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Collins EC, Schmied V, Kildea S, Keedle H, Jackson M, Dahlen HG. Midwives' experiences with PPE during the COVID-19 pandemic: The Birth in the Time of COVID (BITTOC) study. Midwifery 2024; 134:104016. [PMID: 38703427 DOI: 10.1016/j.midw.2024.104016] [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: 01/09/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The COVID-19 pandemic resulted in rapid changes aimed at reducing disease transmission in maternity services in Australia. An increase in personal protective equipment (PPE) in the clinical and community setting was a key strategy. There was variation in the type of PPE and when it was to be worn in clincial practice. AIM This paper reports on Australian midwives' experiences of PPE during the pandemic. METHODS This sequential mixed methods study was part of the Birth in the Time of COVID-19 (BITTOC 2020) study. Data were obtained from in-depth semi-structured interviews with midwives in 2020 followed by a national survey undertaken at two time points (2020 and 2021). Qualitative open-text survey responses and interview data were analysed using content analysis. FINDINGS 16 midwives were interviewed and 687 midwives provided survey responses (2020 n = 477, 2021 n = 210). Whilst midwives largley understood the need for increased PPE, and were mainly happy with this, as it was protective, they reported a number of concerns. These included: inconsistency with PPE type, use, availability, quality, fit and policy; the impact of PPE on the physical and psychological comfort of midwives; and the barriers PPE use placed on communication and woman centred care. This at times resulted in midwives working outside of policy. CONCLUSION These findings highlight the need for future comprehensive pandemic preparedness that ensures policy and procedure recommendations are consistent and PPE is available, of approriate quality, and individually fitted in order to ensure that Australian maternity services are well placed to manage future pandemics.
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Affiliation(s)
- Emma C Collins
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia.
| | - Virginia Schmied
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Charles Darwin university, Ellengowan Drive, Casuarina, NT 0909, Australia
| | - Hazel Keedle
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia
| | - Melanie Jackson
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia
| | - Hannah G Dahlen
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2715, Australia
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Ku Carbonell SE, Ogba P, Vanstone M, Gombay C, Darling EK. Midwives' adaptation of their practice, role, and scope to ensure access to sexual and reproductive services during humanitarian crises: A scoping review. Midwifery 2024; 136:104065. [PMID: 38963995 DOI: 10.1016/j.midw.2024.104065] [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: 12/22/2023] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
PROBLEM Limited research has examined and synthesized the adaptation of midwives and midwife-led interventions during crises. BACKGROUND Evidence suggests that midwives are essential to respond to sexual and reproductive health care needs during disruptive times, and that they adapt to continue to provide their services during those circumstances. AIM To map the adaptations of midwives when providing care during crises globally. Secondary objectives include identifying which midwives adapted, what services were adapted and how, and the demographic receiving care. STUDY METHODS Scoping review using Levac's modifications of Arksey and O'Malley's methods. Publications and grey literature, in English and Spanish, with no limitations based on study design or date were included. Data was extracted and mapped using Wheaton and Maciver's Adaptation framework. FINDINGS We identified 3329 records, of which forty-two were included. Midwives' prior training impacted adaptation. Midwives adapted to the COVID-19 pandemic, epidemics, natural disasters, and World War II. They adapted in hospital and community settings around the provision of antenatal, labor and birth, postpartum, and contraceptive care. However, no specific data identified population demographics. Midwifery adaptations related to their practice, role, and scope of practice. CONCLUSION The limited available evidence identified the challenges, creativity, and mutual aid activities midwives have undertaken to ensure the provision of their services. Evidence is highly concentrated around maternal health services. Further high-quality research is needed to provide a deeper understanding of how midwifery-led care can adapt to guide sustainable responses to ensure access to sexual and reproductive health services during crises.
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Affiliation(s)
- Susana E Ku Carbonell
- McMaster Midwifery Research Center, McMaster University, 1280 Main St W, HSC 4H24, Hamilton, ON L8S 4K1, Canada; Global Health Graduate Programs, McMaster University, 1280 Main Street W, MDCL 3500, Hamilton, ON L8S 4K1, Canada
| | - Patricia Ogba
- Global Health Graduate Programs, McMaster University, 1280 Main Street W, MDCL 3500, Hamilton, ON L8S 4K1, Canada
| | - Meredith Vanstone
- Department of Family Medicine, David Braley Health Sciences Centre, McMaster University, 100 Main Street West, Hamilton, ON L8P 1H6, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, HSC 2C, Hamilton, ON L8S 4K1, Canada
| | - Christy Gombay
- Global Health Graduate Programs, McMaster University, 1280 Main Street W, MDCL 3500, Hamilton, ON L8S 4K1, Canada
| | - Elizabeth K Darling
- McMaster Midwifery Research Center, McMaster University, 1280 Main St W, HSC 4H24, Hamilton, ON L8S 4K1, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, HSC 2C, Hamilton, ON L8S 4K1, Canada; Department of Obstetrics and Gynaecology, McMaster University, 1280 Main St W, HSC 2F, Hamilton, ON L8S 4K1, Canada.
