Abstract
Background and Problem
Existing healthcare systems have been put under immense pressure during the COVID-19
pandemic. Disruptions in essential maternal and newborn services have come from even
high-income countries within the World Health Organization (WHO) European Region.
Aim
To describe the quality of care during pregnancy and childbirth, as reported by the
women themselves, during the COVID-19 pandemic in Sweden, using the WHO ‘Standards
for improving quality of maternal and newborn care in health facilities’.
Methods
Using an anonymous, online questionnaire, women ≥18 years were invited to participate
if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality
of maternal and newborn care was measured using 40 questions across four domains:
provision of care, experience of care, availability of human/physical resources, and
organisational changes due to COVID-19.
Findings
Of the 5003 women included, n = 4528 experienced labour. Of these, 46.7% perceived
a poorer quality of maternal and newborn care due to the COVID-19. Fundal pressure
was applied in 22.2% of instrumental vaginal births, 36.8% received inadequate breastfeeding
support and 6.9% reported some form of abuse. Findings were worse in women undergoing
prelabour Caesarean section (CS) (n = 475). Multivariate analysis showed significant
associations of the quality of maternal and newborn care to year of birth (P < 0.001), parity (P < 0.001), no pharmacological pain relief (P < 0.001), prelabour CS (P < 0.001), emergency CS (P < 0.001) and overall satisfaction (P < 0.001).
Conclusion
Considerable gaps over many key quality measures and deviations from women-centred
care were noted. Findings were worse in women with prelabour CS. Actions to promote
high-quality, evidence-based and respectful care during childbirth for all mothers
are urgently needed.
Abbreviations:
CS (Caesarean section), COVID-19 (Coronavirus disease 2019), IMAgINE-Euro (Improving Maternal Newborn Care in Europe), QMNC (Quality of maternal and newborn care), WHO (World Health Organization)Keywords
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Article info
Publication history
Published online: January 23, 2022
Accepted:
January 19,
2022
Received in revised form:
January 18,
2022
Received:
November 25,
2021
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© 2022 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Midwives.
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