Report No. 3. Impact of the COVID-19 pandemic on the presence during pregnancy care of an accompanying person chosen by the woman

Abstract

In March 2020, the global pandemic caused by COVID-19 generated an international health and care crisis. In Catalonia, as in many other places in Spain, Europe and the world, health services were overwhelmed and at risk of collapse, not only to respond to the ravages caused by the new disease but also to address other situations, such as, for example, care for pregnant women before, during, and after childbirth. In this context, the measures adopted in the health services to face the emergency scenario caused important alterations in the processes of maternity care as it had been carried out up to that moment. Furthermore, some voices denounced that the sexual and reproductive rights of women during pregnancy, labor, or postpartum were being subordinated to the demands of the management of the pandemic and, in some occasions, violated. In some countries, the possibility of having a companion at pregnancy follow-up visits and tests was suspended during the first wave of the pandemic, mainly in the public health care system (Gazar et al., 2021; Vasilevski et al., 2022; Irvine et al., 2022; Linden et al., 2022). In other cases, if appropriate precautions were taken, pregnancy follow-up appointments and tests continued to be performed by allowing access to the accompanying person of the pregnant woman's choice (Coronavirus (COVID-19), 2022; NHS Scotland, 2022; NHS Wales, 2022; NHS Kingston Hospital, n. d.; Martins, 2022). Regardless of the crisis scenario, the World Health Organization (WHO) advocated for the maintenance and protection of the rights of pregnant women, for ensuring dignified treatment, clear communication between women and health personnel, and for accompaniment during labor (World Health Organization, 2022a). However, these guidelines were not respected in a cross-cutting or homogeneous manner. In addition, with the aim of guaranteeing women's sexual and reproductive rights, the WHO recommends interventions in health care systems to improve the use and quality of prenatal care. These include prenatal care, prenatal appointments and accompaniment by midwives during all phases of pregnancy (World Health Organization, 2016). There are studies showing that women without prenatal services are at increased risk of death, fetal death, and other adverse outcomes (Ortiz et al., 2020). In general, the WHO advocates the need to universalize access to sexual and reproductive health (World Health Organization, 2022b). In turn, the Council of Europe has guidelines against obstetric and gynecological violence, which include procedures performed without the patient's consent or without appropriate communication (Blondin, 2019). Based on the interest in understanding the extent and the way in which health care for women was affected at such a fundamental moment in their lives, from the Inclusive Societies, Policies and Communities Research Group (SopCI) and the UNESCO Chair Women, Development and Cultures of the Universitat de Vic-Universitat Central de Catalunya we started in 2021 the research project Sexual and reproductive rights in pandemic times: maternity and COVID-19 in Catalonia. The project received funding from the Ministry of Equality (Secretary of State for Equality and against Gender Violence/State Pact against Gender Violence) and the Secretariat for Universities and Research of the Department of Entreprise and Knowledge of the Generalitat de Catalunya (2017SGR0657). The study was approved by the Research Ethics Committee of the Universitat de Vic-Universitat Central de Catalunya. Beyond the publications and other scientific results derived from the project, we believe that the data generated are of great relevance to shed light on situations, not always positive, that thousands of women in Catalonia had to live at a time in their lives with enormous needs for care and support. Therefore, it also seems important to us to publish the main results of the research in this brief report format to make them accessible to different audiences.