Large gaps in the quality of healthcare experienced by Swedish mothers during the COVID-19 pandemic: A cross-sectional study based on WHO standards.
Mehreen Zaigham, Karolina Linden, Verena Sengpiel and 5 others
PMID 35123922WHAT IT FOUND
Swedish mothers reported gaps in maternity care during the pandemic: 50.7% had no companion of choice, 36.8% had inadequate breastfeeding support, 6.9% reported abuse, and women with prelabour caesarean reported more shortcomings.
Key findings
01Among women who underwent labour, 50.7% were not allowed their companion of choice, 26.5% reported no clear or effective communication, and 6.9% reported physical, verbal or emotional abuse.
02Among women who underwent labour, 36.8% reported inadequate breastfeeding support and 25.3% did not exclusively breastfeed at discharge.
03Women with prelabour caesarean reported more shortcomings than women who underwent labour, including no skin-to-skin contact (16.6% vs 2.9%, OR 6.8) and no early breastfeeding (21.1% vs 7.5%, OR 3.3).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey was online and recruited mainly through Instagram, Facebook, and parenting groups, so women without internet access or with different interests may be missing. The analysed sample was self-selected: 34 391 women accessed the survey, but only 5003 mothers were included after exclusions. Women with a postgraduate or university degree accounted for 68.5% of the cohort, which the authors say may over-represent highly educated women. Results are based on women's own reports in an anonymous online survey. Some indicators, such as dignity and respect, depend on subjective judgement, and the quality indicators lack conventional validation. The study is cross-sectional and did not compare the same women's care before and after the pandemic, so it reports perceptions during the pandemic rather than proof of change over time. Women who had prelabour caesarean often had underlying health conditions, which may influence their reported experience.
Declared interests
No conflicts of interest were declared. The project was funded by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy, with support from Lund University, Sweden.
The easy way to misread this
Do not read these percentages as proof that Swedish maternity care is poor or that the pandemic caused the gaps. They come from a self-selected online survey of women's perceptions, not from objective clinical outcomes or a before-and-after comparison.