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Chapman M, Evans EC, Long MH. Midwifery Practice Leaders' Experiences of Practice Changes Early in the COVID-19 Pandemic: A Qualitative Exploration. J Midwifery Womens Health 2024; 69:236-242. [PMID: 37986664 DOI: 10.1111/jmwh.13584] [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] [Revised: 09/08/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic generated considerable upheaval in all sectors of the US health care system, including maternity care. We focused this inquiry on midwifery practice leaders' experiences and perspectives on changes that occurred in their practices early in the pandemic. METHODS This was a qualitative descriptive study using thematic analysis. The data were responses to an open-ended question in a survey of pandemic-related employment and clinical practice changes. Findings are presented from a constructivist perspective, describing the experiences and perspectives of a group of US midwifery practice leaders during the initial phase of the COVID-19 pandemic. RESULTS Two main themes emerged from the analysis: demands on midwives and driving forces. Demands on midwives were 3-fold: clients' needs, modification of care, and midwives' needs. These encompassed the psychological, physical, and emotional toll that caring for women during the pandemic placed on midwives. Driving forces were those entities that spurred and directed change and included regulations, institutions, financial logistics, and team dynamics. Survey respondents in community (home and birth center) practices reported substantial increases in inquiries and client volume, and many respondents expressed concern about withdrawal of students from clinical placements. DISCUSSION Midwifery practices experienced profound changes in their work environments during the COVID-19 pandemic, with both positive and negative characteristics. These challenges in providing birth care were similar to those reported in other countries. Results indicated existing guidance for maternity care during emergencies did not meet clients' needs. Coordinated planning for maternity care in future prolonged health emergencies should incorporate best practices and include midwives in the process.
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Affiliation(s)
- Meredith Chapman
- School of Nursing, University of Virginia, Charlottesville, Virginia
| | | | - Maryann H Long
- School of Nursing, University of Virginia, Charlottesville, Virginia
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Tam MW, Davis VH, Ahluwalia M, Lee RS, Ross LE. Impact of COVID-19 on access to and delivery of sexual and reproductive healthcare services in countries with universal healthcare systems: A systematic review. PLoS One 2024; 19:e0294744. [PMID: 38394146 PMCID: PMC10889625 DOI: 10.1371/journal.pone.0294744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/01/2023] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic has caused unforeseen impacts on sexual and reproductive healthcare (SRH) services worldwide, and the nature and prevalence of these changes have not been extensively synthesized. We sought to synthesise reported outcomes on the impact of COVID-19 on SRH access and delivery in comparable countries with universal healthcare systems. METHODS Following PRISMA guidelines, we searched MEDLINE, Embase, PsycInfo, and CINAHL from January 1st, 2020 to June 6th, 2023. Original research was eligible for inclusion if the study reported on COVID-19 and SRH access and/or delivery. Twenty-eight OECD countries with comparable economies and universal healthcare systems were included. We extracted study characteristics, participant characteristics, study design, and outcome variables. The methodological quality of each article was assessed using the Quality Assessment with Diverse Studies (QuADS) tool. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed for reporting the results. This study was registered on PROSPERO (#CRD42021245596). SYNTHESIS Eighty-two studies met inclusion criteria. Findings were qualitatively synthesised into the domains of: antepartum care, intrapartum care, postpartum care, assisted reproductive technologies, abortion access, gynaecological care, sexual health services, and HIV care. Research was concentrated in relatively few countries. Access and delivery were negatively impacted by a variety of factors, including service disruptions, unclear communication regarding policy decisions, decreased timeliness of care, and fear of COVID-19 exposure. Across outpatient services, providers favoured models of care that avoided in-person appointments. Hospitals prioritized models of care that reduced time and number of people in hospital and aerosol-generating environments. CONCLUSIONS Overall, studies demonstrated reduced access and delivery across most domains of SRH services during COVID-19. Variations in service restrictions and accommodations were heterogeneous within countries and between institutions. Future work should examine long-term impacts of COVID-19, underserved populations, and underrepresented countries.
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Affiliation(s)
- Michelle W. Tam
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Victoria H. Davis
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Monish Ahluwalia
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- University of Toronto Faculty of Medicine, 1 King’s College Circle, Toronto, ON, Canada
| | - Rachel S. Lee
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Lori E. Ross
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
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Keedle H, Lockwood R, Keedle W, Susic D, Dahlen HG. What women want if they were to have another baby: the Australian Birth Experience Study (BESt) cross-sectional national survey. BMJ Open 2023; 13:e071582. [PMID: 37666545 PMCID: PMC10496680 DOI: 10.1136/bmjopen-2023-071582] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVES To explore if Australian women would do anything differently if they were to have another baby. DESIGN AND SETTING The Birth Experience Study (BESt) online survey explored pregnancy, birth and postnatal experiences for women who had given birth during 2016-2021 in Australia. PARTICIPANTS In 2021, 8804 women responded to the BESt survey and 6101 responses to the open text responses to the survey question 'Would you do anything different if you were to have another baby?' were analysed using inductive content analysis. RESULTS A total of 6101 women provided comments in response to the open text question, resulting in 10 089 items of coding. Six categories were found: 'Next time I'll be ready' (3958, 39.2%) described how women reflected on their previous experience, feeling the need to better advocate for themselves in the future to receive the care or experience they wanted; 'I want a specific birth experience' (2872, 28.5%) and 'I want a specific model of care' (1796, 17.8%) highlighted the types of birth and health provider women would choose for their next pregnancy. 'I want better access' (294, 2.9%) identified financial and/or geographical constraints women experience trying to make choices for birth. Two categories included comments from women who said 'I don't want to change anything' (1027, 10.2%) and 'I don't want another pregnancy' (142, 1.4%). Most women birthed in hospital (82.9%) and had a vaginal birth (59.2%) and 26.7% had a caesarean. CONCLUSION Over 85% of comments left by women in Australia were related to making different decisions regarding their next birth choices. Most concerningly women often blamed themselves for not being more informed. Women realised the benefits of continuity of care with a midwife. Many women also desired a vaginal birth as well as better access to birthing at home.
