Pregnancy and childbirth during the COVID-19 pandemic in Poland: qualitative evidence from experts 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, as well as the reproductive health sector.Methods: This is a qualitative and rapid-response study which addresses the themes around the emerging implications of the viral outbreak. Semi-structured expert interviews were conducted with 46 individuals, all highly-skilled, working in either medical or adjacent sectors connected with reproductive medicine, as well as varied antenatal and postpartum care services. 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 including psychologists and physiotherapists. 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 also 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 both a sudden cessation of extensive degree of medicalization during pregnancy, and a fallback to alienation during intervention-focused hospital deliveries.