Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance
Background: The Coronavirus disease 2019 (COVID-19) pandemic led to healthcare system changes aimed at minimizing disease transmission that impacted experiences with obstetric healthcare. Objective: To explore experiences of clinicians providing obstetric care during the COVID-19 pandemic. Study Des...
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Elsevier
2024-11-01
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| Series: | AJOG Global Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666577824000868 |
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| author | Drishti D. Sinha, MD, MPHS Megan Foeller, MD Abigail S. Bell, BA Anthony J. Nixon, Jr., MPH Darrell Hudson, PhD, MPH Aimee S. James, PhD, MPH Amy R. Scheffer Ana A. Baumann, PhD Emily Diveley, RN Ebony B. Carter, MD, MPH Nandini Raghuraman, MD, MSCI Indira U. Mysorekar, PhD Jeannie C. Kelly, MD, MS |
| author_facet | Drishti D. Sinha, MD, MPHS Megan Foeller, MD Abigail S. Bell, BA Anthony J. Nixon, Jr., MPH Darrell Hudson, PhD, MPH Aimee S. James, PhD, MPH Amy R. Scheffer Ana A. Baumann, PhD Emily Diveley, RN Ebony B. Carter, MD, MPH Nandini Raghuraman, MD, MSCI Indira U. Mysorekar, PhD Jeannie C. Kelly, MD, MS |
| author_sort | Drishti D. Sinha, MD, MPHS |
| collection | DOAJ |
| description | Background: The Coronavirus disease 2019 (COVID-19) pandemic led to healthcare system changes aimed at minimizing disease transmission that impacted experiences with obstetric healthcare. Objective: To explore experiences of clinicians providing obstetric care during the COVID-19 pandemic. Study Design: Qualitative, in-depth, semi-structured interviews were conducted with five nurse practitioners and 16 obstetrical physicians providing a mix of outpatient and inpatient obstetric care during the COVID-19 pandemic in a mid-sized, Midwestern city in the United States. Interviews elucidated challenges and facilitators of obstetric care provision and vaccination of pregnant patients against COVID-19 during the pandemic. Transcripts were coded inductively then deductively using the Health Equity Implementation Framework (HEIF), which integrates a disparities framework and implementation framework to highlight multilevel factors that influence obstetric care. Thematic analysis was conducted, and thematic saturation was reached. Results: We interviewed 21 clinicians. Clinicians recounted personal challenges such as social isolation and burnout that could be countered by social support. Challenges within the clinical encounter included implementation of infection mitigation efforts, vaccine counseling, and limitations of telehealth. However, when successfully implemented, telehealth facilitated care and circumvented barriers. Clinicians cited challenges at the healthcare system level such as rapidly evolving knowledge and recommendations, restrictive visitor policies, personnel shortage, and inadequate institutional resources to support pandemic-related stressors. However, interdisciplinary care and guidelines available for clinicians facilitated care. Clinicians reported that challenges at the societal level included financial strain, lack of childcare, medical mistrust, politicization of medicine, misinformation, and racism. Societal-level facilitators included insurance access, community outreach, positive policy changes, and fostering trust in medicine. Conclusion: The pandemic produced unique stressors and exacerbated existing challenges for clinicians providing obstetric care. Applying the HEIF to the findings emphasizes the influence of societal factors on all other levels. Identified facilitators can inform interventions to address stressors in obstetric care that have resulted from the changed sociopolitical landscape of the pandemic. |
| format | Article |
| id | doaj-art-86bcee1f900e42beb37e7676c5ed7ed7 |
| institution | OA Journals |
| issn | 2666-5778 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
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| series | AJOG Global Reports |
| spelling | doaj-art-86bcee1f900e42beb37e7676c5ed7ed72025-08-20T02:35:47ZengElsevierAJOG Global Reports2666-57782024-11-014410039210.1016/j.xagr.2024.100392Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a GlanceDrishti D. Sinha, MD, MPHS0Megan Foeller, MD1Abigail S. Bell, BA2Anthony J. Nixon, Jr., MPH3Darrell Hudson, PhD, MPH4Aimee S. James, PhD, MPH5Amy R. Scheffer6Ana A. Baumann, PhD7Emily Diveley, RN8Ebony B. Carter, MD, MPH9Nandini Raghuraman, MD, MSCI10Indira U. Mysorekar, PhD11Jeannie C. Kelly, MD, MS12Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (Sinha, Bell, and Mysorekar); Corresponding author: Drishti D. Sinha, MD, MPHS.Saint Alphonsus Health System, Boise, ID (Foeller)Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (Sinha, Bell, and Mysorekar)Brown School, Washington University, St. Louis, MO (Nixon and Hudson)Brown School, Washington University, St. Louis, MO (Nixon and