ABSTRACT
Introduction COVID-19 infection in pregnancy is associated with increased morbidity and mortality for the mother as well as complications for the baby. In July 2021, the Australian Technical Advisory Group on Immunisation and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommended that pregnant women should be prioritised for COVID-19 vaccines and routinely offered Pfizer vaccine at any stage of pregnancy. There is no evidence on the pregnant women’s perceptions and acceptance of COVID-19 vaccine after this recommendation. Aim The aim of this research was to map COVID-19 vaccination in pregnancy acceptance, hesitancy and a change in original vaccination intentions. Methods A cross-sectional, anonymous, online survey was conducted in one area health service in New South Wales, including one large tertiary referral hospital and two smaller metropolitan hospitals. Descriptive analysis was done using SPSS. Results During September 2021 to January 2022, 1103 women responded to the survey and 1,026 completed the questions, with the completion rate of 93%. Women who did not complete the survey beyond demographics (8%) or were not pregnant (3%) were excluded. The mean age of the women was 33.3 years and most were either in their second (31%) or third (49%) trimester of pregnancy. Around half of the women were having their first pregnancy (51%) and born in Australia (47%). The majority of women agreed that COVID-19 vaccine was important for their health (84%) and important to protect others in the community (81%). Although 66% of women reported that at some stage they felt unsure about having the vaccine, the majority (87%) of women had at least one dose of vaccine. Conclusion This is the largest survey of pregnant women in Australia, providing evidence that acceptance of COVID-19 vaccination in pregnancy appears to be high among Australian women living in metropolitan areas.
ABSTRACT
BACKGROUND: There are major shortfalls in the midwifery workforce which has been exacerbated by the COVID 19 pandemic. Midwives have high levels of burnout and many, often early career midwives, are planning to leave the profession. There are reports of a poor workplace culture in maternity units, including bullying. Support is essential for the welfare of the workforce to be able to cope with the demands of their jobs. Supportive strategies, such as Clinical Supervision, a recognised approach in healthcare, enable reflection in a facilitated, structured way, and can enhance professional standards. The purpose of this research is to study burnout levels in midwives, those exiting their workplace and perceptions of workplace culture in relation to access to, and attendance of, monthly Clinical Supervision. METHODS: This study will be a cluster randomised controlled trial of maternity sites within Sydney and the surrounding districts. Twelve sites will be recruited and half will receive monthly Clinical Supervision for up to two years. Midwives from all sites will be requested to complete 6-monthly surveys comprising validated measurement tools: the Copenhagen Burnout Inventory (CBI), the Australian Midwifery Workplace Culture (AMWoC) tool and the Clinical Supervision Evaluation Questionnaire (CSEQ) (the latter for intervention sites only). Primary outcomes are the levels of burnout in midwives (using the CBI). Secondary outcomes will be the quality of the intervention (using the CSEQ), perceptions of workplace culture (using the AMWoC tool) and midwives' intention to stay in their role/profession, as well as sick leave rates and numbers of exiting staff. We will also determine the dose effect - ie the impact in relation to how many Clinical Supervision sessions the midwives have attended, as well as other supportive workplace strategies such as mentoring/coaching on outcomes. DISCUSSION: Through attending monthly Clinical Supervision we hypothesise that midwives will report less burnout and more positive perceptions of workplace culture than those in the control sites. The potential implications of which are a productive workforce giving high quality care with the flow-on effect of having physically and psychologically well women and their babies. TRIAL REGISTRATION: The ACTRN Registration number is ACTRN12621000545864p , dated 10/05/2021,.