwives' perceptions on the use of telemedicine during the COVID-19 pandemic in Spain. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:380-390. [PMID: 37898171 DOI: 10.1016/j.enfcle.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/23/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE To explore the experiences of primary healthcare (PHC) midwives with the implementation of telemedicine in pregnancy and puerperium care during the Covid-19 pandemic. METHOD Exploratory qualitative study based on an inductive content analysis of 15 semi-structured interviews with intentionally selected PHC midwives in four Spanish Autonomous Regions, during 2021-22. RESULTS Five categories were identified: (1) changes in the modality of care in pregnancy and puerperium: prioritization of pregnant women, unprotected puerperium, an increase of home visits and decline of parental education groups, (2) implementation of telemedicine in a changing scenario: the positive and negative side of telemedicine (3) reaction of women to telemedicine (4) strategies implemented by midwives for a humanized care, (5) learning for the future. CONCLUSIONS The use of telemedicine by primary healthcare midwives enabled the care of pregnant and postpartum women during the pandemic in Spain. The positive aspects of the implementation of this type of care raise possibilities for change towards a hybrid format of healthcare.
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Affiliation(s)
- Mariana Loezar-Hernández
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios en Salud, Sociedad, Educación y Cultura de los Cuidados, Universidad de Lleida, Lleida, Spain; Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain
| | - Erica Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios en Salud, Sociedad, Educación y Cultura de los Cuidados, Universidad de Lleida, Lleida, Spain; Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain.
| | - Montserrat Gea-Sánchez
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios en Salud, Sociedad, Educación y Cultura de los Cuidados, Universidad de Lleida, Lleida, Spain; Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB), Lleida, Spain; Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juana Robledo-Martin
- Departamento de Enfermería, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañon (IiSGM), Madrid, Spain
| | - Laura Otero-García
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Silverio SA, De Backer K, Brown JM, Easter A, Khazaezadeh N, Rajasingam D, Sandall J, Magee LA. Reflective, pragmatic, and reactive decision-making by maternity service providers during the SARS-CoV-2 pandemic health system shock: a qualitative, grounded theory analysis. BMC Pregnancy Childbirth 2023; 23:368. [PMID: 37210485 DOI: 10.1186/s12884-023-05641-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/24/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Pregnant and postpartum women were identified as having particular vulnerability to severe symptomatology of SARS-CoV-2 infection, so maternity services significantly reconfigured their care provision. We examined the experiences and perceptions of maternity care staff who provided care during the pandemic in South London, United Kingdom - a region of high ethnic diversity with varied levels of social complexity. METHODS We conducted a qualitative interview study, as part of a service evaluation between August and November 2020, using in-depth, semi-structured interviews with a range of staff (N = 29) working in maternity services. Data were analysed using Grounded Theory analysis appropriate to cross-disciplinary health research. ANALYSIS & FINDINGS Maternity healthcare professionals provided their views, experiences, and perceptions of delivering care during the pandemic. Analysis rendered three emergent themes regarding decision-making during reconfigured maternity service provision, organised into pathways: 1) 'Reflective decision-making'; 2) 'Pragmatic decision-making'; and 3) 'Reactive decision-making'. Whilst pragmatic decision-making was found to disrupt care, reactive-decision-making was perceived to devalue the care offered and provided. Alternatively, reflective decision-making, despite the difficult working conditions of the pandemic, was seen to benefit services, with regards to care of high-quality, sustainability of staff, and innovation within the service. CONCLUSIONS Decision-making within maternity care was found to take three forms - where at best changes to services could be innovative, at worst they could cause devaluation in care being delivered, and more often than not, these changes were disruptive. With regard to positive changes, healthcare providers identified staff empowerment, flexible working patterns (both for themselves and collectively as teams), personalised care delivery, and change-making in general, as key areas to capitalise on current and ongoing innovations borne out of the pandemic. Key learnings included a focus on care-related, meaningful listening and engagement of staff at all levels, in order to drive forward high-quality care and avoid care disruption and devaluation.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 6th Floor Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK.
| | - Kaat De Backer
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Jeremy M Brown
- Health Research Institute, Medical School, Faculty of Health, Social Care & Medicine, Edge Hill University, St. Helen's Road, Ormskirk, L39 4QP, Lancashire, UK
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Nina Khazaezadeh
- Chief Midwifery Office, NHS England and Improvement, Wellington House, 133-155 Waterloo Road, Southwark, London, SE1 8UG, UK
| | - Daghni Rajasingam
- Maternity Services, St. Thomas' Hospital, Guy's and St. Thomas's NHS Foundation Trust, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Laura A Magee
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 6th Floor Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK
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Zachari S, Papagiannis D, Kotsiou O, Malli F, Fradelos EC, Gourgoulianis KI. Factors of Compliance of Dental Patients in Primary Health Care Services during the Pandemic. Vaccines (Basel) 2023; 11:vaccines11040844. [PMID: 37112755 PMCID: PMC10142344 DOI: 10.3390/vaccines11040844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
The compliance of dentists with good hygiene practices during the COVID-19 pandemic was essential to minimize the transmission of SARS-CoV-2 strains, and the pandemic has significantly interrupted the provision of oral health care to many individuals. We aimed to examine, in a cross-sectional study, factors affecting dental patients' compliance in primary dental health settings during the pandemic period. The present study was conducted on 300 dental patients visiting four private dental offices in the city of Larissa in Central Greece during the period October-December 2021. The patients in the study sample were of an average age of 45.79 years with a standard deviation of 15.54 years, and 58% of the sample were females. A significant proportion of the participants, 22%, reported that they would be influenced if they knew that the dentist had been ill with COVID-19 despite being fully recovered. A total of 88% of the participants reported that they would feel safe if they knew their dentist was vaccinated against COVID-19. Regarding the information received by dentists, 88% of the participants agreed that the dentist's role is important in dealing with the COVID-19 pandemic, and 89% of them agreed that the information they received from the dentist about the COVID-19 pandemic was sufficient. One-third of the total sample reported that COVID-19 negatively impacted keeping dental appointments, and 43% of the sample kept scheduled appointments. A total of 98% reported that the dentist followed all health protocols against COVID-19 and that their office was equipped to follow health protocols. In the present study, we observe that dentists had adequate knowledge of, attitudes towards, and practices of infection control protocols against COVID-19 during the second wave, according to patients' perceptions.
