Experiences Of Maternity Care Research Articles

The un-silencing of Japanese women's voices in maternity care: A hermeneutic phenomenological study of the woman–midwife relationship

ObjectiveThe purpose of this article is to understand the meaning of the woman–midwife relationship, with the overall aim to improve maternity care and women's birth experiences in Japan. To better understand the meaning of the woman–midwife relationship, this article presents women's and midwives’ experiences of having or not having a voice in maternity care. Research designHermeneutic phenomenology, as described by Max van Manen, helped to uncover the meaning of the phenomenon—the woman–midwife relationship—through participants’ lived experience. Individual interviews were conducted with 14 women and 10 midwives living in Japan. The interview data were interpreted and thematically analysed to reveal the meaning of the woman–midwife relationship. Findings‘Having a voice’ emerged as a central theme underpinning the meaning of the woman–midwife relationship; aspects of which included, 1) being unheard, 2) losing a voice, 3) having a voice, and 4) midwives speaking for women. Although having a voice should be a legitimate right for women in maternity care, some women's voices were unheard or lost in the experience with midwives. Conversely, some women gained a voice, especially when they positively and continuously developed their relationship with their midwife. How the woman and the midwife related to each other clearly affected their experience of having a voice in maternity care. Key conclusionHaving a voice, which portrays dimensions of choice, control, and autonomy, in their own maternity care is vital for women's positive birth experience. The woman–midwife relationship is critical in enabling women to have a voice and midwives to speak for women. Women and midwives need to develop their relationship. Moreover, the maternity care system needs to allow sufficient time and space, for instance, by ensuring midwife continuity of care to develop a positive woman–midwife relationship.

Perceptions and predictors of respectful maternity care in Malawi: A quantitative cross-sectional analysis

ObjectiveAccess to high-quality, respectful care is a basic human right. A lack of respectful care during childbirth is associated with poor outcomes and can negatively influence care-seeking and maternal mental health. We aimed to describe how women perceive their experience of maternity care in Malawi. MethodsWe implemented a cross-sectional survey of women (n = 660) who delivered in 25 birth facilities in four districts in Malawi in March 2020 using a validated 30-item, 90-point person-centered maternity care (PCMC) scale. We used descriptive statistics to examine women's experience of care and analyzed bivariable and multivariable mixed-effects models to evaluate predictors of PCMC. Statistical models accounted for clustering of women at the facility level and included maternal age, marital status, education, parity, mother or infant complications, timing of antenatal care (ANC), provider cadre and gender, facility type and sector, and district. ResultsMean PCMC score was 57.5 (range 21-84), with the lowest score (12.4 of 27 points) in communication and autonomy. Women reported: being prohibited from having a birth companion during labor (49.4%) or delivery (60.3%); providers did not introduce themselves (81.1%); providers did not ask consent before procedures/examinations (42.4%); women felt they could not ask questions (40.9%); and were not involved in care decisions (61.5%). Few women reported being frequently abused physically (2%) or verbally (3.5%); almost all had water/electricity available (>95%). In bivariate analyses, statistically significant positive associations were found between PCMC score and early ANC, male accompaniment to the facility, male provider, and a lack of complications; all associations remained at least potentially statistically significant in multivariable modeling. ConclusionsPhysical and verbal abuse and a lack of basic amenities were rare, while a lack of communication with patients and social support were common. Maternal characteristics (like timing of ANC and maternal or newborn complications) were predictors of RMC, while facility/system factors, like facility type and sector, were not. Continued efforts to improve respectful care will require strengthening provider communication skills and encouraging patient and companion involvement in care.