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Affiliation(s)
- Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Risharda Lockwood
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Warren Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Daniella Susic
- Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
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Cummins A, Sheehy A, Taylor J, DeVitry-Smith S, Nightingale H, Davis D. Association of continuity of carer and women's experiences of maternity care during the COVID-19 pandemic: A cross-sectional survey. Midwifery 2023; 124:103761. [PMID: 37327712 PMCID: PMC10257573 DOI: 10.1016/j.midw.2023.103761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/19/2023] [Accepted: 06/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Recent research highlights the impact of the COVID-19 pandemic on maternity services, although none to date have analysed the association between continuity of carer and how women felt about the changes to pregnancy care and birth plans. AIM To describe pregnant women's self-reported changes to their planned pregnancy care and associations between continuity of carer and how women feel about changes to their planned care. METHODS A cross-sectional online survey of pregnant women aged over 18 years in their final trimester of pregnancy in Australia. FINDINGS 1668 women completed the survey. Most women reported at least one change to pregnancy care and birthing plans. Women receiving full continuity of carer were more likely to rate the changes to care as neutral/positive (p<.001) when compared with women who received partial or no continuity. DISCUSSION Pregnant women experienced many changes to their planned pregnancy and birth care during the COVID-19 pandemic. Women who received full continuity of carer experienced fewer changes to care and were more likely to feel neutral/positive about the changes than women who did not receive full continuity of carer.
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Affiliation(s)
- Allison Cummins
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Australia.
| | - Annabel Sheehy
- Centre for Midwifery, Child and Family Health - University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia
| | - Jan Taylor
- University of Canberra and ACT Government, Health Directorate, Australia
| | | | - Helen Nightingale
- La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo 3552, Australia
| | - Deborah Davis
- University of Canberra and ACT Government, Health Directorate, Australia
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Knox‐Kazimierczuk F, Trinh S, Odems D, Shockley‐Smith M. Challenges and lessons learned birthing during the COVID-19 pandemic: A scoping review. Health Sci Rep 2023; 6:e1387. [PMID: 37484060 PMCID: PMC10359605 DOI: 10.1002/hsr2.1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Background and Aims The impact of the COVID-19 pandemic on the healthcare system facilitated a change in policies to redress the consequences of increased demand and fear of disease transmission. Restrictive measures throughout the healthcare system limiting access to accompanying partners of birthing people in addition to fears of contracting COVID-19, an increasing number of birthing people chose to have an out-of-hospital birth. Out-of-hospital births are not prevalent in the United States. However, in recent years the percentage of out-of-hospital births has been steadily increasing. COVID-19 was a novel virus imposing a unique birthing situation for millions of women, complicated by lack of integration and varied policies in the U.S. Methods To better understand the challenges of birthing people during the pandemic a scoping review was conducted to explore the literature during the first wave of the pandemic related to out-of-hospital births. The approach for this review made use of the methodology manual published by the Joanna Briggs Institute for scoping reviews. All manner of publications (i.e. peer-reviewed published articles, grey articles, conference proceedings, webinars, editorials, and textbook chapters) were included in the review. Results Articles retrieved from the database search yielded sixty-three articles, after duplicate removal forty-six records were available for screening. Articles were further excluded using the PRISMA process, yielding thirty-one remaining records. From the thirty-one records twelve themes emerged, which were collapsed into four meta-themes. Conclusion These meta-themes focused on (a) advocacy, (b) homebirth infrastructure, (c) support networks, and (d) uncertainty during the pandemic. COVID-19 has accelerated this movement to birthing at home and thought must be given to how the healthcare system is going to support and integrate this mode of birthing.
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Affiliation(s)
| | - Shannon Trinh
- Department of Rehabilitation, Exercise, & Nutrition ScienceUniversity of CincinnatiCincinnatiOhioUSA
| | - Dorian Odems
- Department of Population HealthCollege of Health & Human Services, The University of ToledoToledoOhioUSA
| | - Meredith Shockley‐Smith
- Cradle Cincinnati, Queens Village InitiativeCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsCollege of Medicine, University of CincinnatiCincinnatiOhioUSA
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Whiteing N, Massey D, Rafferty R, Penman O, Samios C, Bowen K, Stephens A, Aggar C. Australian nurses' and midwives' perceptions of their workplace environment during the COVID-19 pandemic. Collegian 2023; 30:39-46. [PMID: 35765377 PMCID: PMC9226292 DOI: 10.1016/j.colegn.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/24/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
Background Working as a front-line worker during a pandemic is a unique situation that requires a supportive work environment. An informed understanding of nurses' and midwives' workplace experiences during a pandemic, such as COVID-19, may enable better preparation and targeted support for future pandemics at an individual, organisational, and policy level. Aim The aim of this study was to explore nurses' and midwives' workplace experiences during the COVID-19 pandemic response. Methods A cross-sectional online survey consisting of open-ended questions was conducted with a convenience sample of nurses and midwives (n = 1003) working in New South Wales Health hospital settings, in Australia. Open-ended questions were analysed using content analysis. Results Five themes were identified; 'organisational communication', 'workplace support', 'availability of personal protective equipment', 'flexible working', and 'new ways of working'. Nurses' and midwives' workplace experiences during COVID-19 were influenced by leaders who were perceived to be adaptive, authentic, responsive, transparent, and visible. While many expressed a number of workplace challenges, including access to personal protective equipment, there was opportunity to explore, develop, and evaluate new and alternate models of care and working arrangements. Conclusion It is important that nurses and midwives are supported and well prepared to cope during pandemics in the workplace. Organisational leadership and timely dissemination of transparent pandemic plans may support nurses' adaptive workplace experiences.