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Affiliation(s)
- Sofia Zachari
- Primary Health Care Post Graduate Program, University of Thessaly, 41110 Larissa, Greece
| | - Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, Department of Nursing, School of Health Science, University of Thessaly, 41500 Larissa, Greece
| | - Ourania Kotsiou
- Human Pathophysiology Laboratory, Department of Nursing, University of Thessaly, 41500 Larissa, Greece
| | - Foteini Malli
- Respiratory Disorders Laboratory, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece
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Childbirth experience during the COVID-19 pandemic: A qualitative thematic analysis. Midwifery 2023; 121:103669. [PMID: 37001431 PMCID: PMC10038889 DOI: 10.1016/j.midw.2023.103669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/16/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Introduction Pregnancy is a period of special vulnerability for the mental health of women. The arrival of the COVID-19 pandemic altered the routines of pregnant women, its effects on this population are thus far unknown. Therefore, the objective of this study is to understand the impact of the pandemic on the birth experience of women during the state of emergency in Andalusia, Spain. Methods A qualitative study was conducted with 14 women, using semistructured interviews via telematics. These were recorded and later transcribed using the F4transkript software. In order to analyse the data retrieved from the interviews and identify the main patterns of meaning/responses, the thematic analysis method was applied. Results The main emerging themes were 'prenatal medical care', 'hospital safety', and 'postpartum with COVID-19 restrictions'. The results indicated that the reorganization of perinatal medical care, the lack of information, and the fear of contagion were the factors that most negatively influenced the participants. Instead, the security during the birth process and the tranquillity in postpartum were the positive aspects of the birth experiences during COVID-19. Conclusion This is the first qualitative study in Andalusia that identifies the specific aspects of the COVID-19 pandemic that have affected the mental health of pregnant women. The results contribute to a broader perception of the experience of women and the creation of health protocols for emergencies akin to the COVID-19 pandemic.
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Escobar MF, Gallego JC, Echavarria MP, Fernandez P, Posada L, Salazar S, Gutierrez I, Alarcon J. Maternal and perinatal outcomes in mixed antenatal care modality implementing telemedicine in the southwestern region of Colombia during the COVID-19 pandemic. BMC Health Serv Res 2023; 23:259. [PMID: 36922841 PMCID: PMC10017345 DOI: 10.1186/s12913-023-09255-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/07/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Contingency measures due to the COVID-19 pandemic limited access to routine prenatal care for pregnant women, increasing the risk of pregnancy complications due to poor prenatal follow-up, especially in those patients at high obstetric risk. This prompted the implementation and adaptation of telemedicine. OBJECTIVE We aim to evaluate the maternal and perinatal outcomes of patients who received prenatal care in-person and by telemedicine. METHODS We conducted a retrospective observational cohort study of pregnant women who received exclusive in-person and alternate (telemedicine and in-person) care from March to December 20,202, determining each group's maternal and neonatal outcomes. RESULTS A total of 1078 patients were included, 156 in the mixed group and 922 in the in-person group. The patients in the mixed group had a higher number of prenatal controls (8 (6-9) vs 6 (4-8) p < 0.001), with an earlier gestational age at onset (7.1 (6-8.5) vs 9.3 (6.6-20.3), p < 0.001), however, they required a longer hospital stay (26 (16,67%) vs 86 (9,33%), p = 0.002) compared to those attended in-person; there were no significant differences in the development of obstetric emergencies, maternal death or neonatal complications. DISCUSSION Incorporating telemedicine mixed with in-person care could be considered as an alternative for antenatal follow-up of pregnant women in low- and middle-income countries with barriers to timely and quality health care access.
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Affiliation(s)
- María Fernanda Escobar
- High Complexity Obstetric Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cra 98 Nro.18-49, 7600.2, Cali, Colombia. .,Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia. .,Department of Telemedicine, Fundación Valle del Lili, Cali, Colombia.
