Semaan Aline, Dey Teesta, Kikula Amani, Asefa Anteneh, Delvaux Thérèse, Langlois Etienne V, van den Akker Thomas, Benova Lenka
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Department of Women's and Children's Health, University of Liverpool, Liverpool, United Kingdom.
PLOS Glob Public Health. 2022 Apr 28;2(4):e0000214. doi: 10.1371/journal.pgph.0000214. eCollection 2022.
Routine postnatal care (PNC) allows monitoring, early detection and management of complications, and counselling to ensure immediate and long-term wellbeing of mothers and newborns; yet effective coverage is sub-optimal globally. The COVID-19 pandemic disrupted availability and quality of maternal and newborn care despite established guidelines promoting continuity of essential services. We conducted a cross-sectional global online survey of 424 maternal and newborn healthcare providers from 61 countries, to explore PNC provision, availability, content and quality following the early phase of the COVID-19 pandemic. The questionnaire (11 languages), included four multiple-choice and four open-text questions on changes to PNC during the pandemic. Quantitative and qualitative responses received between July and December 2020 were analysed separately and integrated during reporting. Tightened rules for visiting postpartum women were reported in health facilities, ranging from shorter visiting hours to banning supportive companions and visitors. A quarter (26%) of respondents reported that mothers suspected/confirmed with COVID-19 were routinely separated from their newborns. Early initiation of breastfeeding was delayed due to waiting for maternal SARS-CoV-2 test results. Reduced provision of breastfeeding support was reported by 40% of respondents in high-income countries and 7% in low-income countries. Almost 60% reported that women were discharged earlier than usual and 27% perceived a reduction in attendance to outpatient PNC. Telemedicine and home visits were mostly reported in high-income countries to ensure safe care provision. Beyond the early phase of the COVID-19 pandemic, severe disruptions to content and quality of PNC continued to exist, whereas disruptions in availability and use were less commonly reported. Depriving women of support, reducing availability of PNC services, and mother-newborn separation could lead to negative long-term outcomes for women, newborns and families, and deny their rights to respectful care. Protecting these essential services is imperative to promoting quality woman-centred PNC during and beyond the pandemic.
常规产后护理（PNC）有助于监测、早期发现和处理并发症，并提供咨询服务，以确保母亲和新生儿的近期和长期健康；然而，全球范围内有效的产后护理覆盖率仍未达到最佳水平。尽管有既定指南促进基本服务的连续性，但新冠疫情仍扰乱了孕产妇和新生儿护理的可及性和质量。我们对来自61个国家的424名孕产妇和新生儿医疗保健提供者进行了一项横断面全球在线调查，以探讨新冠疫情早期阶段之后的产后护理提供情况、可及性、内容和质量。调查问卷（有11种语言）包括四个多项选择题和四个关于疫情期间产后护理变化的开放式问题。2020年7月至12月期间收到的定量和定性回复分别进行分析，并在报告过程中进行整合。据报告，医疗机构对产后妇女的探视规定更加严格，从缩短探视时间到禁止陪护人员和访客探视不等。四分之一（26%）的受访者报告称，疑似/确诊感染新冠的母亲通常会与新生儿分开。由于等待母亲的新冠病毒检测结果，母乳喂养的早期开始被推迟。40%的高收入国家受访者和7%的低收入国家受访者报告称，母乳喂养支持的提供有所减少。近60%的受访者报告称，女性出院时间比往常更早，27%的人认为门诊产后护理的就诊率有所下降。远程医疗和家访大多在高收入国家被报告，以确保安全的护理提供。在新冠疫情早期阶段之后，产后护理的内容和质量仍然受到严重干扰，而可及性和使用方面的干扰报告较少。剥夺妇女的支持、减少产后护理服务的可及性以及母婴分离可能会给妇女、新生儿和家庭带来负面的长期后果，并剥夺他们获得尊重护理的权利。在疫情期间及之后，保护这些基本服务对于促进以妇女为中心的高质量产后护理至关重要。