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Affiliation(s)
- Nicola Whiteing
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
| | - Deb Massey
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
| | - Rae Rafferty
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
| | - Olivia Penman
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
| | - Christina Samios
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
- Australian College of Applied Psychology, 255 Elizabeth Street, Sydney, NSW, Australia
| | - Karen Bowen
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
| | - Alexandre Stephens
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
| | - Christina Aggar
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
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Policies and Practices on Out-of-Hospital Birth: a Review of Qualitative Studies in the Time of Coronavirus. CURRENT SEXUAL HEALTH REPORTS 2023; 15:36-48. [PMID: 36530373 PMCID: PMC9735103 DOI: 10.1007/s11930-022-00354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 12/13/2022]
Abstract
Purpose of Review The purpose of this review is to summarize the current knowledge on out-of-hospital births (at home or in an independent birth center) in high-income countries in the time of coronavirus. Qualitative studies published between 2020 and 2022 providing findings on women's and health providers' perspectives and experiences, as well as policies and practices implemented, are synthetized. Recent Findings During the COVID-19 pandemic, the number of women choosing the home or a birth center to deliver has grown considerably. Main reasons for this choice include fear of contagion in facilities and restrictions during delivery and the post-partum period, especially women's separation from their companion of choice and their newborn. Findings suggest that homebirth within a public model has several advantages in the experience of birth for both women and professionals during the pandemic period, maintaining the benefits of biomedicine when needed. Summary During the COVID-19 pandemic, the interest in out-of-hospital birth increased in high-income countries, and the number of women choosing the home or a birth center to deliver has grown considerably. This review aims to give a more in-depth understanding of women's and health providers' perspectives on and experiences of out-of-hospital birth services during this period. Twenty-five studies in different countries, including the USA, Canada, Australia, Switzerland, the Netherlands, the UK, Spain, Croatia, and Norway, were reviewed. Findings stress that out-of-hospital birth has allowed women to deliver according to their wishes and needs. In addition, the pandemic experience represents an opportunity for policy to better support and integrate out-of-hospital services in the health care system in the future.
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Caddy C, Cheong M, Lim MSC, Power R, Vogel JP, Bradfield Z, Coghlan B, Homer CSE, Wilson AN. "Tell us what's going on": Exploring the information needs of pregnant and post-partum women in Australia during the pandemic with 'Tweets', 'Threads', and women's views. PLoS One 2023; 18:e0279990. [PMID: 36638130 PMCID: PMC9838848 DOI: 10.1371/journal.pone.0279990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The provision of maternity services in Australia has been significantly disrupted in response to the COVID-19 pandemic. Many changes were initiated quickly, often with rapid dissemination of information to women. The aim of this study was to better understand what information and messages were circulating regarding COVID-19 and pregnancy in Australia and potential information gaps. METHODS This study adopted a qualitative approach using social media and interviews. A data analytics tool (TIGER-C19) was used to extract data from social media platforms Reddit and Twitter from June to July 2021 (in the middle of the third COVID-19 wave in Australia). A total of 21 individual semi-structured interviews were conducted with those who were, or had been, pregnant in Australia since March 2020. Social media data were analysis via inductive content analysis and interview data were thematically analysed. RESULTS Social media provided a critical platform for sharing and seeking information, as well as highlighting attitudes of the community towards COVID-19 vaccines in pregnancy. Women interviewed described wanting further information on the risks COVID-19 posed to themselves and their babies, and greater familiarity with the health service during pregnancy, in which they would labour and give birth. Health providers were a trusted source of information. Communication strategies that allowed participants to engage in real-time interactive discussions were preferred. A real or perceived lack of information led participants to turn to informal sources, increasing the potential for exposure to misinformation. CONCLUSION It is vital that health services communicate effectively with pregnant women, early and often throughout public health crises, such as the COVID-19 pandemic. This was particularly important during periods of increased restrictions on accessing hospital services. Information and communication strategies need to be clear, consistent, timely and accessible to reduce reliance on informal and potentially inaccurate sources.