| | - Juan Carlos Gallego
- High Complexity Obstetric Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cra 98 Nro.18-49, 7600.2, Cali, Colombia.,Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
| | - María Paula Echavarria
- High Complexity Obstetric Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cra 98 Nro.18-49, 7600.2, Cali, Colombia.,Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
| | - Paula Fernandez
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
| | - Leandro Posada
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
| | - Shirley Salazar
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
| | - Isabella Gutierrez
- Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
| | - Juliana Alarcon
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
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Hanser A, Qian Y. Pregnant under quarantine: Women's agency and access to medical care under Wuhan's COVID-19 lockdown. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100095. [PMID: 35600563 PMCID: PMC9110303 DOI: 10.1016/j.ssmqr.2022.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/21/2022] [Accepted: 05/05/2022] [Indexed: 01/12/2023]
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de Labrusse C, Abderhalden‐Zellweger A, Mariani I, Pfund A, Gemperle M, Grylka‐Baeschlin S, Mueller AN, Valente E, Covi B, Lazzerini M, Drandić D, Kurbanović M, Virginie R, de La Rochebrochard E, Löfgren K, Miani C, Batram‐Zantvoort S, Wandschneider L, Lazzerini M, Valente EP, Covi B, Mariani I, Morano S, Chertok I, Hefer E, Artzi‐Medvedik R, Pumpure E, Rezeberga D, Jansone‐Šantare G, Jakovicka D, Knoka AR, Vilcāne KP, Liepinaitienė A, Kondrakova A, Mizgaitienė M, Juciūtė S, Arendt M, Tasch B, Nedberg IH, Kongslien S, Vik ES, Baranowska B, Tataj‐Puzyna U, Węgrzynowska M, Costa R, Barata C, Santos T, Rodrigues C, Dias H, Otelea MR, Radetić J, Ružičić J, Drglin Z, Ponikvar BM, Bohinec A, Brigidi S, Castañeda LM, Elden H, Sengpiel V, Linden K, Zaigham M, De Labrusse C, Abderhalden A, Pfund A, Thorn H, Grylka S, Gemperle M, Mueller A. Quality of maternal and newborn care in Switzerland during the COVID-19 pandemic: A cross-sectional study based on WHO quality standards. Int J Gynaecol Obstet 2022; 159 Suppl 1:70-84. [PMID: 36530005 PMCID: PMC9877813 DOI: 10.1002/ijgo.14456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To explore quality of maternal and newborn care (QMNC) in healthcare facilities during the COVID-19 pandemic in Switzerland. METHODS Women giving birth in Switzerland answered a validated online questionnaire including 40 WHO standards-based quality measures. QMNC score was calculated according to linguistic region and mode of birth. Differences were assessed using logistic regression analysis adjusting for relevant variables. RESULTS A total of 1175 women were included in the analysis. Limitations in QMNC during the pandemic were reported by 328 (27.9%) women. Several quality measures, such as deficient communication (18.0%, n = 212), insufficient number of healthcare professionals (19.7%, n = 231), no information on the newborn after cesarean (26.5%, n = 91) or maternal and newborn danger signs (34.1%, n = 401 and 41.4% n = 487, respectively) suggested preventable gaps in QMNC. Quality measures significantly differed by linguistic region and mode of birth. Multivariate analysis established a significantly lower QMNC for women in French- and Italian-speaking regions compared with the German-speaking region. Moreover, in several quality indicators reflecting communication with healthcare providers, women who did not answer the questionnaire in one of the Swiss national languages had significantly worse scores than others. A significant lower QMNC was also found for young and primiparous women and for those who experienced cesarean or instrumental vaginal birth. CONCLUSION Women giving birth in Switzerland during the pandemic reported notable gaps in QMNC. Providers should be attuned to women who are younger, primiparous, and those who had an emergency cesarean or instrumental vaginal birth given the lower QMNC reported by these groups. Women who did not respond in a Swiss national language may need improved communication strategies.
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Affiliation(s)
- Claire de Labrusse
- School of Health Sciences (HESAV)HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland
| | - Alessia Abderhalden‐Zellweger
- School of Health Sciences (HESAV)HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland
| | - Ilaria Mariani
- WHO Collaborating Center for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Anouck Pfund
- School of Health Sciences (HESAV)HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland
| | - Michael Gemperle
- Research Institute for MidwiferyZHAW Zurich University of Applied SciencesWinterthurSwitzerland
| | | | - Antonia N. Mueller
- Research Institute for MidwiferyZHAW Zurich University of Applied SciencesWinterthurSwitzerland
| | - Emanuelle Pessa Valente
- WHO Collaborating Center for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Benedetta Covi
- WHO Collaborating Center for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Marzia Lazzerini
- WHO Collaborating Center for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
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Yadollahi P, Zangene N, Heiran A, Sharafi M, Heiran KN, Hesami E, Saffari M, Azima S, Mirahmadizadeh A. Effect of the COVID-19 pandemic on maternal healthcare indices in Southern Iran: an interrupted time series analysis. BMJ Open 2022; 12:e059983. [PMID: 36288832 PMCID: PMC9615178 DOI: 10.1136/bmjopen-2021-059983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Epidemics are anticipated to influence the coverage of health services. We assessed the impact of the COVID-19 pandemic on maternal healthcare indices and care providers' performance. SETTING 1801 maternal healthcare centres under the auspices of Shiraz University of Medical Sciences, Shiraz, Southern Iran. PARTICIPANTS Approximately 63 000 pregnant women. PRIMARY AND SECONDARY OUTCOME MEASURES In this prospective ecological study, interrupted time series analysis was used to model and compare the trend of maternal healthcare indices before and after the COVID-19 pandemic announcement. RESULTS The results showed a significant drop in count of preconception healthcare visits, first routine laboratory tests, first trimester prenatal care, first trimester sonography, prenatal screening for birth defects at weeks 11-13, prenatal care visits at weeks 16-20, second routine laboratory tests, second trimester sonography, prenatal care visits at weeks 24-30, prenatal care visits at weeks 31-34, postpartum care visits at days 10-15 and postpartum care visits at days 30-42 with the start of the COVID-19 pandemic (-50% (95% CI -48.68% to -51.36%), -19.67% (95% CI -22.12% to -17.15%), -25.88% (95% CI -28.46% to -23.21%), -23.84% (95% CI -26.26% to -21.34%), -20.16% (95% CI -23.01% to -17.20%), -18.53% (95% CI -21.25% to -15.71%), -28.63% (95% CI -31.03% to -26.14%), -27.48% (95% CI -30.07% to -24.79%), -31.08% (95% CI -33.43% to -28.61%), -31.84% (95% CI -34.35% to -29.23%), 32.55% (95% CI -35.12% to -29.89%) and -39.28% (95% CI -41.59% to -36.88%), respectively). Nevertheless, the trend in coverage of these services showed recovery in the subsequent months (8.36%, 10.55%, 5.74%, 8.01%, 4.40%, 5.06%, 11.20%, 7.58%, 7.38%, 7.80%, 9.59% and 9.61% per month, respectively). CONCLUSIONS Using ecological data during the COVID-19 pandemic era, we observed a 'level change and slope change' as the major pattern of interruption of maternal healthcare coverage, indicating a possible indirect effect rather than a causative relationship. Such relative predictability might assist with future pandemic planning.
