Department of Obstetrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.
Midwifery Science, AVAG (Academy Midwifery Amsterdam and Groningen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
PLoS One. 2021 Jun 17;16(6):e0252735. doi: 10.1371/journal.pone.0252735. eCollection 2021.
During the COVID-19 pandemic the organization of maternity care changed drastically; this study into the experiences of maternity care professionals with these changes provides suggestions for the organization of care during and after pandemics.
An online survey among Dutch midwives, obstetricians and obstetric residents. Multinomial logistic regression analyses were used to investigate associations between the respondents' characteristics and answers.
Reported advantages of the changes were fewer prenatal and postpartum consultations (50.1%). The necessity and safety of medical interventions and ultrasounds were considered more critically (75.9%); 14.8% of community midwives stated they referred fewer women to the hospital for decreased fetal movements, whereas 64.2% of the respondents working in hospital-based care experienced fewer consultations for this indication. Respondents felt that women had more confidence in giving birth at home (57.5%). Homebirths seemed to have increased according to 38.5% of the community midwives and 65.3% of the respondents working in hospital-based care. Respondents appreciated the shift to more digital consultations rather than face-to-face consultations. Mentioned disadvantages were that women had appointments alone, (71.1%) and that the community midwife was not allowed to join a woman to obstetric-led care during labour and subsequently stay with her (56.8%). Fewer postpartum visits by family and friends led to more tranquility (59.8%). Overall, however, 48.0% of the respondents felt that the safety of maternity care was compromised due to policy changes.
Maternity care professionals were positive about the decrease in routine care and the increased confidence of women in home birth, but also felt that safety in maternity care was sometimes compromised. According to the respondents in a future crisis situation it should be possible for community midwives to continue to deliver a personal handover after the referral of women to the hospital, and to stay with them.
在 COVID-19 大流行期间，产妇护理的组织形式发生了巨大变化；本研究旨在了解产妇护理专业人员对这些变化的体验，为大流行期间和之后的护理组织提供建议。
对荷兰的助产士、产科医生和产科住院医师进行在线调查。采用多项逻辑回归分析来调查受访者特征与回答之间的关联。
报告的变化优势包括产前和产后咨询减少（50.1%）。对医疗干预和超声检查的必要性和安全性的评估更加严格（75.9%）；14.8%的社区助产士表示，由于胎儿活动减少，她们转诊到医院的女性减少，而 64.2%的在医院工作的受访者因该原因减少了咨询次数。受访者认为女性在家分娩更有信心（57.5%）。根据 38.5%的社区助产士和 65.3%的在医院工作的受访者的说法，似乎增加了家庭分娩。受访者更倾向于采用数字咨询而非面对面咨询。提到的缺点是女性独自预约（71.1%），以及社区助产士不被允许在分娩期间陪同女性转至产科主导的护理，随后与她在一起（56.8%）。产后亲友探望减少，产妇更能获得宁静（59.8%）。然而，总体而言，48.0%的受访者认为政策变化影响了产妇护理的安全性。
产妇护理专业人员对减少常规护理和增加女性对家庭分娩的信心持积极态度，但也认为有时产妇护理的安全性受到影响。根据受访者的说法，在未来的危机情况下，社区助产士应该能够在将女性转诊到医院后继续进行个人交接，并与她们在一起。
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