Impact of the COVID-19 pandemic on midwifery-led service provision in the United Kingdom in 2020-21: Findings of three national surveys

BackgroundThe COVID-19 pandemic required all healthcare systems to adapt quickly. There is some evidence about the impact of the pandemic on United Kingdom maternity services overall, but little is known about the impact on midwifery-led services, including midwifery units and home birth services. ObjectiveTo describe changes to midwifery-led service provision in the United Kingdom and the Channel Islands during the COVID-19 pandemic. DesignThree national surveys were circulated using the United Kingdom Midwifery Study System (UKMidSS) and the Royal College of Midwives (RCM) Heads and Directors of Midwifery Network. The UKMidSS surveys took place in wave 1 (April to June 2020) and in wave 2 (February to March 2021). The RCM survey was conducted in April 2020. FindingsThe response rate to the UKMidSS surveys was 84% in wave 1 and 70% in wave 2, while 48% of Heads and Directors of Midwifery responded to the RCM survey. Around 60% of midwifery units reported being open as usual in wave 1, with the remainder affected by closures. Fewer unit closures (15%) were reported in the wave 2 survey. Around 40% of services reported some reduction in home birth services in wave 1, compared with 15% in wave 2. The apparent impact of the pandemic varied widely across the four nations of the United Kingdom and within the English regions. ConclusionsThe pandemic led to increased centralisation of maternity care and the disruption of midwifery-led services, especially in the first wave. Further research should focus on the reasons behind closures, the regional variation and the impact on maternity care experience and outcomes.

Maternity care during COVID-19: a qualitative evidence synthesis of women’s and maternity care providers’ views and experiences

BackgroundAs COVID-19 continued to impact society and health, maternity care, as with many other healthcare sectors across the globe, experienced tumultuous changes. These changes have the potential to considerably impact on the experience of maternity care. To gain insight and understanding of the experience of maternity care during COVID-19, from the perspectives of women and maternity care providers, we undertook a qualitative evidence synthesis (QES).MethodsThe population of interest for the QES were pregnant and postpartum women, and maternity care providers, who provided qualitative data on their experiences of maternity care during COVID-19. The electronic databases of MEDLINE, CINAHL, EMBASE, PsycINFO and the Cochrane COVID study register were systematically searched from 01 Jan 2020 to 13 June 2021. The methodological quality of the included studies was appraised using a modified version of the quality assessment tool, based on 12-criteria, designed by the Evidence for Policy and Practice Information coordinating Centre (EPPI-Centre). Data were extracted by two reviewers independently and synthesised using the Thomas and Harden framework. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual).ResultsFifty records relating to 48 studies, involving 9,348 women and 2,538 maternity care providers, were included in the QES. The methodological quality of the studies varied from four studies meeting all 12 quality criteria to two studies meeting one quality criterion only. The synthesis revealed eight prominent themes. Five of these reflected women’s experiences: 1) Altered maternity care (women), 2) COVID-related restrictions, 3) Infection prevention and risk, 4) ‘the lived reality’ – navigating support systems, and 5) Interactions with maternity services. Three themes reflected maternity care providers’ experiences: 6) Altered maternity care (providers), 7) Professional and personal impact, and 8) Broader structural impact. Confidence in the findings was high or moderate.ConclusionAlthough some positive experiences were identified, overall, this QES reveals that maternity care during COVID-19 was negatively experienced by both women and maternity care providers. The pandemic and associated changes evoked an array of emotive states for both populations, many of which have the potential to impact on future health and wellbeing. Resource and care planning to mitigate medium- and longer-term adverse sequelae are required.PROSPERO registrationCRD42021232684.

Learning from women: Improving experiences of respectful maternity care during unplanned caesarean birth for women with diverse ethnicity and racial backgrounds

ProblemWomen from diverse ethnicity and racial backgrounds have few opportunities to share birth experiences to inform improvements in care. BackgroundRespectful maternity care is recognised as a global women’s health priority. Integrating that framework into diverse care systems and models may help bridge care gaps for women who had unexpected birth experiences, including unplanned caesarean birth. AimTo describe the experiences of women who had unplanned caesarean births and use knowledge gained to inform best practice recommendations that embody respectful maternity care. MethodsQualitative data were analysed from focus groups involving a convenience sample of 11 English speaking women, from diverse ethnic and racial backgrounds, with prior unplanned caesarean experience. Respectful maternity care was used as the lens for interpreting women’s narratives using Thorne’s interpretive description. The study site was an outpatient prenatal clinic within an urban academic, tertiary-care medical centre in the United States. FindingsTwo predominant, contrasting themes emerged: “not feeling well cared for” and “feeling well supported”. Positive experiences included sources of support and strength from the midwifery practice, group prenatal care, and a doula program. Eight domains of respectful maternity care were applied to findings, highlighting current positive institutional practices and proposing areas for future quality improvement. ConclusionKey practices promoting respectful maternity care include adequate communication and information sharing between pregnancy care providers and women, and a more robust informed consent process. Further emphasis on respectful maternity care is needed to support women to make shared decisions that best fit their circumstances and preferences.