Hudson)Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO (James and Baumann)Department of Obstetrics and Gynecology, Division of OB/GYN Clinical Research, Washington University School of Medicine, St. Louis, MO (Scheffer and Diveley)Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO (James and Baumann)Department of Obstetrics and Gynecology, Division of OB/GYN Clinical Research, Washington University School of Medicine, St. Louis, MO (Scheffer and Diveley)Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Ultrasound, Washington University School of Medicine, St. Louis, MO (Carter, Raghuraman, and Kelly)Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Ultrasound, Washington University School of Medicine, St. Louis, MO (Carter, Raghuraman, and Kelly)Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (Sinha, Bell, and Mysorekar); Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX (Mysorekar); Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX (Mysorekar)Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Ultrasound, Washington University School of Medicine, St. Louis, MO (Carter, Raghuraman, and Kelly)Background: The Coronavirus disease 2019 (COVID-19) pandemic led to healthcare system changes aimed at minimizing disease transmission that impacted experiences with obstetric healthcare. Objective: To explore experiences of clinicians providing obstetric care during the COVID-19 pandemic. Study Design: Qualitative, in-depth, semi-structured interviews were conducted with five nurse practitioners and 16 obstetrical physicians providing a mix of outpatient and inpatient obstetric care during the COVID-19 pandemic in a mid-sized, Midwestern city in the United States. Interviews elucidated challenges and facilitators of obstetric care provision and vaccination of pregnant patients against COVID-19 during the pandemic. Transcripts were coded inductively then deductively using the Health Equity Implementation Framework (HEIF), which integrates a disparities framework and implementation framework to highlight multilevel factors that influence obstetric care. Thematic analysis was conducted, and thematic saturation was reached. Results: We interviewed 21 clinicians. Clinicians recounted personal challenges such as social isolation and burnout that could be countered by social support. Challenges within the clinical encounter included implementation of infection mitigation efforts, vaccine counseling, and limitations of telehealth. However, when successfully implemented, telehealth facilitated care and circumvented barriers. Clinicians cited challenges at the healthcare system level such as rapidly evolving knowledge and recommendations, restrictive visitor policies, personnel shortage, and inadequate institutional resources to support pandemic-related stressors. However, interdisciplinary care and guidelines available for clinicians facilitated care. Clinicians reported that challenges at the societal level included financial strain, lack of childcare, medical mistrust, politicization of medicine, misinformation, and racism. Societal-level facilitators included insurance access, community outreach, positive policy changes, and fostering trust in medicine. Conclusion: The pandemic produced unique stressors and exacerbated existing challenges for clinicians providing obstetric care. Applying the HEIF to the findings emphasizes the influence of societal factors on all other levels. Identified facilitators can inform interventions to address stressors in obstetric care that have resulted from the changed sociopolitical landscape of the pandemic.http://www.sciencedirect.com/science/article/pii/S2666577824000868challengesCOVID-19 vaccinationfacilitatorshealth equitymisinformationmistrust |
| spellingShingle | Drishti D. Sinha, MD, MPHS Megan Foeller, MD Abigail S. Bell, BA Anthony J. Nixon, Jr., MPH Darrell Hudson, PhD, MPH Aimee S. James, PhD, MPH Amy R. Scheffer Ana A. Baumann, PhD Emily Diveley, RN Ebony B. Carter, MD, MPH Nandini Raghuraman, MD, MSCI Indira U. Mysorekar, PhD Jeannie C. Kelly, MD, MS Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance AJOG Global Reports challenges COVID-19 vaccination facilitators health equity misinformation mistrust |
| title | Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance |
| title_full | Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance |
| title_fullStr | Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance |
| title_full_unstemmed | Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance |
| title_short | Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemicAJOG Global Reports at a Glance |
| title_sort | experiences of midwestern obstetric clinicians during the coronavirus disease 2019 pandemicajog global reports at a glance |
| topic | challenges COVID-19 vaccination facilitators health equity misinformation mistrust |
| url | http://www.sciencedirect.com/science/article/pii/S2666577824000868 |
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