Abstract
BACKGROUND: Maternity services around the world have been disrupted since the outbreak of the COVID-19 pandemic. The International Confederation of Midwives (ICM) representing one hundred and forty-three professional midwifery associations across the world sought to understand the impact of the pandemic on women and midwives. AIM: The aim of this study was to understand the global impact of COVID-19 from the point of view of midwives' associations. METHODS: A descriptive cross-sectional survey using an on-line questionnaire was sent via email to every midwives' association member of ICM. SURVEY INSTRUMENT: The survey was developed and tested by a small global team of midwife researchers and clinicians. It consisted of 106 questions divided into seven discreet sections. Each member association was invited to make one response in either English, French or Spanish. RESULTS: Data were collected between July 2020 and April 2021. All respondents fulfilling the inclusion criteria irrespective of whether they completed all questions in the survey were eligible for analysis. All data collected was anonymous. There were 101 surveys returned from the 143 member associations across the world. Many countries reported being caught unaware of the severity of the infection and in some places, midwives were forced to make their own PPE, or reuse single use PPE. Disruption to maternity services meant women had to change their plans for place of birth; and in many countries maternity facilities were closed to become COVID-19 centres. Half of all respondents stated that women were afraid to give birth in hospitals during the pandemic resulting in increased demand for home birth and community midwifery. Midwifery students were denied access to practical or clinical placements and their registration as midwives has been delayed in many countries. More than 50% of the associations reported that governments did not consult them, and they have little or no say in policy at government levels. These poor outcomes were not exclusive to high-, middle- or low-income countries. CONCLUSIONS: Strong recommendations that stem from this research include the need to include midwifery representation on key government committees and a need to increase the support for planned out of hospital birth. Both these recommendations stand to enhance the effectiveness of midwives in a world that continues to face and may face future catastrophic pandemics.
| Original language | English |
|---|---|
| Article number | e0276459 |
| Pages (from-to) | e0276459 |
| Journal | PLoS One |
| Volume | 17 |
| Issue number | 11 November |
| DOIs | |
| Publication status | Published - Nov 2022 |
Bibliographical note
Funding Information:Contracted project by United National Population Fund (UNFPA): https://www.unfpa.org UNFPA played no direct role in the undertaking of this research. A UNFPA representative (Dr Bar-Zeev) was member of the steering committee and due to her unique role in maternal health in UNFPA contributed to the study design and survey tool development. The authors would like to acknowledge the midwives of the world and the ICM Midwifery Association Members for their amazing work and endurance during the Global COVID 19 pandemic and for continuing to care for mothers, babies, families and fellow midwives in some of the most trying times and conditions.
Publisher Copyright:
Copyright: © 2022 Hartz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.