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Affiliation(s)
| | - Marc Cheong
- Burnet Institute, Melbourne, VIC, Australia
- School of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia
| | | | | | - Joshua P. Vogel
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Zoe Bradfield
- Burnet Institute, Melbourne, VIC, Australia
- Curtin University, Bentley, WA, Australia
- King Edward Memorial Hospital, Subiaco, WA, Australia
| | | | - Caroline S. E. Homer
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Alyce N. Wilson
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
- * E-mail:
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Memmott C, Smith J, Korzuchowski A, Tan HL, Oveisi N, Hawkins K, Morgan R. 'Forgotten as first line providers': The experiences of midwives during the COVID-19 pandemic in British Columbia, Canada. Midwifery 2022; 113:103437. [PMID: 35908443 PMCID: PMC9303060 DOI: 10.1016/j.midw.2022.103437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore midwives' experiences working on the frontlines of the COVID-19 pandemic in British Columbia, Canada. DESIGN Qualitative study involving three semi-structured focus groups and four in-depth interviews with midwives. SETTING The COVID-19 pandemic in British Columbia, Canada from 2020-2021. PARTICIPANTS 13 midwives working during the first year of the COVID-19 pandemic in British Columbia. FINDINGS Qualitative analysis surfaced four key themes. First, midwives faced a substantial lack of support during the pandemic. Second, insufficient support was compounded by a lack of recognition. Third, participants felt a strong duty to continue providing high-quality care despite COVID-19 related restrictions and challenges. Lastly, lack of support, increased workloads, and moral distress exacerbated burnout among midwives and raised concerns around the sustainability of their profession. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Lack of effective support for midwives during the initial months of the COVID-19 pandemic exacerbated staffing shortages that existed prior to the pandemic, creating detrimental gaps in essential care for pregnant people, especially with increasing demands for homebirths. Measures to support midwives should combat inequities in the healthcare system, mitigating the risks of disease exposure, burnout, and professional and financial impacts that may have long-lasting implications on the profession. Given the crucial role of midwives in women- and people-centred care and advocacy, protecting midwives and the communities they serve should be prioritized and integrated into pandemic preparedness and response planning to preserve women's health and rights around the world.
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Affiliation(s)
- Christina Memmott
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD, 21205, USA
| | - Julia Smith
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Dr, Burnaby, British Columbia, V5A 1S6, USA.
| | - Alexander Korzuchowski
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Dr, Burnaby, British Columbia, V5A 1S6, USA
| | - Heang-Lee Tan
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD, 21205, USA
| | - Niki Oveisi
- University of British Columbia, Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, USA
| | - Kate Hawkins
- Pamoja Communications, 20-22 Wenlock Road, London, N1 7GU, England
| | - Rosemary Morgan
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD, 21205, USA
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Flaherty SJ, Delaney H, Matvienko-Sikar K, Smith V. Maternity care during COVID-19: a qualitative evidence synthesis of women's and maternity care providers' views and experiences. BMC Pregnancy Childbirth 2022; 22:438. [PMID: 35619069 PMCID: PMC9132752 DOI: 10.1186/s12884-022-04724-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/03/2022] [Indexed: 01/16/2023] Open
Abstract
Background As COVID-19 continued to impact society and health, maternity care, as with many other healthcare sectors across the globe, experienced tumultuous changes. These changes have the potential to considerably impact on the experience of maternity care. To gain insight and understanding of the experience of maternity care during COVID-19, from the perspectives of women and maternity care providers, we undertook a qualitative evidence synthesis (QES). Methods The population of interest for the QES were pregnant and postpartum women, and maternity care providers, who provided qualitative data on their experiences of maternity care during COVID-19. The electronic databases of MEDLINE, CINAHL, EMBASE, PsycINFO and the Cochrane COVID study register were systematically searched from 01 Jan 2020 to 13 June 2021. The methodological quality of the included studies was appraised using a modified version of the quality assessment tool, based on 12-criteria, designed by the Evidence for Policy and Practice Information coordinating Centre (EPPI-Centre). Data were extracted by two reviewers independently and synthesised using the Thomas and Harden framework. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Results Fifty records relating to 48 studies, involving 9,348 women and 2,538 maternity care providers, were included in the QES. The methodological quality of the studies varied from four studies meeting all 12 quality criteria to two studies meeting one quality criterion only. The synthesis revealed eight prominent themes. Five of these reflected women’s experiences: 1) Altered maternity care (women), 2) COVID-related restrictions, 3) Infection prevention and risk, 4) ‘the lived reality’ – navigating support systems, and 5) Interactions with maternity services. Three themes reflected maternity care providers’ experiences: 6) Altered maternity care (providers), 7) Professional and personal impact, and 8) Broader structural impact. Confidence in the findings was high or moderate. Conclusion Although some positive experiences were identified, overall, this QES reveals that maternity care during COVID-19 was negatively experienced by both women and maternity care providers. The pandemic and associated changes evoked an array of emotive states for both populations, many of which have the potential to impact on future health and wellbeing. Resource and care planning to mitigate medium- and longer-term adverse sequelae are required. PROSPERO registration CRD42021232684. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04724-w.
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Affiliation(s)
| | - Hannah Delaney
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland.,Health Research Board-Trials Methodology Research Network (HRB-TMRN), National University of Ireland, Galway, Ireland
| | | | - Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland.
