Care of women and application of the principle of informed consent to interventions during birth in the COVID-19 pandemic period.

INTRODUCTION: In the early phases of the COVID-19 pandemic, inadequate intrapartum care protocols were in place. Many organizations have responded promptly and recognized the importance of adherence to appropriate guidelines. The International Confederation of Midwives issued an official statement on 29 March 2020, which states that every woman has the right to information, to give consent, to refuse consent, and to have her choices and decisions respected and upheld. No research has been conducted in Lithuania to reveal the care of women who gave birth during the COVID-19 pandemic and the application of informed consent to interventions. METHODS: This study is quantitative of cross-sectional design. An anonymous questionnaire survey method was used. One hundred fifty-two women who gave birth in Lithuania during the COVID-19 pandemic (March 2020 - May 2022) and had COVID-19 infection during childbirth, participated in the study. Statistical data analysis was performed. RESULTS: During the COVID-19 pandemic, women's care was characterized by always or almost always adequate information from health professionals on all issues to minimize the stress of new procedures necessitated by the COVID-19 pandemic and allowing them to stay with newborns as long as possible. The application of the principle of informed consent to interventions during the COVID-19 pandemic was not always applied to the performance of transvaginal examination manual compression of the uterine fundus to facilitate the expulsion period. CONCLUSIONS: Most women said that they were properly informed by healthcare professionals about all questions related to the new procedures that became necessary due to the COVID-19 pandemic and felt included in their own choice. However, mothers felt the need of relatives during childbirth, and consent was often not asked for vaginal examination.

Lithuanian midwives' attitudes and actions during low-risk birth.

INTRODUCTION: This study sheds light on the attitudes and practices of Lithuanian midwives during low-risk births. The aim is to reveal how autonomous work is incorporated into daily routines, how care is oriented towards the mother, and how care is delivered before and during interventions. It highlights midwives' views on both their own and their colleagues' actions during labor, what is aimed for and what outcome is expected. METHODS: A qualitative research method was chosen. Midwives were interviewed individually in February and April 2022 by random sampling and semi-structured interviews, after the purpose of the survey was explained and their consent was given to use the information only for scientific work purposes. Midwives were recruited through social networks, sharing information about the study and its nature. All data were coded and analyzed in aggregate form. Ten midwives working in the labor ward participated in the study. RESULTS: From the midwives' point of view, every birth and its experience are unique. Midwives work together with mothers to achieve the common goal of a positive birth experience. Communication with the mother and her family, good rapport, clear information and informed decision-making are key aspects for midwives during labor. The midwife's actions must be reasonable and purposeful, with a preference for non-medicated methods of pain and stress relief. CONCLUSIONS: A low-risk birth that is within the competence of midwives is one in which there is a low likelihood of medical interventions. Midwives are encouraged to minimize the use of interventions and to provide high quality delivery care.