An exploratory study of client and provider experience and perceptions of facility-based childbirth care in Quich\xe9, Guatemala

IntroductionRespectful maternity care (RMC) is fundamental to women’s and families’ experience of care and their decision about where to give birth. Studies from multiple countries describe the mistreatment of women during facility-based childbirth, though only a small number of studies from Guatemala have been published. Less information is available on women’s negative and positive experiences of childbirth care and health workers’ perceptions and experiences of providing maternity care.MethodsAs part of a program implemented in the Western Highlands of Guatemala to improve quality of reproductive maternal newborn and child health care, a mixed methods assessment was conducted in three hospitals and surrounding areas to understand women’s and health workers’ experience and perceptions of maternity care. The quantitative component included a survey of 31 maternity health workers and 140 women who had recently given birth in these hospitals. The qualitative component included in-depth interviews (IDIs) and focus group discussions (FGDs) with women and maternity health workers and managers.ResultsWomen reported a mix of positive and negative experiences of childbirth care related to interpersonal and health system factors. 81% of surveyed women reported that health workers had treated them with respect while 21.4% of women reported verbal abuse. Fifty-five percent and 12% of women, respectively, reported not having access to a private toilet and bath or shower. During IDIs and FGDs, many women described higher rates of verbal abuse directed at women who do not speak Spanish. A regression analysis of survey results indicated that speaking Ixil or K’iche at home was associated with a higher likelihood of women being treated negatively during childbirth in a facility. Health worker survey results corroborated negative aspects of care described by women and also reported mistreatment of health workers by clients and families (70.9%) and colleagues (48.2%).ConclusionsThis study adds to the literature on women’s experience of institutional childbirth and factors that influence this experience by triangulating experience and perceptions of both women and health workers. This assessment highlights opportunities to address mistreatment of both women and health workers and to build on positive care attributes to strengthen RMC for all women.

To call or not to call: exploring the validity of telephone interviews to derive maternal self-reports of experiences with facility childbirth care in northern Nigeria

BackgroundTo institutionalise respectful maternity care, frequent data on the experience of childbirth care is needed by health facility staff and managers. Telephone interviews have been proposed as a low-cost alternative...

Women's experiences with maternity care in public health facilities of Assam, India.

India is committed to Sustainable Development Goal 3 of reducing the national maternal mortality ratio to <70/100,000 live births by 2030. This article describes women's experiences of maternity care in public health facilities in three districts of the north-eastern Indian state of Assam. Fourteen focus-group discussions were carried out among 149 married women aged 18-45 years belonging to different ethnic communities. Data were analyzed using a grounded theory approach and organized using a framework of dimensions of maternal satisfaction. The findings suggest that access and distance were important considerations determining maternal care quality, especially in the two remote districts. Women reported inadequate infrastructure, lack of cleanliness, and poor access to medicines. Lack of prompt care was identified as an important issue, and women complained about being left unattended during labor and facing obstetric violence in the labor room. Our findings point toward the need to strengthen referral transport systems and establish maternity waiting homes in remote areas. It is important to also sensitize health providers about obstetric violence and the right of women to receive prompt and respectful maternity care.