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Gaucher L, Dupont C, Gautier S, Baumann S, Rousseau A. The challenge of care coordination by midwives during the COVID-19 pandemic: a national descriptive survey. BMC Pregnancy Childbirth 2022; 22:437. [PMID: 35614384 PMCID: PMC9131711 DOI: 10.1186/s12884-022-04772-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND As part of a decades-long process of restructuring primary care, independent (also known as community) healthcare workers are being encouraged to work in groups to facilitate their coordination and continuity of care in France. French independent midwives perform about half of the early prenatal interviews that identify mothers' needs during pregnancy and then refer them to the appropriate resources. The French government, however, structured the COVID-19 pandemic response around public health institutions and did not directly mobilise these community healthcare workers during the lockdown phase. These responses have raised questions about their role within the healthcare system in crises. This survey's main objectives were to estimate the proportion of independent midwives who experienced new difficulties in referring women to healthcare facilities or other caregivers and in collaborating with hospitals during the first stage of this pandemic. The secondary objective was to estimate the proportion, according to their mode of practice, of independent midwives who considered that all the women under their care had risked harm due to failed or delayed referral to care. METHODS We conducted an online national survey addressed to independent midwives in France from 29 April to 15 May 2020, around the end of the first lockdown (17 March-11 May, 2020). RESULTS Of the 5264 registered independent midwives in France, 1491 (28.3%) responded; 64.7% reported new or greater problems during the pandemic in referring women to health facilities or care-providers, social workers in particular, and 71.0% reported new difficulties collaborating with hospitals. Nearly half (46.2%) the respondents considered that all the women in their care had experienced, to varying degrees, a lack of or delay in care that could have affected their health. This proportion did not differ according to the midwives' form of practice: solo practice, group practice with other midwives only, or group practice with at least two types of healthcare professionals. CONCLUSIONS The pandemic has degraded the quality of pregnant women's care in France and challenged the French model of care, which is highly compartmentalised between an almost exclusively independent primary care (community) sector and a predominantly salaried secondary care (hospital) sector.
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Affiliation(s)
- Laurent Gaucher
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Geneva, Western Switzerland Switzerland
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, 69008 Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère-Enfant, 69500 Bron, France
| | - Corinne Dupont
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, 69008 Lyon, France
- Réseau Périnatal AURORE, 69004 Lyon, France
| | - Sylvain Gautier
- Paris-Saclay University, Inserm U1018, Versailles Saint Quentin University, 78180 Montigny-le-Bretonneux, France
- Département Hospitalier d’épidémiologie Et de Santé Publique Assistance Publique des Hôpitaux de Paris, Hôpital Raymond Poincaré, 92380 Garches, France
| | - Sophie Baumann
- Midwifery Department, Paris-Saclay University, Versailles Saint Quentin University, 78180 Montigny-le-Bretonneux, France
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, 78300 Poissy, France
| | - Anne Rousseau
- Midwifery Department, Paris-Saclay University, Versailles Saint Quentin University, 78180 Montigny-le-Bretonneux, France
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, 78300 Poissy, France
- Paris-Saclay University, CESP, Epidémiologie Clinique, Versailles Saint Quentin University, 78180 Montigny-le-Bretonneux, France
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14
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Palo SK, Dubey S, Negi S, Sahay MR, Patel K, Swain S, Mishra BK, Bhuyan D, Kanungo S, Som M, Merta BR, Bhattacharya D, Kshatri JS, Pati S. Effective interventions to ensure MCH (Maternal and Child Health) services during pandemic related health emergencies (Zika, Ebola, and COVID-19): A systematic review. PLoS One 2022; 17:e0268106. [PMID: 35536838 PMCID: PMC9089853 DOI: 10.1371/journal.pone.0268106] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Ensuring accessible and quality health care for women and children is an existing challenge, which is further exacerbated during pandemics. There is a knowledge gap about the effect of pandemics on maternal, newborn, and child well-being. This systematic review was conducted to study maternal and child health (MCH) services utilization during pandemics (Zika, Ebola, and COVID-19) and the effectiveness of various interventions undertaken for ensuring utilization of MCH services. METHODOLOGY A systematic and comprehensive search was conducted in MEDLINE/PubMed, Cochrane CENTRAL, Embase, Epistemonikos, ScienceDirect, and Google Scholar. Of 5643 citations, 60 potential studies were finally included for analysis. The included studies were appraised using JBI Critical appraisal tools. Study selection and data extraction were done independently and in duplicate. Findings are presented narratively based on the RMNCHA framework by World Health Organization (WHO). RESULTS Maternal and child health services such as antenatal care (ANC) visits, institutional deliveries, immunization uptake, were greatly affected during a pandemic situation. Innovative approaches in form of health care services through virtual consultation, patient triaging, developing dedicated COVID maternity centers and maternity schools were implemented in different places for ensuring continuity of MCH care during pandemics. None of the studies reported the effectiveness of these interventions during pandemic-related health emergencies. CONCLUSION The findings suggest that during pandemics, MCH care utilization often gets affected. Many innovative interventions were adopted to ensure MCH services. However, they lack evidence about their effectiveness. It is critically important to implement evidence-based appropriate interventions for better MCH care utilization.
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Affiliation(s)
| | - Shubhankar Dubey
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sapna Negi
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Kripalini Patel
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Swagatika Swain
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Dinesh Bhuyan
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Meena Som
- United Nations Children’s Fund (UNICEF), Odisha, India
| | | | | | | | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Sahay MR, Dubey S, Sahoo RK, Kanungo S, Sahoo KC, Pati S. Health-Related Challenges and Coping Strategies Among Women During Pandemics: A Systematic Review of Qualitative Studies. FRONTIERS IN HEALTH SERVICES 2022; 2:847753. [PMID: 36925852 PMCID: PMC10012754 DOI: 10.3389/frhs.2022.847753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/21/2022] [Indexed: 12/23/2022]
Abstract
Equality and empowerment for women are among the 17 Sustainable Development Goals (SDGs 5). Although women were confronted with more challenges in various ways during pandemics; however, there is hardly any systematic synthesis of evidence on women's health-related challenges during pandemics. We reviewed the health challenges faced by women during the pandemic. We searched MEDLINE, PsycINFO, and CINAHL following PRISMA guidelines. We identified 2,831 studies, of which we included 17. Reproductive health, psychosocial health, and gender-based violence emerged as significant challenges. Many studies reported challenges in provisions for routine services and increased anxiety, fear, and stress among women. The findings highlighted that pandemic have a significant impact on women's health. Women must have equal rights and opportunities without discrimination, which requires urgent action to enhance women's rights and to achieve SDGs. Women engagement/involvement in pandemic-related services needs to be explored, which will aid in developing strategies to alleviate vulnerabilities.
