Magnification of existing problems: maternity services in crisis
Our findings showed an emerging chronological narrative of how a sudden influx of staff and resources early in the pandemic, combined with a sense of camaraderie, public support and professional pride, led to an unexpectedly positive work environment. However, these protective factors did not last; the initial boost was quickly followed by warnings of deteriorating morale, compassion fatigue and moral distress. The reasons for this were complex, with interviewees reporting fundamental issues with staff recruitment and retention, deteriorating physical and psychological wellbeing, and unmanageable workloads. A lack of emotional resources and focus on a ‘checkbox’ style system of care, with overwhelming documentation and supposed safety measures which paradoxically made it harder for staff to be ‘with woman’, were reported to be at odds with the safe and personalised care that they wanted to provide. The sustained pressures of the pandemic magnified these daily struggles, which led to a loss of meaning and of loss of desire to continue working within maternity.
Respondents reported making a consistent professional effort to maintain safety for service users, sometimes at the expense of their own wellbeing. This may contribute to the fact that around half of the women who were interviewed did not mention staff wellbeing. However, 13 women out of the 26 interviews in our sample indicated that they were very aware of staffing shortages and the way it affected their experience of care, with more reports of dissatisfaction given by those in our sample who birthed later in the pandemic.