The end of a challenging year

British Journal of MidwiferyVol. 29, No. 12 EditorialThe end of a challenging yearSuzannah AllkinsSuzannah AllkinsEditorSearch for more papers by this authorSuzannah AllkinsPublished Online:2 Dec 2021https://doi.org/10.12968/bjom.2021.29.12.665AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Baby Lifeline. Mind the gap. 2021. https://bit.ly/3DSyBHW (accessed 24 November 2021) Google ScholarBBC News. Austria to go into full lockdown as Covid surges. 2021. https://bbc.in/32xhsWG (accessed 25 November 2021) Google ScholarGov.uk. Government to introduce COVID-19 vaccination as a condition of deployment for all frontline health and social care workers. 2021. https://bit.ly/3xi15bQ (accessed 24 November 2021) Google ScholarJardine J, Walker K, Gurol-Urganci I et al.. Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study. The Lancet. 2021;398(10314):1905–1912. https://doi.org/10.1016/S0140-6736(21)01595-6 Crossref, Google ScholarMartin H, Hameed A. The effect of COVID-19 on intrapartum care: a case review from early in the pandemic. Br J Midwifery. 2021;29(9):532–535. https://doi.org/10.12968/bjom.2021.29.9.532 Link, Google ScholarRoyal College of Midwives. RCM outlines next steps for pay campaign. 2021. https://bit.ly/3HNLJAx (accessed 24 November 2021) Google ScholarSmith V, Panda S, O'Malley D, Vallejo N, Barry P. COVID-19 and clinical outcomes of pregnancy: a comparative study. Br J Midwifery. 2021;29(11):642–647. https://doi.org/10.12968/bjom.2021.29.11.642 Link, Google ScholarStacey T, Darwin Z, Keely A, Smith A, Farmer D, Heighway K. Experiences of maternity care during the COVID-19 pandemic in the North of England. Br J Midwifery. 2021;29(9):516–523. https://doi.org/10.12968/bjom.2021.29.9.516 Link, Google Scholar FiguresReferencesRelatedDetails 2 December 2021Volume 29Issue 12ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 2 December 2021 Published in print 2 December 2021 Information© MA Healthcare LimitedPDF download

Quantifying the differences in birth outcomes and out-of-pocket costs between Australian Defence Force servicewomen and civilian women: A data linkage study

ObjectivesServicewomen in Defence Forces the world over are constrained in their health service use by defence healthcare policy. These policies govern a woman’s ability to choose who she receives maternity care from and where. The aim of this study was to compare Australian Defence Force (ADF) servicewomen and children’s birth outcomes, health service use, and out-of-pocket costs to those of civilian women and children. MethodsRetrospective cohort study using linked administrative data for women giving birth between 1 July 2012 and 30 June 2018 in Queensland, Australia (n = 365,138 births). Women serving in the ADF at the time of birth were identified as having their care funded by the Department of Defence (n = 395 births). Propensity score matching was used to identify a mixed public/private civilian sample of women to allow for comparison with servicewomen, controlling for baseline characteristics. Sensitivity analysis was also conducted using a sample of civilian women accessing only private maternity care. FindingsNearly all servicewomen gave birth in the private setting (97.22%). They had significantly greater odds of having a caesarean section (OR 1.71, 95%CI 1.29−2.30) and epidural (OR 1.56, 95%CI 1.11−2.20), and significantly lower odds of having a non-instrumental vaginal birth (OR 0.57, 95%CI 0.43−0.75) compared to women in the matched public/private civilian sample. Compared to civilian children, children born to servicewomen had significantly higher out-of-pocket costs at birth ($275.93 ± 355.82), in the first ($214.98 ± 403.45) and second ($127.75 ± 391.13) years of life, and overall up to two years of age ($618.66 ± 779.67) despite similar health service use. ConclusionsADF servicewomen have higher rates of obstetric intervention at birth and also pay significantly higher out-of-pocket costs for their children’s health service utilisation up to 2-years of age. Given the high rates of obstetric intervention, greater exploration of servicewomen’s maternity care experiences and preferences is warranted, as this may necessitate further reform to ADF maternity healthcare policy.

