Objective: Although the World Health Organization (WHO) recommends the presence of a support person, several hospitals in Latvia have restricted the presence of supporting persons due to COVID-19. This study was conducted to understand the importance of partnership and the role of the accompanying person in childbirth in the context of COVID-19 in Latvia.Methods: A mixed method study with sequential explanatory design was conducted from 26 July to 30 October 2020. The quantitative study consisted of a behavioral cross-sectional online survey with convenience sampling. The survey items, methods, and implementation were performed as part of the I-SHARE study carried out in 33 countries, with standardized survey instruments that were focused on sexual and reproductive health issues. In Latvia it was supported by the National Research Program to lessen the effects of COVID-19. Our study analyses only one part of all data. To answer the research question besides quantitative data the qualitative study that consisted of 7 semi-structured in-depth interviews and 11 focus group discussions was integrated.Results: 1,173 people of Latvia have participated in the I-SHARE online survey. The answers of 662 women of reproductive age and 70 pregnant women have been analyzed. Pregnant women had less tension with their partners and received higher partner emotional support before the COVID-19 pandemic than other women of reproductive age, and pregnant women were less frustrated during COVID-19 than non-pregnant women of reproductive age (p < .05). More than half (61.4%) of the pregnant women felt anxiety and depression due to COVID-19 restrictions. The qualitative part of the study revealed that having a partner during childbirth was an important aspect when choosing a facility to give birth in, as the lack of an accompanying person caused anxiety and additional stress.Conclusions: COVID-19 has increased anxiety and depression among pregnant women. Birth companions should not be considered third parties, and establishing a delivery unit visitor policy is necessary to balance the benefits and risks in an evidence-based and compassionate manner.

Qualitative research is focused on the influence of COVID-19 pandemic and restriction measures on sexual and reproductive health in Latvia. Results of the anonymous online survey (I-SHARE) of 1173 people living in Latvia age 18 and over were used as a background in finalization the interview and the focus group discussion protocols ensuring better understanding of the influencing factors. Protocols included 9 parts (0.Introduction. 1. COVID-19 general influence, 2. SRH, 3. Communication with health professionals, 4.Access to SRH services, 5.Communication with population incl. three target groups 5.1. Pregnant women, 5.2. People with suspected STIs, 5.3.Women, who require abortion, 6. HIV/COVID-19, 7. External support, 8. Conclusions and recommendations. Data include audiorecords in Latvian of: 1) 11 semi-structures interviews with policy makers including representatives from governmental and non-governmental organizations involved in sexual and reproductive health, information and health service provision. 2) 12 focus group discussions with pregnant women (1), women in postpartum period (3) and their partners (3), people living with HIV (1), health care providers involved in maternal health care and emergency health care for women (4) (2021-02-18) Subject: Medicine, Health and Life Sciences Keywords: Sexual and reproductive health, COVID-19, access to services, Latvia

The results of the anonymous online survey of people living in Latvia age 18 and over, using internationally (I-SHARE) and nationally validated questionnaire. Data include following variables: Selection, socio-demographics, social distancing measures, couple and family relationships, sexual behavior, access to condoms and contraceptives, access to reproductive health services, antenatal care, pregnancy and maternal and child health, abortion, sexual and gender-based violence, HIV/STI, mental health, and nutrition. (2021-02-08)

Purpose: Since the beginning of COVID-19 restrictions, almost all domains of people's lives have been affected, including couple and family relationships and sexual life. There are various factors that are likely to influence the partner availability, intimacy, emotional well-being, contraception access and interpersonal tension. Materials and methods:Behavioural cross-sectional online survey (I-SHARE) combined with structured interviews with the aim to determine the impact of COVID-19 social restriction measures on sexual health and psychological well-being and behaviour was conducted.Results and conclusions: Results showed increase of tension and its negative impact on frequency and satisfaction with sex life. Frequency of sexual intercourse decreased more for people who did not live with their partner. Increase of alcohol consumption and loss of job decreased satisfaction with sex life. Controversial data about contraception availability and intimate partner violence were obtained showing no impact in survey, but revealing contraception access restrictions and intimate partner violence increase during qualitative research interviews.

Background. Simulation as a proxy tool for conditional clinical training became a powerful technique for introducing trainees to the ultrasound imaging world, allowing them to become a trained sonographer taking into consideration different rates of progress completing a specific task against the time and ensuring the long-lasting maintenance of the obtaining practical skills. Adding a costly, but effective high-fidelity simulator to the residency program justified the expense, demonstrating efficiency of training for improving the clinical performance and confidence of trainees. Materials and methods. A pilot study in Riga Maternity Hospital within the framework of the study “Role of metabolome, biomarkers and ultrasound parameters in successful labour induction” (Fundamental and Applied Research Programme lzp-2021/1-0300) was performed between March 1st 2022 and 31st April 2022. A virtual-reality simulator (Scantrainer, MedaphorTM, Cardiff, UK) was used with the teaching module for assessment of the uterine cervix. Five trainees in obstetrics and two young specialists included in the study. None of them had Fetal Medicine Foundation certificate of competence in the assessment of the uterine cervical lenght before. The time used on the simulator, the number of simulations and a mean confidence in cervical length assessment before and after simulation were recorded. Results. The study on assesment of uterine cervical lenght demonstrated statistically significant increase in confidence (p=0.008) and statistically significant decrease in time needed to complete correctly the same tasks for the trainees (p=0.008) that shows a positive learning curve over the time of training on ScanTrainer, Medaphor. Conclusions. The simple task allows to become a certified specialist in uterine cervical assessment in the short period of time. That support the productiveness of the simulation-based education. The training program should be updated taking into consideration simulation curriculum.