Table 4 Theme development for maternity care providers’ views and experiences
Codes (reduced for illustrative purposes) | Descriptive themes | Analytical sub-themes | Analytical theme |
|---|---|---|---|
Inadequate staff resources; Adequate staff resources; Access to safety resources; Staff training; Reduced capacity to provide care; Limited staff; Fear of illness impacting provision of care; Lack of personal contact as barrier to care provision; Language barriers; Lack of digital literacy as barrier to care; Clear communication as enabler; Telehealth enabling continued care | Staff resources, barriers, and enablers of care | Capacity to provide care | Theme 1 Altered maternity care |
Reducing in-person care; Need for flexibility; Increased demand for homebirth; Restrictions impacting on women’s autonomy; Move to telehealth; Telehealth not optimal; Increased medicalization of birth; Rapid change; Changing protocols; Uncertainty in protocol; Certainty of protocol; Lack of informed decisions; COVID exacerbating inequalities; Racial inequalities; Inequalities in care; Minimal change to care | Changing provision of care, uncertainty, inequalities and continued need for care | Altered care structures and provision | |
Positive change to workload; Increased staff workload; Increased staff need; Sense of collegiality; Impact on colleague relationships; Lack of support (colleagues/management); Feeling supported; Conflicting professional beliefs; Inequalities in staff | Impact on workload and relationships with colleagues | Professional Impact | Theme 2 Professional and Personal Impact |
Increased personal burden; Increased financial burden; Emotional burden; Fear and anxiety; Two different worlds – in and outside hospital; Managing two lives – work and home; Sense of exclusion. Combative environment; A feeling of inevitability; Self as threat to others; COVID as threat to self | Burden, different worlds, and COVID as a personal threat | Personal Impact | |
Future worries; Longer term impact on care provision; Longer term health outcomes | Future worries | N/A | Theme 3 Broader structural impact |
COVID viewed as an opportunity; Improved provision of care; Improved health outcomes; Gaining a new perspective | COVID as an opportunity |