Effects of the COVID-19 pandemic on working conditions of maternity staff - a scoping review

Abstract

Background: The COVID-19 pandemic significantly disrupted healthcare systems, with a pronounced impact on maternity care. Midwives and obstetricians faced numerous structural, organizational, and subjective challenges in maintaining high-quality care under unprecedented conditions. This review examines the multifaceted effects of the COVID-19 pandemic on maternity staff and the challenges encountered during this period.

Methods: This scoping review adhered to the methodologies outlined by Arksey & O'Malley and the Joanna Briggs Institute. We searched six bibliographic databases for English and German articles published between January 2020 and September 2023 that addressed the pandemic's impact on maternity staff in OECD countries. The themes and subthemes were deductively established from the extracted results, synthesized into descriptive narratives and charted within a schematic diagram. The reporting followed the PRISMA-ScR statement.

Results: This scoping review included 83 articles. Key findings were categorized into the two broader topics "structural challenges" and "mental health impacts on the workforce". Structural challenges included staff shortages, restructuring, inadequate personal protective equipment (PPE), transition to virtual communication, managing SARS-CoV-2 positive patients, and restrictions on accompanying persons. Mental health impacts were significant, with increased levels of anxiety, stress and moral dilemmas among staff. Despite these challenges, a strong sense of occupational solidarity was observed.

Conclusions: The findings emphasize the need for improved support systems for maternity care staff during pandemics to mitigate these adverse effects. Recommendations include better resource allocation, enhanced mental health support, and clear communication strategies to navigate future healthcare crises effectively. These results may inform pandemic preparedness for future health crises.

Trial registrations: This scoping review was registered with OSF on October 24th, 2023 and the published protocol is openly available via https://doi.org/10.17605/OSF.IO/AVYDX.

Keywords: COVID‑19; Maternal Health Services; Maternity care; Midwife; Obstetrician; Occupational Stress.

Fig. 1

Prisma 2020 Flow Diagram. * The journals”German Midwives Journal (Deutsche Hebammenzeitschrift [DHZ])”,”Midwives’ Forum (Hebammenforum)” of the German Association of Midwives, and Midwife-knowledge (Hebammen-Wissen)” are not included in this flow chart, as the corresponding articles did not meet the defined inclusion criteria

Fig. 2

Overview of the emerging themes and their corresponding sub-themes