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Affiliation(s)
- Parvin Yadollahi
- Maternal-Fetal Medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Negar Zangene
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Alireza Heiran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Mehdi Sharafi
- Students Research Committee, School of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Khadije Neda Heiran
- Department of Midwifery, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Sistan and Baluchestan, Iran
| | - Elham Hesami
- Midwifery Counseling, Family Health Unit, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Masoumeh Saffari
- Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Sara Azima
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Alireza Mirahmadizadeh
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Thorn-Cole H, De Labrusse C, Abderhalden-Zellweger A, Kaech C, Hammer R. Impact of the COVID-19 pandemic on maternity services in Europe: a mixed methods systematic review protocol. JBI Evid Synth 2022; 20:2303-2311. [PMID: 35989639 PMCID: PMC9593326 DOI: 10.11124/jbies-22-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: This review will synthesize and integrate the best available evidence on the changes caused by the COVID-19 pandemic in access to and the provision of maternity services in Europe. The review will also consider health care professionals’ experiences in providing maternity care during the COVID-19 pandemic in Europe. Introduction: Governments and maternity services have introduced various protective sanitary and organizational measures to reduce the spread of COVID-19 and protect the global population, including health care professionals. Since March 2020, the number of publications on this topic has soared, yet little is known about the effect of the pandemic and the accompanying measures on access to and the provision of maternity care in Europe. Inclusion criteria: The review will consider quantitative, qualitative, and mixed methods studies on the impact of COVID-19 on European maternity services. For the quantitative component, the review will consider studies evaluating maternity services outcomes across all types of maternity care settings. For the qualitative component, the review will consider studies exploring maternity health care providers’ experiences and perceptions of the impact of the pandemic on care provided to women and their babies. Methods: Six bibliographic databases will be searched for published and unpublished studies since March 2020. Study selection, critical appraisal, data extraction, and data synthesis will follow JBI's segregated mixed methods approach. The quantitative component will be adapted to follow the JBI requirements for systematic reviews of etiology and risk. Systematic review registration number: PROSPERO CRD42021283878
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Affiliation(s)
- Harriet Thorn-Cole
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Nimavat N, Hasan MM, Charmode S, Mandala G, Parmar GR, Bhangu R, Khan I, Singh S, Agrawal A, Shah A, Sachdeva V. COVID-19 pandemic effects on the distribution of healthcare services in India: A systematic review. World J Virol 2022; 11:186-197. [PMID: 36159611 PMCID: PMC9372784 DOI: 10.5501/wjv.v11.i4.186] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/19/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has brought fundamental changes to our problems and priorities, especially those related to the healthcare sector. India was one of the countries severely affected by the harsh consequences of the COVID-19 pandemic.
AIM To understand the challenges faced by the healthcare system during a pandemic.
METHODS The literature search for this review was conducted using PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. We also used Reference Citation Analysis (RCA) to search and improve the results. We focused on the published scientific articles concerned with two major vital areas: (1) The Indian healthcare system; and (2) COVID-19 pandemic effects on the Indian healthcare system.
RESULTS The Indian healthcare system was suffering even before the pandemic. The pandemic has further stretched the healthcare services in India. The main obstacle in the healthcare system was to combat the rising number of communicable as well as noncommunicable diseases. Besides the pandemic measures, there was a diversion of focus of the already established healthcare services away from the chronic conditions and vaccinations. The disruption of the vaccination services may have more severe short and long-term consequences than the pandemic’s adverse effects.
CONCLUSION Severely restricted resources limited the interaction of the Indian healthcare system with the COVID-19 pandemic. Re-establishment of primary healthcare services, maternal and child health services, noncommunicable diseases programs, National Tuberculosis Elimination Program, etc. are important to prevent serious long-term consequences of this pandemic.
