Accelerating the digital transformation of community midwifery during the COVID-19 pandemic

Abstract

The digital transformation of health systems represents a concrete challenge and an urgent priority across the world. At the same time, women of childbearing potential belong to a digitally literate generation comprising frequent users of digital tools, internet services, and social media, although disparities are, of course, present, with various determinants affecting the ability to access and use said tools and services. The midwives caring for these women are also much more likely to have some degree of familiarity with such tools and services and awareness regarding [the emerging digital transformation] the emerging digital transformation. Although they may not be structurally supported or empowered and/or may lack formal training on how to optimize or modify their practice, community midwives may offer digital tools or services to the women, on an individual or group level. The coronavirus (COVID-19) pandemic has led to a dramatic increase in the volume of prenatal and postnatal virtual visits1. Indeed, women and their families seek to obtain timely care from the safety of their homes. Many community midwives saw their online visit volume rapidly rise over a very short period of time and had to radically adapt their practice in a manner for which neither themselves nor the women they cared for may have been prepared, oftentimes, without any support or guidance available to them. Community midwives rapidly organized themselves, often innovating in a disruptive manner, to start utilizing digital tools in their communication, to transform their practice from physical to virtual spaces, to change routines, and to ensure women were safe in terms of COVID-19, ensuring quality services were available to them2. On many occasions, utilizing online platforms and videoconferencing software proved to be a manner of interaction and practice that could not adequately support the midwife-woman communication or indeed the trust relationship that has to be build and maintained. Therefore, such solutions can only be considered temporary measures and certainly not representing sustainable practice and system change. At the same time, women and their families have come to trust or even prefer virtual visits given these represent a safe option during the COVID-19 pandemic, a time of high uncertainty and multiple risks, nevertheless systematic research on how mother and child outcomes are affected from the delivery of such care lags behind.