Monitored but not sufficiently guided – A qualitative descriptive interview study of maternity care experiences and needs in women with chronic medical conditions

ObjectiveTo explore maternity care experiences and needs of women with various types of chronic medical conditions receiving specialised maternity care. Design A qualitative descriptive study. SettingA highly specialised hospital providing maternity care to women with high-risk pregnancies in Copenhagen, Denmark. Participants Fourteen purposefully selected women referred to specialist maternity care at a large tertiary hospital due to one or more chronic medical conditions. MethodsIndividual in-depth interviews (n = 14) were performed between January 2018 and June 2019. Analysed using thematic analysis. ResultsOne overarching theme was identified: Monitored but not sufficiently guided. Three main themes unfolding this overarching theme were: Chronic condition as determining pregnancy care, Childbearing woman as messenger and interpreter, and Feelings of abandonment after giving birth. Key conclusionsAcross various types of chronic medical conditions, women expressed a need for increased continuity in specialised maternity care. Healthcare professionals should help women with chronic medical conditions navigate the healthcare system and interpret complex information. Implications for practicePregnancy should be recognised as a significant life event, even though the childbearing woman is living with a chronic medical condition, and professionals should emphasise the aspects of pregnancy that develop uncomplicated. Information about the anticipated development of chronic medical conditions postpartum and concerns regarding breastfeeding could preferably be addressed during pregnancy. Continuity of care was particularly important to the women and could relieve some of the worrying women experienced during pregnancy.

Prenatal mental and physical health, behaviours, and maternity care experiences during the COVID-19

Abstract Background During pregnancy, women's mental and physical health, health behaviours, and experiences of maternity care can have significant implications for obstetric, maternal and child outcomes. These factors can be impacted by adverse life-events, such as the COVID-19 pandemic. Aim This study examined pregnant women's mental and physical health, health behaviours, and experiences of maternity care during the COVID-19 pandemic. Methods An international online survey was conducted in June and July 2020. Pregnant women self-reported levels of general stress, pregnancy-specific stress and COVID-19 related stress. Women also self-reported their mental and physical health, general health behaviours and COVID-19 related health behaviours. Maternity care experiences were reported using closed and open-ended questions. Descriptive statistics and thematic analyses were used for quantitative and qualitative data respectively. Results 573 pregnant women from 15 countries participated. Women reported high levels of pregnancy-specific and COVID-19-related stress, and low levels of mental and physical health, during the pandemic. Women reported distress related to restrictions implemented in their maternity care that limited in-person interactions with healthcare professionals and partner attendance at antenatal appointments. Lack of information on COVID-19 and pregnancy also led to uncertainty for women about pregnancy and birth. Encouragingly, pregnant women reported high levels of adherence to public health advice and healthy prenatal behaviours. Conclusions The COVID-19 pandemic is having significant adverse effects on the mental and physical health of pregnant women. Population level interventions targeting pregnancy- and pandemic-specific stress are needed to better support the mental and physical health of women during the on-going pandemic and minimise adverse outcomes for women and children. Key messages The COVID-19 pandemic is significantly adversely impact the mental and physical health of pregnant women, indicating need for population level interventions for prenatal mental and physical health. Restrictions in maternity care and uncertainty about COVID-19 impacts are key determinant of adverse prenatal physical and mental health outcomes.

Social media and experiences of maternity care during the Covid-19 pandemic

BackgroundSocial media offer expecting and new mothers a space to discuss birth-related fears, hopes and experiences. This is particularly the case during the Covid-19 pandemic, which has altered delivery of maternity care. Measures to reduce transmission risk in birth facilities and changes in birth plans are likely to have had an impact on new mothers' experiences of birth and birth care. From a feminist epidemiology perspective, seeking to incorporate more the views of the “researched”, we explored themes discussed by (expecting) mothers on social media, hoping that those real-life concerns would find echo in the design of future research instruments for data collection.MethodsUsing content analysis, we identified key themes in 200+ comments posted on a social media public page as a reaction to the dissemination of a research survey on maternity care during the Covid-19 pandemic in Germany.ResultsIn the comments, the most mentioned topics were own mask wearing, having a companion of choice during birth, visiting hours, and the possibility to welcome visitors (e.g. siblings of the newborn, other relatives and friends). Those topics also generated the most reactions, revealing compassion from other women and mixed feeling about health measures (from acceptance to anger). Concerns about quality or appropriateness of care were almost absent from the data.ConclusionsSocial media content analysis shows clearly that women giving birth during the pandemic are most concerned with a specific set of disrupting and potentially upsetting measures. These spontaneous testimonies differ content-wise from what research surveys tend to ask women about (e.g. care standards). Those discrepancies are to some extent inevitable, but integrating more bottom-up generated topics from social media into research instruments could help move forward toward better care.Key messages On social media, women were most concerned with own mask wearing, presence of a birth companion and visits from the newborn’s siblings.Social media analysis brings valuable insights into what matters the most to women who give birth during the pandemic and could inform future research developments.

