Brislane Áine, Larkin Fionnuala, Jones Helen, Davenport Margie H
School of Science, Technology and Health, York St. John University, York, United Kingdom.
School of Education, Language and Psychology, York St. John University, York, United Kingdom.
Front Glob Womens Health. 2021 Feb 10;2:628625. doi: 10.3389/fgwh.2021.628625. eCollection 2021.
During the COVID-19 pandemic, obstetric care has adopted new precautions to ensure services can be maintained for pregnant women. The aim of this study was to describe access to and quality of obstetric care for pregnant and postpartum women during the COVID-19 pandemic and to identify factors that predict quality of care at this time. Between May 3 and June 28, 2020, we recruited women who were pregnant or within the first 6 months after delivery to participate in an online survey. This included questions on access to obstetric healthcare (type and place of health care provider, changes to obstetric appointments/services, appointment preferences) and the Quality of Prenatal Care Questionnaire (QPCQ). Of the 917 eligible women, 612 (67%) were pregnant and 305 (33%) were in the first 6 months after delivery. Sixty-two percent ( = 571) reported that COVID-19 had affected their healthcare; appointments were rearranged, canceled or occurred virtual means for 29% ( = 166), 29% ( = 167), and 31% ( = 175) of women, respectively. The majority preferred to physically attend appointments (74%; = 676) and perceived the accompaniment of birth partners as important (77%; = 471). Sixty-two percent ( = 380) were permitted a birth partner at delivery, 18% ( = 111) were unsure of the rules while 4% ( = 26) were not permitted accompaniment. During pregnancy, QPCQ was negatively associated with disruption to obstetric services including exclusion or uncertainty regarding birth partner permissions [ = 11.5, < 0.001, = 0.16] while QPCQ was negatively associated with inadequate breastfeeding support postpartum [ = 12.05, = 0.001, = 0.08]. Pregnant and postpartum have experienced disruption in their access to obstetric healthcare. Perceived quality of obstetric care was negatively influenced by cancellation of appointment(s), suspension of services and exclusion of birth partners at delivery. During this time, continuity of care can be fulfilled virtual and/or phone appointments and women should receive clear guidance on changes to services including birth partner permissions to attend delivery.
在新冠疫情期间，产科护理采取了新的预防措施，以确保能为孕妇维持服务。本研究的目的是描述新冠疫情期间孕妇和产后妇女获得产科护理的情况及护理质量，并确定此时预测护理质量的因素。2020年5月3日至6月28日，我们招募了怀孕或产后6个月内的妇女参与一项在线调查。这包括关于获得产科医疗服务的问题（医疗服务提供者的类型和地点、产科预约/服务的变化、预约偏好）以及产前护理质量问卷（QPCQ）。在917名符合条件的妇女中，612名（67%）为孕妇，305名（33%）处于产后6个月内。62%（n = 571）报告称新冠疫情影响了她们的医疗保健；分别有29%（n = 166）、29%（n = 167）和31%（n = 175）的妇女的预约被重新安排、取消或通过虚拟方式进行。大多数人更喜欢亲自参加预约（74%；n = 676），并认为分娩伴侣的陪伴很重要（77%；n = 471）。62%（n = 380）的妇女在分娩时被允许有分娩伴侣陪伴，18%（n = 111）不确定相关规定，而4%（n = 26）不被允许有陪伴。在孕期，QPCQ与产科服务中断呈负相关，包括分娩伴侣陪伴的排除或不确定性[β = 11.5，P < 0.001，R² = 0.16]，而QPCQ与产后母乳喂养支持不足呈负相关[β = 12.05，P = 0.001，R² = 0.08]。孕妇和产后妇女在获得产科医疗服务方面经历了中断。产科护理的感知质量受到预约取消、服务暂停以及分娩时分娩伴侣被排除的负面影响。在此期间，可通过虚拟和/或电话预约实现连续护理，并且妇女应在包括分娩伴侣陪伴分娩的服务变化方面获得明确指导。
