Martín Badia Júlia, Goberna-Tricas Josefina, Obregón-Gutiérrez Noemí, Biurrun-Garrido Ainoa
Autonomous University of Barcelona, Bellaterra, Barcelona, Spain.
Faculty of Nursing, ADHUC Theory, Gender, and Sexuality Research Center, University of Barcelona, Barcelona, Spain.
Heliyon. 2024 Nov 22;10(23):e40474. doi: 10.1016/j.heliyon.2024.e40474. eCollection 2024 Dec 15.
The birth plan promotes women's autonomy allowing them to express their care preferences and to participate actively in decision-making. During the Covid-19 pandemic, concerns about infection placed limitations on women's decision-making and infringed upon some of their rights. The role of the birth plan, after the pandemic, needs to be reassessed to protect women's rights and ensure high-quality maternity care.
To explore Spanish midwives' perspective on the principle of respect for autonomy and how this is reflected in the birth plan, and to identify aspects that can be improved in the new post-pandemic scenario.
A descriptive phenomenological study of the experiences of Spanish midwives before, during and after the COVID-19 pandemic that addresses the use of the birth plan and the impact that the pandemic has had on women's rights. Individual online interviews and face-to-face focus groups were used.
Prior to the pandemic, midwives felt that birth plans had problems related to the unrealistic expectations of some women as well as to a lack of awareness of their usefulness. During the pandemic, women mobilized to challenge restrictive regulations, but faced problems with information dissemination and professional coordination, leading to continued infringement of women's rights post-pandemic.
To enhance the effectiveness of the birth plan in supporting women's autonomy, a deliberative approach is needed, along with improvements in midwives' ethical and communication skills. The COVID-19 pandemic has created a new scenario in which the discussion about the possibility of increasing the number of birthing centres or offering home birth care funded by the public system, should be debated.
分娩计划促进了女性的自主权，使她们能够表达自己的护理偏好并积极参与决策。在新冠疫情期间，对感染的担忧限制了女性的决策，并侵犯了她们的一些权利。疫情之后，需要重新评估分娩计划的作用，以保护女性权利并确保高质量的产妇护理。
探讨西班牙助产士对尊重自主权原则的看法，以及这一原则在分娩计划中的体现，并确定在疫情后的新情况下可以改进的方面。
对西班牙助产士在新冠疫情之前、期间和之后的经历进行描述性现象学研究，涉及分娩计划的使用以及疫情对女性权利的影响。采用了个人在线访谈和面对面焦点小组的方式。
在疫情之前，助产士认为分娩计划存在一些问题，比如一些女性的期望不切实际，以及对其有用性缺乏认识。在疫情期间，女性动员起来挑战限制性规定，但面临信息传播和专业协调方面的问题，导致疫情后女性权利仍持续受到侵犯。
为提高分娩计划在支持女性自主权方面的有效性，需要一种协商性方法，同时提高助产士的伦理和沟通技能。新冠疫情创造了一个新的局面，即应讨论增加分娩中心数量或提供由公共系统资助的家庭分娩护理的可能性。