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Affiliation(s)
- Nirav Nimavat
- Department of Community Medicine, Dr. Kiran C Patel Medical College and Research Institute, Bharuch 392001, India
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Tangail 1902, Bangladesh
| | - Sundip Charmode
- Department of Anatomy, All India Institute of Medical Sciences, Rajkot 360006, Gujarat, India
| | - Gowthamm Mandala
- Independent Researcher, Centre Groove High School, Greenwood, IN 46143, United States
| | | | - Ranvir Bhangu
- Department of Medical, Caribbean Medical University, Des Plaines, IL 60018, United States
| | - Israr Khan
- Shifa International Hospital, Islamabad 999010, Pakistan
| | - Shruti Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Patna 801507, India
| | - Amit Agrawal
- Department of Paediatrics, Gandhi Medical College, Bhopal 462001, India
| | - Ashish Shah
- Department of Pharmacy, Sumandeep Vidyapeeth, Vadodara 391760, India
| | - Vishi Sachdeva
- Department of Medical, Adesh Institute of Medical Sciences and Research, Bathinda 151009, India
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Hildersley R, Easter A, Bakolis I, Carson L, Howard LM. Changes in the identification and management of mental health and domestic abuse among pregnant women during the COVID-19 lockdown: regression discontinuity study. BJPsych Open 2022; 8:e96. [PMID: 35657694 PMCID: PMC9171064 DOI: 10.1192/bjo.2022.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Domestic violence and abuse (DVA) and mental illness during pregnancy have long-lasting and potentially serious consequences, which may have been exacerbated during the COVID-19 pandemic. AIMS To investigate how the UK COVID-19 lockdown policy influenced the identification of DVA and depressive symptoms during pregnancy in health services in South-East London in Spring 2020, using eLIXIR (Early-Life Data Cross-Linkage in Research) maternity and mental routine healthcare data. METHOD We used a regression discontinuity approach, with a quasi-experimental study design, to analyse the effect of the transition into and out of the COVID-19 lockdown on the rates of positive depression screens, DVA recorded in maternity and secondary mental health services, and contact with secondary mental health services during pregnancy. RESULTS We analysed 26 447 pregnancies from 1 October 2018 to 29 August 2020. The rate of DVA recorded in maternity services was low throughout the period (<0.5%). Within secondary mental health services, rates of DVA dropped by 78% (adjusted odds ratio 0.219, P = 0.012) during lockdown, remaining low after lockdown. The rate of women screening positive for depression increased by 40% (adjusted odds ratio 1.40, P = 0.023), but returned to baseline after lockdown lifted. CONCLUSIONS Rates of DVA identification in secondary mental health services dropped during and after lockdown, whereas overall rates of DVA identified in maternity services were concerningly low. Healthcare services must adopt guidance to facilitate safe enquiry, particularly in remote consultations. Further research is vital to address the longer-term impact on women's mental health caused by the increase in depression during the lockdown.
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Affiliation(s)
- Rosanna Hildersley
- Section of Women's Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Abigail Easter
- Section of Women's Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Centre for Implementation Science, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lauren Carson
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK; and Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Louise M. Howard
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK
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Kuipers YJ, Bleijenbergh R, Van den Branden L, van Gils Y, Rimaux S, Brosens C, Claerbout A, Mestdagh E. Psychological health of pregnant and postpartum women before and during the COVID-19 Pandemic. PLoS One 2022; 17:e0267042. [PMID: 35421171 PMCID: PMC9009654 DOI: 10.1371/journal.pone.0267042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 01/02/2023] Open
Abstract
Background The COVID-19 pandemic is likely to influence psychological health of pregnant and postpartum women. Methods We conducted a non-concurrent cross-sectional study among 1145 women living in the Dutch-speaking part of Belgium, 541 pregnant and 604 postpartum women. We measured psychological health with the Whooley questions, Generalized Anxiety Disorder 2-item (GAD-2) and the Edinburgh Postnatal Depression Scale (EPDS) and compared the scores of pregnant and postpartum women before and during the COVID-19 pandemic. Results No differences were observed in the Whooley, GAD-2 or EPDS scores among pregnant women. The postpartum total GAD-2 scores before vs during the pandemic showed significant differences. Controlling for confounders, we observed a small main positive effect of having an infant during time of COVID-19 (F(1.13) = 5.06, p.025, d.27). The effect was significantly larger for women with (a history of) perinatal psychological problems (F(1.12) = 51.44, p < .001, d.82). Emotional support was significantly related to GAD-2 scores of postpartum women during the pandemic (F(1.90) = 35.54, p < .001). Postpartum women reported significant higher effects of the pandemic on their behavior compared to pregnant women (p.034). Conclusion The COVID-19 pandemic seems to have a positive effect on postpartum women during the first year postpartum, in particular for women with (a history of) perinatal psychological problems and for those women who experienced emotional support. The findings suggest that less external stimuli caused by lockdown restrictions might have a positive effect on postpartum women’s emotional wellbeing. The sample consisted of white, educated women in a relationship and information regarding the extent of exposure to adverse COVID-19 consequences was lacking. We relied on self-selection and self-report. The postpartum pandemic sample was small.
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Affiliation(s)
- Yvonne J. Kuipers
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland
- * E-mail:
| | - Roxanne Bleijenbergh
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Laura Van den Branden
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Yannic van Gils
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Sophie Rimaux
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
| | - Charlotte Brosens
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
| | - Astrid Claerbout
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
| | - Eveline Mestdagh
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
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20
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Kluwgant D, Homer C, Dahlen H. “Never let a good crisis go to waste”: Positives from disrupted maternity care in Australia during COVID-19. Midwifery 2022; 110:103340. [PMID: 35504154 PMCID: PMC9013427 DOI: 10.1016/j.midw.2022.103340] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/26/2022] [Accepted: 04/10/2022] [Indexed: 11/22/2022]
Abstract
Objective Due to the COVID-19 pandemic, a number of changes to maternity care were rapidly introduced in all countries, including Australia, to reduce the risk of infection for pregnant women and their care providers. While many studies have reported on the negative effects of these changes, there is a paucity of evidence on factors which women and their providers perceived as positive and useful for future maternity care. Design Data was analysed from the Birth in the time of COVID-19 (BITTOC 2020) study survey. Conventional content analysis and descriptive statistics were used to analyse the data and examine which aspects of COVID-amended care women experienced as positive. Data from women were compared to data from midwives. Setting This project took place in Australia in 2020-2021. Participants The survey was distributed to women who gave birth and midwives who worked in Australia during the COVID-19 pandemic (March 2020 onwards). Measurements and findings Women reported a variety of positives from their maternity care during COVID-19. These included both care-related factors as well as contextual factors. The most commonly mentioned positives for pregnant and postnatal women were care-related, namely fewer visitors in hospital, having increased access to telehealth services. These were also the most commonly reported positives by midwives. Having midwifery continuity of care models, giving birth at home and having their partner work from home were also highlighted by women as positives. Key conclusions Despite the negative effect of COVID-19-related restrictions on maternity care, a variety of changes were viewed as positive by both women and midwives, with strong agreement between the two groups. Implications for practice These findings provide evidence to support the inclusion of these positive elements of care and ensure that the lessons learned from the pandemic are utilised to improve maternity care in Australia going forward.
