Pregnancy and childbirth during the COVID-19 pandemic in Poland: qualitative evidence from expert interviews.

Abstract

Background: The COVID-19 outbreak has significantly altered the provisions and shape of medical services for expecting mothers worldwide. In Poland, the country where pregnancy and childbirth are subject to comparably greater medicalization, those shifts are particularly tangible. This study aimed at capturing how maternal health professionals tackle care over pregnant and birthing women during a pandemic, highlighting possible long-term implications for the expecting and new mothers. Methods: This is a qualitative study which addresses the themes around the emerging implications of the viral outbreak. Semi-structured expert interviews were conducted with 46 individuals working in either medical or adjacent sectors connected with reproductive medicine. In this analysis, 7 digital experts were excluded as observers rather than field practitioners. Among 38 interviews, 5 have been conducted with OB-GYNs, 13 with midwives, 6 with doulas, 14 broadly-conceived category of maternal support experts. The recorded data were input into thematic grids and meticulously transcribed prior to being subject to an inductive, thematic analysis. Results: The findings revealed that the context of the heightened medicalization of pregnancy and hospital care during birth in Poland, resulted in strong restrictions and immediate fall back to a clinical care model. The majority claimed that the COVID-19 pandemic exacerbated the implications of the decades of Polish maternal health recommendations contradicting the WHO regulations. Professionals’ anxieties concern limited access to services assisting women during pregnancies. While those linked to hospitals pointed out physiological risks, other maternal support experts drew attention to the effects of stress and uncertainty on maternal mental health. Conclusions: Experts face various challenges when providing care to pregnant and birthing women in Poland. They underscore both the information chaos surrounding recommendations and procedures, and see the pandemic as a moment of reflection, mostly being vocal in their critiques of the over-medicalized Polish care model. The interviewed maternal health experts believe that the pandemic will have multifaceted consequences that are being exacerbated by a sudden cessation of extensive degree of medicalization during pregnancy, and a fallback to alienation during intervention-focused hospital deliveries.

Birthing under the Condition of the COVID-19 Pandemic in Germany: Interviews with Mothers, Partners, and Obstetric Health Care Workers

“…With this in mind, obstetric HCW are able to enforce the presence of the father at least for the last phase of birth [46,47]. However, if this is not the case, in line with international studies, a concern remains about the restrictions: They may affect 'the rights of birthing women on safe motherhood during the COVID-19 pandemic' or fear of a 'fallback to alienation during intervention-focused hospital deliveries' if partners are excluded from some part of the process [48,49]. Thus, alternative ways of working when facing the COVID-19 pandemic require awareness but also skills such as speaking up and shared decision making [50].…”

The impact of COVID-19 pandemic on reproductive intentions among the Polish population

“…Children had to get used to remote learning and home education [5]. Another aspect of the pandemic is that the healthcare system is struggling with problems and overloading [6,7]. Access to healthcare is more difficult.…”