Ukrainian women's maternity care strategies in Poland after the outbreak of the full-scale war: Understanding unequal access to quality care.

The outbreak of the full-scale war launched by Russia against Ukraine and, following it, significant migrations have not only increased the diversity of the Ukrainian migrant population in Poland, but also added to the complexity of their health needs and strategies. This study seeks to explore Ukrainian migrant women's experiences and practices related to the use of maternity care services. The article is based on fieldwork conducted between February and October 2023 and included 23 semi-structured interviews with Ukrainian migrant women who gave birth in Poland after February 24, 2022.

"We were left to our own devices": Midwives' experiences of providing maternity care to Ukrainian women in Poland after the outbreak of the full-scale war in Ukraine.

Background: After the outbreak of the full-scale war in Ukraine, about 2 million people sought protection in Poland. Providing high-quality care for migrants and refugees, especially in times of significant arrivals, can be particularly challenging.

Aim: To learn about the experiences and strategies of midwives providing maternity care to Ukrainian migrant women in Poland after the outbreak of the full-scale war in Ukraine.

Perinatal Outcomes and Level of Labour Difficulty in Deliveries with Right and Left Foetal Position-A Preliminary Study.

Background: Many studies have shown the negative influence of the foetus's occiput posterior position during birth on the final perinatal outcome. This study aims to add to the discussion on the impact of foetus positioning on the course of labour and subjective assessment of the level of labour difficulty.

Methods: The cross-sectional study took place from February 2020 to September 2021, and consisted of filling out observation forms and the assessment by the midwives and women of the level of labour difficulty.

A jump into the deep end - Women's strategies on the way to VBAC in Poland.

Problem: In Poland, as in other high-income countries, the rate of caesarean sections (CS) is alarmingly high. Promoting vaginal birth after caesarean section (VBAC) is one of the ways that may help to decrease CS rate. Despite the recommendations by the Polish Association of Gynaecologists and Obstetricians that one previous CS should not be an indication for a subsequent one and VBAC should be promoted, the rate of VBAC in Poland remains low.

Using Robson classification to analyze cesarean section and induction rates in relation to changes in the standards of perinatal care in one hospital in Poland.

Background: Poland has one of the highest cesarean birth (CB) rates in Europe. For this study, we used the Robson Ten-Group Classification System (TGCS) to analyze trends in the induction and CB rates in one hospital in Poland over a period of 11 years. We compare these trends with changes in National Legislative and Medical Guidelines introduced during this time that were aimed at lowering rates of unnecessary medical interventions.

Investment in the peace of mind? How private services change the landscape of maternity care in Poland.

For over two decades midwifery research advocated for the continuity of care and the ability to establish a relationship between care providers and care users as an important features of quality maternity services. In many countries, while unavailable through public services, continuity of care became commercialized and can be access as a private service. In Poland, private prenatal consultations and dedicated midwifery care allow women to access continuity and establish personal relationships with care providers.

Parental experiences of prenatal education when preparing for labor and birth of infant with a lethal diagnosis.

Aim: The aim of this study was to describe the unique experiences of parents facing a Life Limiting Fetal Conditions (LLFC) diagnosis, who chose to continue with their pregnancy, as they prepare for childbirth through individual and group prenatal education.

Design: A qualitative study.

Methods: We employed the phenomenological approach and the Colaizzi strategy to analyse semi-structured interviews.

Cooperation between midwives and doulas in the context of perinatal care - a integrative review of qualitative and quantitative studies.

Background: A doula is a person who provides support to women in the perinatal period without providing medical services. During childbirth, the doula becomes a member of the interdisciplinary team. This integrative review aims to analyse the nature of the cooperation between doulas and midwives, its efficiency and challenges and ways of strengthening this cooperation.

Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities: Results of the IMAgiNE EURO study in 16 countries.

Objective: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean.

Methods: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities.

Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland: a prospective, observational study.

Background: Pelvic girdle pain (PGP) is a type of pregnancy-related lumbopelvic pain. This study aimed to examine the prevalence, severity, and factors associated with postpartum PGP in a selected group of postpartum women in Poland.

Methods: This was a prospective, observational study.

"This pregnancy makes sense": Experiences of women who have decided to continue pregnancy after lethal fetal diagnosis.

Lethal fetal diagnosis defines severe developmental disorders that lead to the death of a fetus or newborn. Using semi-structured interviews, we explored the experiences of women in Poland who actively decided to continue with the pregnancy after diagnosis. We thematically analyzed data collected from 10 women.

Oxytocin administration for induction and augmentation of labour in polish maternity units - an observational study.

Background: There is not enough data regarding practices and protocols on the dose of oxytocin administrated to women during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in two maternity units in Poland.

"I knew there has to be a better way": Women's pathways to freebirth in Poland.

Background: Each year a small number of women decide to birth at home without midwifery and medical assistance despite the availability of maternity services in the country. This phenomenon is called freebirth and can be used as a lens to look into shortcomings of maternity care services.

Aim: By exploring women's pathways to freebirth, this article aims to examine the larger context of maternity services in Poland and identify elements of care contributing to women's decision to birth without midwifery and medical assistance.

Health Care Providers' Perceptions of Quality of Childbirth and Its Associated Risks in Poland.

Objective: To describe Polish maternity care providers' cognitive frames of quality of childbirth and how they relate to providers' perceptions of childbirth using Baranowska's model of quality of care.

Design: Mixed-methods, cross-sectional.

Setting: Twenty-four hospitals and outpatient clinics that provide maternity care located in two central districts of Poland.

Private Services and the Fragmentation of Maternity Care in Poland.

As a result of reforms aimed at adjusting it to the market economy, the Polish health care system has become a complicated mix of public and private services. Using as an example maternity services, I show how private services allow a subtle process of patient selection to emerge, contributing to the fragmentation of public care. The process of selection is based on social relations formed between health care providers and patients through the use of private services.

Polish maternity services in times of crisis: in search of quality care for pregnant women and their babies.

The current COVID-19 pandemic put a burden on healthcare services around the globe and impacted many areas of care delivery, including maternity services. Prioritizing ringfenced community care to keep women away from hospitals may be the best strategic response to ensure pregnant and laboring women receive optimal care. By analyzing the structure of maternity services in Poland and their response to the current crisis, we show that while the available model allows to provide large share of prenatal services outside hospital settings, it allows no alternative to hospital births.