Polish maternity services in times of crisis: in search of quality care for pregnant women and their babies

Abstract

The current COVID-19 pandemic put a burden on healthcare services around the globe and impacted many areas of care delivery, including maternity services. Prioritizing ringfenced community care to keep women away from hospitals may be the best strategic response to ensure pregnant and laboring women receive optimal care. By analyzing the structure of maternity services in Poland and their response to the current crisis, we show that while the available model allows to provide large share of prenatal services outside hospital settings, it allows no alternative to hospital births. In addition, medicalization, inequalities in access and fragmentation of care hinder services' ability to respond in a way it ensures best possible care.

Is job seniority a protective factor against anxiety among midwives during the SARS-CoV-2 pandemic?

“…During such meetings or classes, it is absolutely essential to follow the guidelines and adhere to all necessary safety precautions for limiting the spread of COVID-19 [6,8,10]. The aim of these recommendations was and still is to limit the possibility of infection with the SARS-CoV-2 virus for both patients and the health care professionals who care for them [2][3][4][5][6][7][8][9][10].…”

“…The implementation of sudden changes in perinatal care in conditions of uncertainty and threats to occupational safety has increased the sense of anxiety among health care workers, including midwives [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. It has also intensified the need to investigate the determinants of these problems [18][19][20].…”

“…a midwife or a doctor. Although the use of telemedicine has also been recommended, in situations requiring an in-person contact with a midwife or doctor, the appointment should take place following all necessary safety precautions, and the pregnant woman should report for her appointment punctually and alone [6][7][8]. In addition, the Ultrasound Section of the Polish Society of Gynecologists and Obstetricians recommends the use of Covid-19 screening questions prior to ultrasound examinations.…”

“…However, in the case of emergencies, hospital care in dedicated COVID health centres is recommended. Moreover, pregnant women with COVID-19 or tested positive for SARS-CoV-2 should have their ultrasound examination performed only in justifiable situations, and in multidisciplinary healthcare facilities dedicated to COVID-19 [6,8,9]. Antenatal education provided by midwives after the 21st week of gestation can only take place with the use of technology.…”

Effects of the Covid-19 Pandemic on Maternity Staff in 2020 – A Scoping Review

“…In the Netherlands, partners Covid-19 symptoms could accompany woman if they donned respiratory masks and kept their distance [18]. In Poland, Wegrzynowska et al reported that partners with negative test results could accompany women, but the tests were expensive and di cult to procure [49].…”