Faculty of Health and Environmental Sciences, Center for Midwifery and Women's Health Research, Auckland University of Technology, Auckland, New Zealand.
School of Nursing, Midwifery and Health Practice, Te Herenga Waka Victoria University of Wellington, New Zealand.
Women Birth. 2022 May;35(3):213-222. doi: 10.1016/j.wombi.2021.05.008. Epub 2021 Jun 5.
COVID-19 guidance from professional and health organisations created uncertainty leading to professional and personal stress impacting on midwives providing continuity of care in New Zealand (NZ). The COVID-19 pandemic resulted in massive amounts of international and national information and guidance. This guidance was often conflicting and not suited to New Zealand midwifery.
To examine and map the national and international guidance and information provided to midwifery regarding COVID-19 and foreground learnt lessons for future similar crises.
A systematic scoping review informed by Arksey and O'Malley's five-stage framework. A range of sources from grey and empirical literature was identified and 257 sources included.
Four categories were identified and discussed: (1) guidance for provision of maternity care in the community; (2) guidance for provision of primary labour and birth care; (3) Guidance for midwifery care to women/wāhine with confirmed/suspected COVID-19 infection, including screening processes and management of neonates of infected women/wāhine (4) Guidance for midwives on protecting self and own families and whānau (extended family) from COVID-19 exposure.
Guidance was mainly targeted and tailored for hospital-based services. This was at odds with the NZ context, where primary continuity of care underpins practice. It is evident that those providing continuity of care constantly needed to navigate an evolving situation to mitigate interruptions and restrictions to midwifery care, often without fully knowing the personal risk to themselves and their own families. A key message is the need for a single source of evidence-based guidance, regularly updated and timestamped to show where advice changes over time.
专业和健康组织发布的 COVID-19 指南导致不确定性，给提供连续护理的新西兰助产士带来专业和个人压力。COVID-19 大流行导致大量国际和国家信息和指导。这些指导通常存在冲突，不适合新西兰的助产士。
检查和绘制针对 COVID-19 向助产士提供的国家和国际指南，并为未来类似危机总结经验教训。
受 Arksey 和 O'Malley 的五阶段框架启发的系统范围审查。确定了一系列灰色和经验文献来源，并纳入了 257 个来源。
确定并讨论了四个类别：（1）社区提供产妇护理的指南；（2）提供主要分娩和分娩护理的指南；（3）为确诊/疑似 COVID-19 感染的妇女/女性提供助产护理的指南，包括筛查流程和感染妇女/女性新生儿的管理；（4）关于保护自己和家人免受 COVID-19 暴露的助产士指南。
指南主要针对和针对基于医院的服务。这与新西兰的情况不符，新西兰的主要连续护理是实践的基础。显然，那些提供连续护理的人经常需要应对不断变化的情况，以减轻对助产护理的中断和限制，而通常并不完全了解自己和家人面临的个人风险。一个关键信息是需要一个单一的基于证据的指南来源，定期更新和标记时间戳，以显示随时间变化的建议。