Ethnic minority women’s interactions with antenatal care providers in Europe

Abstract Background Ethnic minority women are at greater risk of maternal morbidity and mortality. Antenatal care reduces risks of adverse maternal and neonatal outcomes and supports a positive transition to motherhood. Important components of quality antenatal care are interactions between women and care providers which are supportive and empowering. Methods We conducted a systematic review to identify and synthesise qualitative evidence on ethnic minority women's experiences of accessing antenatal care in European countries. Following a comprehensive search of 8 databases and two-step screening process, we included 27 studies from various European countries. Study findings were coded and synthesised using a ‘best-fit' framework approach. Findings Overall women expressed satisfaction with their antenatal care, frequently framed in relation to experiences of maternity care in countries of origin. Women highly valued interactions with antenatal care providers which were supportive and trust-inducing, and when there was continuity of carer to facilitate this. However, studies frequently showed a dichotomy between reported satisfaction with antenatal care and experiences of interactions with care providers which could be discriminatory, stigmatising and disempowering. Some women blamed themselves for negative interactions. Language barriers were frequently identified by women as a factor which hindered their communication with antenatal care providers and the subsequent quality of care received, when suitable interpreters were not available. Negative interactions with antenatal care providers could result in a withdrawal from ongoing antenatal care for some women. Conclusions This review highlights the importance of quality interactions between ethnic minority women and antenatal care providers. Policy implications: Antenatal care should be provided in such a way as to facilitate trust, support and effective communication between women and care providers. Key messages Positive interactions with care providers form an important element of quality antenatal care for ethnic minority women in Europe. Trust, support and the provision of suitable interpreters, where needed, contribute to positive interactions with antenatal care providers for ethnic minority women in Europe.

Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.

Peri-urban settings have high maternal mortality and the quality of care received in different types of health facilities is varied. Yet few studies have explored the construct of person-centered maternity care (PCMC) within peri-urban settings. Understanding women's experience of maternity care in peri-urban settings will allow health facility managers and policy makers to improve services in these settings. This study examines factors associated with PCMC in a peri-urban setting in Kenya. We analyzed data from a cross-sectional study with 307 women aged 18-49 years who had delivered a baby within the preceding six weeks. Women were recruited from public (n = 118), private (n = 76), and faith based (n = 113) health facilities. We measured PCMC using the 30-item validated PCMC scale which evaluates women's experiences of dignified and respectful care, supportive care, and communication and autonomy. Factors associated with PCMC were evaluated using multilevel models, with women nested within facilities. The average PCMC score was 58.2 (SD = 13.66) out of 90. Controlling for other factors, literate women had, on average, about 6-point higher PCMC scores than women who were not literate (β = 5.758, p = 0.006). Women whose first antenatal care (ANC) visit was in the second (β = -5.030, p = 0.006) and third trimester (β = -7.288, p = 0.003) had lower PCMC scores than those whose first ANC were in the first trimester. Women who were assisted by an unskilled attendant or an auxiliary nurse/midwife at birth had lower PCMC than those assisted by a nurse, midwife or clinical officer (β = -8.962, p = 0.016). Women who were interviewed by phone (β = -7.535, p = 0.006) had lower PCMC scores than those interviewed in person. Factors associated with PCMC include literacy, ANC timing and duration, and delivery provider. There is a need to improve PCMC in these settings as part of broader quality improvement activities to improve maternal and neonatal health.

