Experiences of Dutch maternity care professionals during the first wave of COVID-19 in a community based maternity care system

Eline L M van Manen*, Martine Hollander, Esther Feijen-de Jong, Ank de Jonge, Corine Verhoeven, Janneke Gitsels

*Corresponding author for this work

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    Abstract

    BACKGROUND AND OBJECTIVE: During the COVID-19 pandemic the organization of maternity care changed drastically; this study into the experiences of maternity care professionals with these changes provides suggestions for the organization of care during and after pandemics.

    DESIGN: An online survey among Dutch midwives, obstetricians and obstetric residents. Multinomial logistic regression analyses were used to investigate associations between the respondents' characteristics and answers.

    RESULTS: Reported advantages of the changes were fewer prenatal and postpartum consultations (50.1%). The necessity and safety of medical interventions and ultrasounds were considered more critically (75.9%); 14.8% of community midwives stated they referred fewer women to the hospital for decreased fetal movements, whereas 64.2% of the respondents working in hospital-based care experienced fewer consultations for this indication. Respondents felt that women had more confidence in giving birth at home (57.5%). Homebirths seemed to have increased according to 38.5% of the community midwives and 65.3% of the respondents working in hospital-based care. Respondents appreciated the shift to more digital consultations rather than face-to-face consultations. Mentioned disadvantages were that women had appointments alone, (71.1%) and that the community midwife was not allowed to join a woman to obstetric-led care during labour and subsequently stay with her (56.8%). Fewer postpartum visits by family and friends led to more tranquility (59.8%). Overall, however, 48.0% of the respondents felt that the safety of maternity care was compromised due to policy changes.

    CONCLUSIONS: Maternity care professionals were positive about the decrease in routine care and the increased confidence of women in home birth, but also felt that safety in maternity care was sometimes compromised. According to the respondents in a future crisis situation it should be possible for community midwives to continue to deliver a personal handover after the referral of women to the hospital, and to stay with them.

    Original languageEnglish
    Article numbere0252735
    JournalPLoS ONE
    Volume16
    Issue number6
    DOIs
    Publication statusPublished - 17-Jun-2021

    Keywords

    • Adult
    • COVID-19/epidemiology
    • Female
    • Home Childbirth/methods
    • Hospitals/statistics & numerical data
    • Humans
    • Labor, Obstetric
    • Logistic Models
    • Male
    • Maternal Health Services/statistics & numerical data
    • Middle Aged
    • Midwifery/statistics & numerical data
    • Netherlands
    • Pregnancy
    • Prenatal Care/methods
    • SARS-CoV-2/isolation & purification
    • Surveys and Questionnaires/statistics & numerical data

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