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21
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Experiences of Perinatal Mental Health Care among Minority Ethnic Women during the COVID-19 Pandemic in London: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041975. [PMID: 35206163 PMCID: PMC8872278 DOI: 10.3390/ijerph19041975] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/06/2023]
Abstract
(1) Background: Approximately one in five women will experience mental health difficulties in the perinatal period. Women from ethnic minority backgrounds face a variety of barriers that can prevent or delay access to appropriate perinatal mental health care. COVID-19 pandemic restrictions created additional obstacles for this group of women. This study aims to explore minority ethnic women's experiences of perinatal mental health services during COVID-19 in London. (2) Methods: Eighteen women from ethnic minority backgrounds were interviewed, and data were subject to a thematic analysis. (3) Results: Three main themes were identified, each with two subthemes: 'Difficulties and Disruptions to Access' (Access to Appointments; Pandemic Restrictions and Disruption), 'Experiences of Remote Delivery' (Preference for Face-to-Face Contact; Advantages of Remote Support); and 'Psychosocial Experiences' linked to COVID-19 (Heightened Anxiety; Social Isolation). (4) Conclusions: Women from ethnic minority backgrounds experienced disrupted perinatal mental health care and COVID-19 restrictions compounding their mental health difficulties. Services should take women's circumstances into account and provide flexibility regarding remote delivery of care.
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22
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Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031749. [PMID: 35162772 PMCID: PMC8834942 DOI: 10.3390/ijerph19031749] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services' use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a lack of resources, while barriers related to the population were predisposing (fear of contagion, stigma, or anticipating barriers) and enabling characteristics (worse socioeconomic status and an increase in technological barriers). In conclusion, our results show a general reduction in services' use in the early stages of the pandemic, as well as new barriers to access and the exacerbation of existing ones. In view of these results, more studies are required on the subsequent stages of the pandemic, to shed more light on the factors that have influenced access and the pandemic's impact on equity of access.
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23
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Handley SC, Ledyard R, Lundsberg LS, Passarella M, Yang N, Son M, McKenney K, Greenspan J, Dysart K, Culhane JF, Burris HH. Changes in prenatal testing during the COVID-19 pandemic. Front Pediatr 2022; 10:1064039. [PMID: 36440341 PMCID: PMC9682111 DOI: 10.3389/fped.2022.1064039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, including prenatal care. The study objective was to assess if timing of routine prenatal testing changed during the COVID-19 pandemic. METHODS Retrospective observational cohort study using claims data from a regional insurer (Highmark) and electronic health record data from two academic health systems (Penn Medicine and Yale New Haven) to compare prenatal testing timing in the pre-pandemic (03/10/2018-12/31/2018 and 03/10/2019-12/31/2019) and early COVID-19 pandemic (03/10/2020-12/31/2020) periods. Primary outcomes were second trimester fetal anatomy ultrasounds and gestational diabetes (GDM) testing. A secondary analysis examined first trimester ultrasounds. RESULTS The three datasets included 31,474 pregnant patients. Mean gestational age for second trimester anatomy ultrasounds increased from the pre-pandemic to COVID-19 period (Highmark 19.4 vs. 19.6 weeks; Penn: 20.1 vs. 20.4 weeks; Yale: 18.8 vs. 19.2 weeks, all p < 0.001). There was a detectable decrease in the proportion of patients who completed the anatomy survey <20 weeks' gestation across datasets, which did not persist at <23 weeks' gestation. There were no consistent changes in timing of GDM screening. There were significant reductions in the proportion of patients with first trimester ultrasounds in the academic institutions (Penn: 57.7% vs. 40.6% and Yale: 78.7% vs. 65.5%, both p < 0.001) but not Highmark. Findings were similar with multivariable adjustment. CONCLUSION While some prenatal testing happened later in pregnancy during the pandemic, pregnant patients continued to receive appropriately timed testing. Despite disruptions in care delivery, prenatal screening remained a priority for patients and providers during the COVID-19 pandemic.
