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It was tough, but necessary. Organizational changes in a community based maternity care system during the first wave of the COVID-19 pandemic: A qualitative analysis in the Netherlands.
Appelman, Iris F; Thompson, Suzanne M; van den Berg, Lauri M M; van der Wal, Janneke T Gitsels; de Jonge, Ank; Hollander, Martine H.
  • Appelman IF; Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Thompson SM; Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • van den Berg LMM; Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • van der Wal JTG; Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • de Jonge A; Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Hollander MH; Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands.
PLoS One ; 17(3): e0264311, 2022.
Article in English | MEDLINE | ID: covidwho-1896449
ABSTRACT

INTRODUCTION:

The Coronavirus SARS-CoV-2pandemic necessitated several changes in maternity care. We investigated maternity care providers' opinions on the positive and negative effects of these changes and on potential areas of improvement for future maternity care both in times of crisis and in regular maternity care.

METHODS:

We conducted nineteen semi-structured in-depth interviews with obstetricians, obstetric residents, community-based and hospital-based midwives and obstetric nurses. The interviews were thematically analysed using inductive Thematic analysis.

RESULTS:

Five themes were generated '(Dis)proportionate measures', 'A significant impact of COVID-19', 'Differing views on inter-provider cooperation', 'Reluctance to seek help' and 'Lessons learnt'. The Central Organizing Concept was 'It was tough but necessary'. The majority of participants were positive about most of the measures that were taken and about their proportionality. These measures had a significant impact on maternity care providers, both mentally and on an organizational level. Most hospital-based care providers were positive about professional cooperation and communication, but some community-based midwives indicated that the cooperation between different midwifery care practices was suboptimal. Negative effects mentioned were a higher threshold for women to seek care, less partner involvement and perceived more fear among women and their partners, especially around birth. The most significant positive effect mentioned was increased use of eHealth tools. Recommendations for future care were to consider the necessity of prenatal and postnatal care more critically, to replace some face-to-face visits with eHealth and to provide more individualised care.

CONCLUSION:

Maternity care providers experienced measures and organizational changes during the first wave of the COVID19-pandemic as tough, but necessary. They believed that a more critical consideration of medically necessary care, increased use of e-health and more individualised care might contribute to making maternity care more sustainable during and after the pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Personnel / COVID-19 / Maternal Health Services Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adult / Female / Humans / Male / Pregnancy Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0264311

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Personnel / COVID-19 / Maternal Health Services Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adult / Female / Humans / Male / Pregnancy Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0264311