Posted: October 30th, 2023

Analyzing the challenges encountered in maternity wards

Analyzing the challenges encountered in maternity wards

Maternity wards are essential settings for providing quality care to pregnant women, women in labor, postpartum women and newborns. However, maternity wards face various challenges that may compromise the safety, equity and engagement of both patients and staff. Some of these challenges are:

– Staff shortages and restructuring: The Covid-19 pandemic has exacerbated the problem of insufficient and overworked maternity staff, who have to cope with increased workload, infection risk, personal protective equipment shortages and staff redeployment (Schmitt et al., 2021). Even before the pandemic, many maternity wards in low- and middle-income countries suffered from a lack of skilled obstetricians, midwives and clinical officers, leading to delays in emergency care and poor outcomes (McAuliffe et al., 2015).
– Communication and coordination: Effective teamwork, communication and coordination among maternity staff are crucial for ensuring quality care and preventing adverse events. However, some maternity wards experience poor working relationships, lack of trust, role confusion and power imbalances among different professional groups, such as obstetricians, midwives and community-based workers (Portela et al., 2018; CQC, 2022). Moreover, the pandemic has forced many maternity wards to switch to virtual communication modes, which may pose challenges for information sharing, patient education and emotional support (Schmitt et al., 2021).
– Risk assessment and management: Maternity wards need to have robust systems for identifying and managing potential risks for patients and staff, such as complications, infections, violence and discrimination. However, some maternity wards lack clear protocols, guidelines and training for risk assessment and management, resulting in inconsistent practices, missed opportunities for prevention and intervention, and increased liability (Portela et al., 2018; CQC, 2022).
– Patient engagement and satisfaction: Maternity wards should provide patient-centered care that respects the preferences, needs and values of women and their families. However, some maternity wards fail to engage with, listen to and learn from the diverse experiences of local women, especially those from minority ethnic backgrounds who face racism and inequities in access and outcomes (CQC, 2022; BMJ, 2021). Furthermore, some maternity wards have restricted or excluded accompanying persons during the pandemic, which may affect the emotional well-being and satisfaction of women and their partners (Schmitt et al., 2021).

These challenges highlight the need for maternity wards to implement contextually-sensitive improvement interventions that address the structural and subjective factors affecting the quality of care. Such interventions may include redesigning work organization, promoting multi-professional teamwork and communication, improving risk assessment and management systems, enhancing staff competence and accountability, investing in staff well-being and support, and fostering patient engagement and satisfaction.

References:

BMJ (2021) Racism is “at the root” of inequities in UK maternity care, finds inquiry. Available at: https://www.bmj.com/content/377/bmj.o1300 (Accessed: 30 October 2023).

CQC (2022) Safety, equity and engagement in maternity services. Available at: https://www.cqc.org.uk/publications/themes-care/safety-equity-engagement-maternity-services (Accessed: 30 October 2023).

McAuliffe E., Daly M., Kamwendo F., Masanja H., Sidat M. & de Pinho H. (2015) Too few staff,
too many patients: a qualitative study of the impact on obstetric care providers
and on quality of care in Malawi. BMC Pregnancy Childbirth 15:65.

Portela M.C., Lima S.M.L., Reis L.G.C., Martins M.M. & Aveling E.L. (2018) Challenges to the improvement of obstetric care in maternity hospitals of a large Brazilian city: an exploratory qualitative approach on contextual issues. BMC Pregnancy Childbirth 18:459.

Schmitt N., Mattern E., Cignacco E., Seliger G., König-Bachmann M., Striebich S. & Ayerle G.M. (2021) Effects of the Covid-19 pandemic on maternity staff in 2020 – a scoping review. BMC Health Services Research 21:1364.