'We are going into battle without appropriate armour': A qualitative study of Indonesian midwives' experiences in providing maternity care during the COVID-19 pandemic.

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.