Factors influencing women\u2019s perceptions of choice and control during pregnancy and birth: a cross-sectional study

BackgroundWomen across the world value choice and control throughout their maternity care experiences. In response to this health policy and frameworks are adapting and developing. The concepts of choice and control are extrinsically complex and open to interpretation by healthcare professionals and service users, with the two not necessarily aligning. Depending on a number of factors, women’s experiences of choice and control within the same maternity care system may be very different. This study aimed to investigate the factors influencing women’s perceptions of choice and control during pregnancy and birth in Ireland.MethodsWe conducted a cross-sectional study using an adapted version of the UK national maternity experience survey (National Perinatal Epidemiology Unit). During March – July 2017, a sample of 1277 women were recruited from the postnatal wards of three maternity units and a tertiary maternity hospital. Poisson regression was used to assess the association between twelve factors and a series of measures of the women’s perception of choice and control.ResultsMost women reported not having choice in the model or location of their maternity care but most reported being involved enough in decision-making, especially during birth. Women who availed of private maternity care reported higher levels of choice and control than those who availed of public maternity care. This factor was the most influential factor on almost all choice and control measures.ConclusionMost women experiencing maternity care in Ireland report not having choice in the model and location of care. These are core elements of the Irish maternity strategy and significant investment will be required if improved choice is to be provided. Availing of private maternity care has the strongest influence on a woman’s perceived choice and control but many women cannot afford this type of care, nor may they want this model of care.

Experiences of maternity care during the COVID-19 pandemic in the North of England

Background During 2020, UK maternity services made changes to service delivery in response to the COVID-19 pandemic. Aims To explore service users' and their partners' experiences of maternity services in the North of England during the COVID-19 pandemic. Methods Respondents (n=606) completed a co-produced survey during August 2020. Data were analysed using descriptive statistics and content analysis. Findings Five major categories were identified: valuing support from health professionals, feeling lost in and let down by the system, the impact of restrictions to partners and others, virtual contact is not the same as in-person contact, and the need for emotional and psychological wellbeing support. Conclusion The changes implemented may have compromised mental health and wellbeing in a critical period of vulnerability. Bringing stakeholders together can maximise learning from the emergency measures, to better inform future service provision. Work is needed to better hear from minoritised groups and ensure they are not further marginalised by changes.

Exploring ethnic minority women’s experiences of maternity care during the SARS-CoV-2 pandemic: a qualitative study

ObjectiveTo explore the experiences of pregnancy, childbirth, antenatal and postnatal care in women belonging to ethnic minorities and to identify any specific challenges that these women faced during the SARS-CoV-2...

A guide to caesarean wound healing

A guide to caesarean wound healing

Women's views and experiences of maternity care during COVID-19 in Ireland: A qualitative descriptive study

ObjectiveTo gain insight and understanding of women's views and experiences of maternity care during the COVID-19 pandemic in Ireland. DesignA qualitative descriptive study using semi-structured interviews. Due to social distancing and associated COVID-19 restrictions at the time of the study, the interviews were held remotely via telephone. The interviews were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the interview data. Setting & participantsA large urban tertiary referral maternity unit (greater than 8000 births per year) in the Republic of Ireland. Women of low and high obstetric risk, primiparous and multiparous, who gave birth in April or May of 2020 were eligible for inclusion. Women were invited to take part via a hospital-based gatekeeper who had no other involvement in the study. FindingsNineteen women consented to take part and were interviewed. Four dominant themes reflective of women's views and experiences emerged during data analysis. These were: ‘navigating the system’, ‘at the end of the day it's just you’, ‘preparing for and adapting to uncertainty’ and ‘blessing in disguise’. Key conclusions and implications for practiceWomen experienced added challenges as a result of COVID-19 associated altered care structures and processes. Some changes implemented in response to the pandemic were positively experienced by women. The findings will contribute to and assist in planning future services for women and their partners, and in tailoring care to meet women's expectations and needs as the COVID-19 pandemic continues and beyond.