Combellick Joan L, Basile Ibrahim Bridget, Julien Tamika, Scharer Kirsten, Jackson Kierra, Powell Kennedy Holly
School of Nursing, Yale University, Orange, Connecticut, USA.
School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Birth. 2022 Jun;49(2):341-351. doi: 10.1111/birt.12616. Epub 2022 Feb 25.
The COVID pandemic exposed many inadequacies in the maternity care system in the United States. Maternity care protocols put in place during this crisis often did not include input from childbearing people or follow prepandemic guidelines for high-quality care. Departure from standard maternity care practices led to unfavorable and traumatic experiences for childbearing people. This study aimed to identify what childbearing people needed to achieve a positive birth experience during the pandemic.
This mixed-methods, cross-sectional study was conducted among individuals who gave birth during the COVID pandemic from 3/1/2020 to 11/1/2020. Participants were sampled via a Web-based questionnaire that was distributed nationally. Descriptive and bivariate statistics were analyzed. Thematic and content analyses of qualitative data were based on narrative information provided by participants. Qualitative and convergent quantitative data were reported.
Participants (n = 707) from 46 states and the District of Columbia completed the questionnaire with 394 contributing qualitative data about their experiences. Qualitative findings reflected women's priorities for (a) the option of community birth, (b) access to midwives, (c) the right to an advocate at birth, and (d) the need for transparent and affirming communication. Quantitative data reinforced these findings. Participants with a midwife provider felt significantly better informed. Those who gave birth in a community setting (at home or in a freestanding birth center) also reported significantly higher satisfaction and felt better informed. Participants of color (BIPOC) were significantly less satisfied and more stressed while pregnant and giving birth during the pandemic.
High-quality maternity care places childbearing people at the center of care. Prioritizing the needs of childbearing people, in COVID times or otherwise, is critical for improving their experiences and delivering efficacious and safe care.
新冠疫情暴露出美国孕产妇护理系统存在的诸多不足。在这场危机期间实施的孕产妇护理方案往往没有纳入孕产妇的意见，也未遵循疫情前的高质量护理指南。偏离标准的孕产妇护理做法给孕产妇带来了不良和痛苦的经历。本研究旨在确定孕产妇在疫情期间实现积极分娩体验所需的条件。
这项混合方法的横断面研究是在2020年3月1日至2020年11月1日新冠疫情期间分娩的个体中进行的。通过在全国范围内分发的基于网络的问卷对参与者进行抽样。分析描述性和双变量统计数据。定性数据的主题和内容分析基于参与者提供的叙述性信息。报告定性和收敛性定量数据。
来自46个州和哥伦比亚特区的707名参与者完成了问卷，其中394人提供了有关其经历的定性数据。定性研究结果反映了女性的优先事项，包括（a）社区分娩的选择、（b）获得助产士服务、（c）分娩时有辩护人在场的权利以及（d）透明且肯定性沟通的必要性。定量数据强化了这些发现。有助产士服务的参与者感觉了解的信息明显更多。在社区环境（家中或独立分娩中心）分娩的人也报告了明显更高的满意度，并且感觉了解的信息更多。在疫情期间怀孕和分娩时，有色人种参与者（BIPOC）的满意度明显较低，压力更大。
高质量的孕产妇护理将孕产妇置于护理的中心。无论在新冠疫情期间还是其他时候，优先考虑孕产妇的需求对于改善她们的体验以及提供有效和安全的护理至关重要。
