The Impacts of COVID-19 on US Maternity Care Practices: A Followup Study.

This article extends the findings of a rapid response article researched in April 2020 to illustrate how providers' practices and attitudes toward COVID-19 had shifted in response to better evidence, increased experience, and improved guidance on how SARS-CoV-2 and COVID-19 impacted maternity care in the United States. This article is based on a review of current labor and delivery guidelines in relation to SARS-CoV-2 and COVID-19, and on an email survey of 28 community-based and hospital-based maternity care providers in the United State, who discuss their experiences and clients' needs in response to a rapidly shifting landscape of maternity care during the COVID-19 pandemic. One-third of our respondents are obstetricians, while the other two-thirds include midwives, doulas, and labor and delivery nurses. We present these providers' frustrations and coping mechanisms in shifting their practices in relation to COVID-19. The primary lessons learned relate to improved testing and accessing PPE for providers and clients; the need for better integration between community- and hospital-based providers; and changes in restrictive protocols concerning labor support persons, rooming-in with newborns, immediate skin-to-skin contact, and breastfeeding. We conclude by suggesting that the COVID-19 pandemic offers a transformational moment to shift maternity care in the United States toward a more integrated and sustainable model that might improve provider and maternal experiences as well as maternal and newborn outcomes.

How Birth Providers in the United States are Responding to the COVID-19 Pandemic

Providers face changing hospital protocols, lack of personal protective equipment (PPE), and unclear guidelines for practice. Keywords: COVID-19, pregnancy, birth, maternity care, obstetricians, midwives, doulas, homebirth, freebirth, SARS-CoV-2, maternal health This rapid-response article seeks to describe the quick and dramatic changes occurring in birth practices across the United States resulting from the pandemic of the novel coronavirus, SARS-CoV-2, and the lifethreatening disease it produces, COVID-19. [...]Lauren Hicks, a labor and delivery (L&D) nurse from San Antonio, Texas, stressed a fear-mitigating factor for women laboring in her hospital-that their anxiety is decreased by seeing the nurses and doctors being so cautious following strict personal protective equipment (PPE) guidelines to protect themselves and the patient. Amy Romano stated, "I know at Vanderbilt they are diverting some of their low-risk hospital births to the birth center there, and the [inhospital birth center] has done a substantial amount of planning and transformed their service model to create the capacity."

Pregnancy, Birth and the COVID-19 Pandemic in the United States.

How quickly and in what ways are US maternity care practices changing due to the COVID-19 pandemic? Our data indicate that partners and doulas are being excluded from birthing rooms leaving mothers unsupported, while providers face lack of protective equipment and unclear guidelines. We investigate rapidly shifting protocols for in- and out-of-hospital births and the decision making behind them. We ask, will COVID-19 cause women, families, and providers to look at birthing in a different light? And will this pandemic offer a testing ground for future policy changes to generate effective maternity care amidst pandemics and other types of disasters?