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Hazfiarini A, Akter S, Homer CSE, Zahroh RI, Bohren MA. 'We are going into battle without appropriate armour': A qualitative study of Indonesian midwives' experiences in providing maternity care during the COVID-19 pandemic. Women Birth 2021; 35:466-474. [PMID: 34656517 PMCID: PMC9239738 DOI: 10.1016/j.wombi.2021.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022]
Abstract
Background The COVID-19 pandemic has impacted the provision of maternity care worldwide. The continuation of maternity services during the pandemic is vital, but midwives have reported feeling overwhelmed in providing these services at this time. However, there are limited studies in Indonesia that have explored the experiences of midwives in providing care during the pandemic. Aim Our study aims to explore Indonesian midwives’ experiences in providing maternity care during the COVID-19 pandemic. Methods We used a descriptive qualitative approach using in-depth interviews to explore the experiences of 15 midwives working in different level of maternity care facilities in two regions in Indonesia, Surabaya and Mataram. All interviews were conducted via WhatsApp call and were audio-recorded with permission. Data were analysed using inductive thematic analysis. Findings Four themes were identified: 1) fear for the wellbeing of the family and herself, 2) increased workload, 3) motivation and support for midwives, and 4) challenges in providing maternity care for women. Discussion Sense of duty and loyalty to other midwives motivated midwives to continue working despite their fears and increased workload. Inadequate protection and support and practical challenges faced by midwives should be addressed to ensure midwives’ wellbeing and the continuity of maternity care. Conclusion Our study provides insight into Indonesian midwives’ experiences in providing maternity care during the COVID-19 pandemic. Adequate protection through PPE availability, effective training and support for midwives’ wellbeing is needed to support midwives in providing maternity care during the pandemic. Community’s adherence to COVID-19 protocols and good collaboration between primary health centres and hospitals would also benefit midwives.
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Affiliation(s)
- Alya Hazfiarini
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
| | - Shahinoor Akter
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
| | - Caroline S E Homer
- Maternal, Child and Adolescent Health, Burnet Institute, Melbourne, VIC, Australia.
| | - Rana Islamiah Zahroh
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
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No one asked us: Understanding the lived experiences of midwives providing care in the north west suburbs of Melbourne during the COVID-19 pandemic: An interpretive phenomenology. Women Birth 2021; 35:447-457. [PMID: 34627733 PMCID: PMC8493470 DOI: 10.1016/j.wombi.2021.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/22/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022]
Abstract
Problem Within the Victorian healthcare system, a rapid response to the COVID-19 pandemic has necessitated frequent and ongoing changes to midwifery practice. Background Midwives are a vital workforce at risk of burnout, attrition, and trauma. Emotional consequences of the pandemic for midwives remain largely unknown. Aim To understand the lived experiences of midwives providing care in the north west suburbs of Melbourne, Victoria during the pandemic. Methods Purposive and snowball sampling facilitated the recruitment of eight midwives in the north west suburbs of Melbourne, Victoria. Semi-structured interviews were audio recorded and transcribed, occurring via telephone or video between September and October 2020. Interpretive phenomenology was the methodology used, informed by the writings of Heidegger and Gadamer. Findings Insights gleaned from the data embody a range of understandings. The unknown cost of change and adaptation; waves of the virus; balancing risk; telehealth; personal protective equipment; stripping away support; the privilege of abiding by the restrictions; separation, distress, uncertainty; and, professional strength. Discussion Experiences of midwives during the pandemic are characterised by sensations of voicelessness and professional invisibility. Distinctive differences in personal wellbeing and professional satisfaction exist between midwives working with and without continuity of care. Conclusion This paper voices the lived experiences of Victorian midwives, in the midst of an extended lockdown, during the COVID-19 pandemic. Knowledge obtained from this research provides important understandings for leaders, policymakers, and healthcare systems, in planning a long-term response to the pandemic that supports the wellbeing and longevity of a vital workforce.
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Blums T, Donnellan-Fernandez R, Sweet L. Women's perceptions of inclusion and exclusion criteria for publicly-funded homebirth - A survey. Women Birth 2021; 35:413-422. [PMID: 34518118 DOI: 10.1016/j.wombi.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are 15 publicly-funded homebirth programs in Australia. Women's access to these programs is determined by program specific inclusion and exclusion criteria. AIMS To examine women's perception of inclusion and exclusion criteria for publicly-funded homebirth programs in Australia and how these perceptions may influence women's choices and access to these programs. METHODS A national online survey was conducted and promoted through social media networks to women interested in homebirth in Australia. Quantitative data were analysed to generate descriptive statistics and a content analysis was performed on qualitative data. FINDINGS A total of 830 surveys were collected. Most women were supportive of inclusion and exclusion criteria related to social and environmental factors, although there was ambivalence about requiring ambulance cover, not having a history of domestic violence in the current relationship and requiring the woman to speak basic English. With regards to obstetric factors, only a requirement for labour to commence spontaneously at term was supported by over half of participants. All other obstetric related criteria had over half of participants disagreeing or strongly disagreeing that they should be used to prevent a woman from birthing at home. A desire for choice and access was frequently mentioned in the qualitative data. CONCLUSION There is a need to address the lack of choice many women experience when pregnant and the lack of equitable access to affordable homebirth services in Australia.