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Affiliation(s)
- Sara C Handley
- Divison of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Leonard Davis Institute of Health Economics, Philadelphia, PA, United States
| | - Rachel Ledyard
- Divison of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Lisbet S Lundsberg
- Department of Obstetrics, Gynecology, and Reproductive Services, Yale School of Medicine, New Haven, CT, United States
| | - Molly Passarella
- Divison of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Nancy Yang
- Divison of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Moeun Son
- Department of Obstetrics, Gynecology, and Reproductive Services, Yale School of Medicine, New Haven, CT, United States
| | - Kathryn McKenney
- Department of Obstetrics & Gynecology, University of Colorado, Aurora, CO, United States
| | - Jay Greenspan
- Division of Neonatology, Nemours duPont Pediatrics, Philadelphia, PA, United States.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Kevin Dysart
- Division of Neonatology, Nemours duPont Pediatrics, Philadelphia, PA, United States.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jennifer F Culhane
- Department of Obstetrics & Gynecology, University of Colorado, Aurora, CO, United States
| | - Heather H Burris
- Divison of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Leonard Davis Institute of Health Economics, Philadelphia, PA, United States
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24
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Schmitt N, Mattern E, Cignacco E, Seliger G, König-Bachmann M, Striebich S, Ayerle GM. Effects of the Covid-19 pandemic on maternity staff in 2020 - a scoping review. BMC Health Serv Res 2021; 21:1364. [PMID: 34961510 PMCID: PMC8710925 DOI: 10.1186/s12913-021-07377-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
In the spring of 2020, the SARS-CoV-2 virus caused the Covid-19 pandemic, bringing with it drastic changes and challenges for health systems and medical staff. Among the affected were obstetricians and midwives, whose close physical contact with pregnant women, women who recently gave birth, and their children was indispensable. In the obstetric setting, births cannot be postponed, and maternity staff had to adapt to assure obstetric safety while balancing evidence-based standards with the new challenges posed by the pandemic. This scoping review gives a comprehensive overview of the effecs the Covid-19 pandemic had on maternity staff. We followed the evidence-based approach described by Arksey & O'Malley: we searched several databases for English and German articles published between January 2020 and January 2021 that discussed or touched upon the effects the pandemic had on maternity staff in OECD countries and China. We found that structural challenges caused by the crisis and its subjective effects on maternity staff fell into two main topic areas. Structural challenges (the first main topic) were divided into five subtopics: staff shortages and restructuring; personal protective equipment and tests; switching to virtual communication; handling women with a positive SARS-CoV-2 infection; and excluding accompanying persons. The pandemic also strongly affected the staff's mental health (the second main topic.) Attempting to meet challenges posed by the pandemic while afraid of contamination, suffering overwork and exhaustion, and struggling to resolve ethical-moral dilemmas had severe negative subjective effects. Several studies indicated increased depression, anxiety, stress levels, and risk of post-traumatic stress symptoms, although the crisis also generated strong occupational solidarity. Care for pregnant, birthing, and breast-feeding women cannot be interrupted, even during a pandemic crisis that requires social distancing. Maternity staff sometimes had to abandon normal standards of obstetric care and were confronted with enormous challenges and structural adjustments that did not leave them unscathed: their mental health suffered considerably. Researchers should study maternity staff's experiences during the pandemic to prepare recommendations that will protect staff during future epidemics.
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Affiliation(s)
- Nadine Schmitt
- Institute of Health and Nursing Science, Center for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Saale, Germany.
| | - Elke Mattern
- Department of Applied Health Sciences, University of Applied Sciences Bochum, Bochum, Germany
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Gregor Seliger
- Department of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Hospital Halle (Saale) and Center for Reproductive Medicine and Andrology, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
| | | | - Sabine Striebich
- Institute of Health and Nursing Science, Center for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Saale, Germany
| | - Gertrud M Ayerle
- Institute of Health and Nursing Science, Center for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Saale, Germany
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25
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Silverio SA, Easter A, Storey C, Jurković D, Sandall J. Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic. BMC Pregnancy Childbirth 2021; 21:840. [PMID: 34937548 PMCID: PMC8693591 DOI: 10.1186/s12884-021-04292-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic poses an unprecedented risk to the global population. Maternity care in the UK was subject to many iterations of guidance on how best to reconfigure services to keep women, their families and babies, and healthcare professionals safe. Parents who experience a pregnancy loss or perinatal death require particular care and support. PUDDLES is an international collaboration investigating the experiences of recently bereaved parents who suffered a late miscarriage, stillbirth, or neonatal death during the global COVID-19 pandemic, in seven countries. In this study, we aim to present early findings from qualitative work undertaken with recently bereaved parents in the United Kingdom about how access to healthcare and support services was negotiated during the pandemic. METHODS In-depth semi-structured interviews were undertaken with parents (N = 24) who had suffered a late miscarriage (n = 5; all mothers), stillbirth (n = 16; 13 mothers, 1 father, 1 joint interview involving both parents), or neonatal death (n = 3; all mothers). Data were analysed using a template analysis with the aim of investigating bereaved parents' access to services, care, and networks of support, during the pandemic after their bereavement. RESULTS All parents had experience of utilising reconfigured maternity and/or neonatal, and bereavement care services during the pandemic. The themes utilised in the template analysis were: 1) The Shock & Confusion Associated with Necessary Restrictions to Daily Life; 2) Fragmented Care and Far Away Families; 3) Keeping Safe by Staying Away; and 4) Impersonal Care and Support Through a Screen. Results suggest access to maternity, neonatal, and bereavement care services were all significantly reduced, and parents' experiences were notably affected by service reconfigurations. CONCLUSIONS Our findings, whilst preliminary, are important to document now, to help inform care and service provision as the pandemic continues and to provide learning for ongoing and future health system shocks. We draw conclusions on how to enable development of safe and appropriate services during this pandemic and any future health crises, to best support parents who experience a pregnancy loss or whose babies die.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - Davor Jurković
- Gynaecology Diagnostic Outpatient Treatment Unit, University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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26
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Gemperle M, Grylka-Baeschlin S, Klamroth-Marganska V, Ballmer T, Gantschnig BE, Pehlke-Milde J. Midwives' perception of advantages of health care at a distance during the COVID-19 pandemic in Switzerland. Midwifery 2021; 105:103201. [PMID: 34864326 PMCID: PMC8580889 DOI: 10.1016/j.midw.2021.103201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 10/30/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore midwives' perceptions of the advantages of telemedicine during the COVID-19 pandemic in Switzerland. DESIGN Cross-sectional study based on an online survey using quantitative methods. SETTING Midwives working in Switzerland. PARTICIPANTS Self-selected convenience sample of 630 members of the Swiss Federation of Midwives. MEASUREMENT Open questions on advantages of health care at a distance and workrelated characteristics were used in the online questionnaire. The information was coded and integrative content analysis was applied. FINDINGS A good half of the respondents associated telemedicine with either an advantage beyond the pandemic ("Reduced workload", "Improved health care provision", "Greater self-care of clients"), while the others saw a pandemic-related advantage ("Protection from COVID-19", "Maintaining care/counseling in an exceptional situation"), or no advantage at all. Older, more experienced midwives were less likely to see an advantage beyond the pandemic. The motive "Reduced workload" was positively associated with professionals aged younger than 40 years and midwives with up to 14 years of professional experience, and "Protection from COVID-19" was more likely cited by midwives aged 50 and more and by midwives working solely in hospitals. Midwives who stated "Maintaining care" and "Improved health care provision" as motives to embrace telemedicine were more likely to experience health care at a distance as a positive treatment alternative. KEY CONCLUSION Midwives' perceptions of the advantages of health care at a distance vary substantially with age and years of professional experience, as well as workrelated characteristics. Further research is necessary to acquire a sound understanding of underlying reasons, including the sources of the general attitudes involved. IMPLICATION FOR PRACTICE Understanding the differences in perceptions of health care at a distance is important in order to improve the work situation of midwives and the health care they provide to women and families. Different sensitivities represent an important source in the ongoing discussion about the future use of telemedicine in health care.
