Relationship between pregnant women and their partners during COVID-19 and the role of accompanying persons during childbirth

Abstract

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.

Womenʼs perspectives on the quality of maternal and newborn care in childbirth during the COVID‐19 pandemic in Latvia: Results from the IMAgiNE EURO study on 40 WHO standards‐based quality measures

“…In Latvia, by the end of 2021 more than 4300 people had died from COVID-19. 41 In this complex historical moment, when the COVID-19 pandemic had increased levels of stress for most pregnant women, 17 and when vaccine hesitancy and resistance to COVID-19 prevention measures have been a global problem, healthcare providers should be an example of good practices for all patients, particularly for prevention procedures that aim to protect both patients and colleagues. Notably, the availability of physical and human resources domain showed the lowest QMNC index across the four domains.…”

“…Regarding women's experience of care, very little previous evidence is available for Latvia 17,35 . A number of studies from different settings worldwide, including high‐income countries, 19,35–39 show that women are frequently subjected to improper care, such as receiving poor emotional support, enquiries are ignored or rejected, or experience of lack of privacy or other types of mistreatment and abuse, such as rude, insulting, and judgmental attitudes from all levels of healthcare staff.…”

“…Regarding women's experience of care, very little previous evidence is available for Latvia. 17 , 35 A number of studies from different settings worldwide, including high‐income countries, 19 , 35 , 36 , 37 , 38 , 39 show that women are frequently subjected to improper care, such as receiving poor emotional support, enquiries are ignored or rejected, or experience of lack of privacy or other types of mistreatment and abuse, such as rude, insulting, and judgmental attitudes from all levels of healthcare staff. WHO recommends that every healthcare facility should provide respectful maternity care and effective communication, including sensitive, caring, and friendly attitudes from all healthcare personnel 40 and in general.…”

“…use of personal protective equipment [PPE] during labor, reduced numbers of healthcare personnel, requirement for COVID-19 testing, and increased risk of spread of intrahospital infections) were all factors that may have affected perceived quality of care during the pandemic. [17][18][19] Inappropriate practices, such as unnecessary separation of the baby from the mother and violations of women's rights, have also been documented during the pandemic. [20][21][22] IMAgiNE EURO is a multicountry study 23…”