This article extends the findings of a rapid response article researched in April 2020 to illustrate how providers’ practices and attitudes toward COVID-19 had shifted in response to better evidence, increased experience, and improved guidance on how SARS-CoV-2 and COVID-19 impacted maternity care in the United States. This article is based on a review of current labor and delivery guidelines in relation to SARS-CoV-2 and COVID-19, and on an email survey of 28 community-based and hospital-based maternity care providers in the United State, who discuss their experiences and clients’ needs in response to a rapidly shifting landscape of maternity care during the COVID-19 pandemic. One-third of our respondents are obstetricians, while the other two-thirds include midwives, doulas, and labor and delivery nurses. We present these providers’ frustrations and coping mechanisms in shifting their practices in relation to COVID-19. The primary lessons learned relate to improved testing and accessing PPE for providers and clients; the need for better integration between community- and hospital-based providers; and changes in restrictive protocols concerning labor support persons, rooming-in with newborns, immediate skin-to-skin contact, and breastfeeding. We conclude by suggesting that the COVID-19 pandemic offers a transformational moment to shift maternity care in the United States toward a more integrated and sustainable model that might improve provider and maternal experiences as well as maternal and newborn outcomes.
【저자키워드】 COVID-19, Pregnancy, Newborn care, Maternity care, midwives, SARS—CoV—2, community births, doulas, 【초록키워드】 SARS-CoV-2, Breastfeeding, protocol, COVID-19 pandemic, Nurses, outcomes, Newborn, Community, PPE, Care, Guidance, mechanism, Evidence, Contact, rapid response, Support, offer, The United States, state, shifting, IMPROVE, include, the United State, changes in, concerning, impacted, 【제목키워드】 Impact, maternity,