Open AccessIt was tough, but necessary. Organizational changes in a community based maternity care system during the first wave of the COVID-19 pandemic: A qualitative analysis in the Netherlands
Author(s) -
Iris F. Appelman,
Suzanne Thompson,
Lauri M. M. van den Berg,
Janneke T. Gitsels-van der Wal,
Ank de Jonge,
Martine Hollander
Publication year - 2022
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0264311
Subject(s) - thematic analysis , maternity care , nursing , qualitative research , pandemic , medicine , postnatal care , prenatal care , covid-19 , psychology , health care , family medicine , pregnancy , population , environmental health , economics , genetics , economic growth , social science , disease , pathology , sociology , biology , infectious disease (medical specialty)
The Coronavirus SARS-CoV-2pandemic necessitated several changes in maternity care. We investigated maternity care providers’ opinions on the positive and negative effects of these changes and on potential areas of improvement for future maternity care both in times of crisis and in regular maternity care. Methods We conducted nineteen semi-structured in-depth interviews with obstetricians, obstetric residents, community-based and hospital-based midwives and obstetric nurses. The interviews were thematically analysed using inductive Thematic analysis. Results Five themes were generated: ‘(Dis)proportionate measures’, ‘A significant impact of COVID-19’, ‘Differing views on inter-provider cooperation’, ‘Reluctance to seek help’ and ‘Lessons learnt’. The Central Organizing Concept was: ‘It was tough but necessary’. The majority of participants were positive about most of the measures that were taken and about their proportionality. These measures had a significant impact on maternity care providers, both mentally and on an organizational level. Most hospital-based care providers were positive about professional cooperation and communication, but some community-based midwives indicated that the cooperation between different midwifery care practices was suboptimal. Negative effects mentioned were a higher threshold for women to seek care, less partner involvement and perceived more fear among women and their partners, especially around birth. The most significant positive effect mentioned was increased use of eHealth tools. Recommendations for future care were to consider the necessity of prenatal and postnatal care more critically, to replace some face-to-face visits with eHealth and to provide more individualised care. Conclusion Maternity care providers experienced measures and organizational changes during the first wave of the COVID19-pandemic as tough, but necessary. They believed that a more critical consideration of medically necessary care, increased use of e-health and more individualised care might contribute to making maternity care more sustainable during and after the pandemic.