A qualitative study of Turkish midwives' experience of providing care to pregnant women infected with COVID-19

Meta-synthesis of the experiences of midwives providing care during the COVID-19 pandemic

PROBLEM

During the COVID-19 pandemic, midwives faced emotional and physical risks while on the frontlines providing care.

BACKGROUND

To maintain a healthy midwifery workforce, it is necessary to understand midwives' pandemic challenges and successes, including how they personally and professionally faced changes to care provision.

AIM

The aim of this meta-synthesis was to understand the experiences of midwives working during the COVID-19 pandemic.

METHODS

Noblit and Hare's (1988) approach to synthesising qualitative research studies was followed. Fifteen qualitative research reports were identified using PRISMA guidelines, producing a sample of 588 midwives from 12 countries.

FINDINGS

The synthesis revealed three overarching themes: (1) Turmoil and confusion: a spectrum of emotions due to ever-changing protocols, (2) COVID-19 stripped the "being with" out of midwifery care, and (3) Finding our way: midwifery resilience and growth. Analysed together, these three themes contribute to understanding the experiences of midwives working during the COVID-19 pandemic.

DISCUSSION

Midwives experienced fear, stress, and anxiety. They felt they couldn't physically be with women during the pandemic. They were frustrated by being left out of institutional decision-making regarding COVID-19 protocols that impacted the women they served. Professional growth as a midwife, and personal resilience were ultimately realised.

CONCLUSIONS

The COVID-19 pandemic disrupted the routine ways in which midwives provide care in all settings. Understanding the complete experience of midwives during the pandemic allows for midwifery organizations to be aware of their members' needs, as well as for institutions to ensure supports are in place for midwives in the event of future pandemics.

Knowledge, Attitudes, and Anxiety of Midwives Toward Maternal Care During the COVID-19 Pandemic: A Descriptive Study on Midwives Who Experience the Perinatal and Breastfeeding Phases

Background

People all over the world, including pregnant women, have experienced stress and anxiety due to the coronavirus disease 2019 (COVID-19) pandemic. Providing services during the pandemic is something that midwives in primary health care cannot avoid. This study assesses a midwife's knowledge, attitude, and anxiety toward providing maternal care during the pandemic.

Material and Method

A cross-sectional design was used in this study, which involved 183 midwives who provided midwifery services at hospitals and health centers and had experience with the perinatal and breastfeeding phases. Using the Google Forms tool, respondents completed a questionnaire regarding their knowledge, attitudes, and anxiety toward maternal care during the COVID-19 pandemic.

Results

One hundred eighty-two midwives (99.50%) understood maternal care well during the COVID-19 pandemic. In addition, the maternal care provided during the COVID-19 pandemic was viewed favorably by almost all the participants. The percentage of midwives working in primary care in the perinatal phase who had moderate-to-severe anxiety levels during the COVID-19 pandemic was 17 women (27.42%).

Conclusions

The knowledge and attitudes of midwives about the COVID-19 pandemic in this study were good, and there was a smaller percentage of midwives with an extreme level of anxiety.

Barrier measures implemented in French maternity hospitals during the COVID-19 pandemic: A cross-sectional survey

OBJECTIVES

The objectives of this survey were 1) to describe the changes over time of barrier measures in maternity units, specifically, co-parent visits and women wearing masks in birth rooms, and 2) to identify potential institutional determinants of these barrier measures.

DESIGN

We used an online questionnaire to conduct a descriptive cross-sectional survey from May to July 2021.

SETTING

All districts in mainland France.

PARTICIPANTS

Midwife supervisor of each maternity unit.

MEASUREMENTS

Primary outcomes were "banning of visits" in the postnatal department during the first lockdown (March-May 2020), and "mandated mask-wearing in birth rooms" during the survey period (May-July 2021); the independent variables were maternity unit characteristics and location in a crisis area. Co-parent visits were considered only during the first lockdown as they were mostly allowed afterwards, and the wearing of masks was studied only during the survey period, as masks were unavailable for the population during the first lockdown.

RESULTS

We obtained 343 responses, i.e., 75.2% of French maternity units. Visits to the postnatal department were forbidden in 39.3% of the maternity units during the first lockdown and in none during the study period. Maternity hospitals with neonatal intensive care units were the most likely to ban co-parent hospital visits (adjusted OR 2.34 [1.12; 4.96]). However, those were the maternity units least likely to encourage or require women to wear masks while pushing (adjusted OR, 0.31; 95% confidence interval [CI], 0.11-0.77). Maternity units in crisis areas (i.e., with very high case counts) during the first lockdown banned visits significantly more often (adjusted OR, 1.68; 95% CI, 1.05-2.70).

KEY CONCLUSIONS

Our study showed that barrier measures evolved during the course of the pandemic but remained extremely variable between facilities.

IMPLICATIONS FOR PRACTICE

Maternity units implemented drastic barrier measures at the beginning of the pandemic but were able to adapt these measures over time. It is now time to learn from this experience to ensure that women and infants are no longer harmed by these measures.

Self-Reported Experiences of Midwives Working in the UK across Three Phases during COVID-19: A Cross-Sectional Study

Maternity services cannot be postponed due to the nature of this service, however, the pandemic resulted in wide-ranging and significant changes to working practices and services. This paper aims to describe UK midwives' experiences of working during the COVID-19 pandemic. This study forms part of a larger multiple phase research project using a cross-sectional design based on an online survey. The online survey used validated psychometric tools to measure work-related quality of life, wellbeing, coping, and burnout as well as open-ended questions to further understand the experiences of staff working during the pandemic. This paper reports the qualitative data collected from the open-ended questions. The qualitative data were subjected to thematic analysis and the four main themes that emerged were 'relentless stress/pressure', 'reconfiguration of services', 'protection of self and others', and 'workforce challenges'. The key conclusions were that midwives experienced a reduction in quality of working life and significant stress throughout the pandemic due to a range of factors including staffing shortages, restrictions placed on women's partners, changes to services and management support, all of which compounded workforce pressures that existed prior to the pandemic. This research recommends consultation of front-line midwives in relation to possible changes in practice and workforce planning in preparation for crises such as a pandemic and to ensure equitable and supportive management with access to practical and psychological support.