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Affiliation(s)
- Michael Gemperle
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Research Institute for Midwifery Science, Katharina-Sulzer-Platz 9, Winterthur 8401, Switzerland; ZHAW Zurich University of Applied Sciences, ZHAW digital, Gertrudstrasse 15, Winterthur 8401, Switzerland.
| | - Susanne Grylka-Baeschlin
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Research Institute for Midwifery Science, Katharina-Sulzer-Platz 9, Winterthur 8401, Switzerland
| | - Verena Klamroth-Marganska
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Research Institute for Occupational Therapy, Katharina-Sulzer-Platz 9, Winterthur 8401, Switzerland
| | - Thomas Ballmer
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Research Institute for Occupational Therapy, Katharina-Sulzer-Platz 9, Winterthur 8401, Switzerland
| | - Brigitte E Gantschnig
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Research Institute for Occupational Therapy, Katharina-Sulzer-Platz 9, Winterthur 8401, Switzerland
| | - Jessica Pehlke-Milde
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Research Institute for Midwifery Science, Katharina-Sulzer-Platz 9, Winterthur 8401, Switzerland
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27
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Stulz VM, Bradfield Z, Cummins A, Catling C, Sweet L, McInnes R, McLaughlin K, Taylor J, Hartz D, Sheehan A. Midwives providing woman-centred care during the COVID-19 pandemic in Australia: A national qualitative study. Women Birth 2021; 35:475-483. [PMID: 34688582 PMCID: PMC8514642 DOI: 10.1016/j.wombi.2021.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 11/19/2022]
Abstract
Background The COVID-19 pandemic has caused isolation, fear, and impacted on maternal healthcare provision. Aim To explore midwives’ experiences about how COVID-19 impacted their ability to provide woman-centred care, and what lessons they have learnt as a result of the mandated government and hospital restrictions (such as social distancing) during the care of the woman and her family. Methods A qualitative interpretive descriptive study was conducted. Twenty-six midwives working in all models of care in all states and territories of Australia were recruited through social media, and selected using a maximum variation sampling approach. Data were collected through in-depth interviews between May to August, 2020. The interviews were recorded, transcribed verbatim, and thematically analysed. Findings Two overarching themes were identified: ‘COVID-19 causing chaos’ and ‘keeping the woman at the centre of care’. The ‘COVID-19 causing chaos’ theme included three sub-themes: ‘quickly evolving situation’, ‘challenging to provide care’, and ‘affecting women and families’. The ‘Keeping the woman at the centre of care’ theme included three sub-themes: ‘trying to keep it normal’, ‘bending the rules and pushing the boundaries’, and ‘quality time for the woman, baby, and family unit’. Conclusion Findings of this study offer important evidence regarding the impact of the pandemic on the provision of woman-centred care which is key to midwifery philosophy. Recommendations are made for ways to preserve and further enhance woman-centred care during periods of uncertainty such as during a pandemic or other health crises.
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Affiliation(s)
- Virginia M Stulz
- Western Sydney University, School of Nursing and Midwifery, Centre for Nursing and Midwifery Research. Nepean Hospital, NSW 2745, Australia.
| | - Zoe Bradfield
- Curtin University, School of Nursing, Bentley, WA, 6845, Australia; King Edward Memorial Hospital, Subiaco, WA, 6008, Australia.
| | - Allison Cummins
- University of Newcastle, School of Nursing and Midwifery, Central Coast Clinical School and Research Institute, Gosford, NSW, Australia.
| | - Christine Catling
- University of Technology Sydney, Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, Australia.
| | - Linda Sweet
- Deakin University, School of Nursing and Midwifery, Centre for Quality Patient Safety, Western Health Partnership, VIC 3021, Australia.
| | - Rhona McInnes
- Griffith University and Gold Coast University Hospital, School of Nursing and Midwifery, QLD 4215, Australia.
| | - Karen McLaughlin
- University of Newcastle, School of Nursing and Midwifery, NSW, Callaghan campus, Wallsend, Australia.
| | - Jan Taylor
- University of Canberra, Discipline of Midwifery, Faculty of Health ACT 2617, Australia.
| | - Donna Hartz
- Charles Darwin University, Molly Wardaguga Research Centre, College of Nursing & Midwifery, Australia.
| | - Athena Sheehan
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia.
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