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Affiliation(s)
- Tija Blums
- School of Nursing and Midwifery, Griffith University, Australia; Western Health, St Albans, VIC, Australia.
| | - Roslyn Donnellan-Fernandez
- School of Nursing and Midwifery, Griffith University, Australia; Transforming Maternity Care Collaborative, Australia. https://twitter.com/@RozDFernandez
| | - Linda Sweet
- Western Health, St Albans, VIC, Australia; School of Nursing & Midwifery, Faculty of Health, Deakin University, Australia. https://twitter.com/@ProfLindaSweet
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19
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Goberna-Tricas J, Biurrun-Garrido A, Perelló-Iñiguez C, Rodríguez-Garrido P. The COVID-19 Pandemic in Spain: Experiences of Midwives on the Healthcare Frontline. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126516. [PMID: 34204286 PMCID: PMC8296391 DOI: 10.3390/ijerph18126516] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022]
Abstract
Background: Midwives look after women during pregnancy, childbirth and puerperium. In Spain, the first wave of COVID was particularly virulent. There are few studies about the experiences of midwives providing care during the COVID pandemic and very few have been undertaken in the countries of southern Europe such as Spain. This article sets out to take a more in-depth look at the experiences of midwives who were on the frontline of care during the early months of the COVID-19 pandemic as well as to identify new needs and resilience strategies that can help midwives. Methods: A qualitative methodology of phenomenological tradition was used, interviewing 10 midwives from primary care, hospital and independent care. Results: After content analysis, three central categories emerged: (a) cascade of emotions; (b) professional occupation and concern for the women; (c) resisting the day-to-day; resilience and resistance strategies. Conclusions: Despite the difficulties, midwives are concerned about the loss of rights and autonomy and about the increased vulnerability of women. Midwives have become aware of the power they have in their actions both in health management and administration, as well as in the care of women, creating strategies to provide dignified care to their users.
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Affiliation(s)
- Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, 08007 Barcelona, Spain
- Correspondence: (J.G.-T.); (A.B.-G.)
| | - Ainoa Biurrun-Garrido
- Campus Docent, Sant Joan de Déu, Fundació Privada, School of Nursing, Universitat de Barcelona, 08034 Barcelona, Spain
- Sexual and Reproductive Health Clinic, Parc Salut Mar, 08003 Barcelona, Spain
- Correspondence: (J.G.-T.); (A.B.-G.)
| | - Carme Perelló-Iñiguez
- PhD Program in Citizenship and Human Rights, Universitat de Barcelona, 08007 Barcelona, Spain;
| | - Pía Rodríguez-Garrido
- Nursing and Health PhD Program, Universitat de Barcelona, 08007 Barcelona, Spain;
- Area of Sexuality and Diversity of the Department of Equity and Gender, University of O’Higgins, Rancagua 2820000, Chile
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20
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Shanahan MC, Akudjedu TN. Australian radiographers' and radiation therapists' experiences during the COVID-19 pandemic. J Med Radiat Sci 2021; 68:111-120. [PMID: 33590670 PMCID: PMC8013350 DOI: 10.1002/jmrs.462] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Radiographers and radiation therapists are key patient-facing health practitioners supporting the delivery of optimal patient care during the COVID-19 pandemic. The aim of this research was to investigate the impact of COVID-19 on clinical service delivery and well-being of these healthcare professionals in Australia. METHODS A cross-sectional online survey of Australian radiographers and radiation therapists was conducted in June-July 2020. The survey collected data on demographic characteristics, and the impact of COVID-19 on professional practice, infection control and workplace-related stress. RESULTS A total of 218 responses were received. Changes in work hours (P < 0.001) and workload (P = 0.022) were experienced due to COVID-19. Diagnostic radiographers reported increased procedural pressure on mobile radiography, computed tomography and general radiography. For radiation therapists, most pressure included areas of simulation and linear accelerator. PPE was in short supply at the start of the pandemic, and at the time of the study, shortages were identified for all PPE items. There was no difference in PPE supply reported by diagnostic radiographers and radiation therapists except for hand sanitiser (P = 0.003). Respondents experienced increased personal stress (61.4%) and anxiety (58.2%) at work due to COVID-19. In addition, their work caused increased stress to their family, partners or friends (57.4%). CONCLUSIONS COVID-19 has resulted in changes to clinical working patterns and service delivery. PPE shortages, as well as increased workplace-related stress, were identified. Workplaces should seek to mitigate the pandemic impact through the provision of adequate PPE for safe practice as well as implement strategies to support and enhance staff well-being.
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Affiliation(s)
- Madeleine C Shanahan
- Discipline of Medical Radiation ScienceFaculty of HealthUniversity of CanberraBruceACTAustralia
| | - Theophilus N Akudjedu
- Institute of Medical Imaging & VisualisationFaculty of Health & Social SciencesBournemouth UniversityBournemouthUK
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