Midwives and maternity vaccination programs: critical learnings from the COVID-19 pandemic

INTRODUCTION: Vaccination against COVID-19 is an urgent global public health strategy. Health professionals including midwives and doctors support and influence vaccination uptake by childbearing women in their care. The aim of this study was to address the gap in knowledge and explore the perceptions and intentions regarding COVID-19 vaccination from consumers and providers of maternity care in Australia from early in the vaccination roll-out. METHODS: A national cross-sectional online study conducted in May 2021 in Australia. Recruitment was undertaken through parenting and health professional social media sites and professional college distribution lists. A total of 853 completed responses were received, from women of childbearing age (n=326), doctors (n=58), midwives (n=391) and midwifery students (n=78). FINDINGS: Early on in the vaccination roll-out, personal intention to be vaccinated ranged from 48-89% with doctors most likely and women least likely. Doctors and midwifery students were significantly more likely to recommend the vaccine to pregnant women in their care than midwives (p<0.001). More than half of the midwives (53%) had concerns about the COVID-19 vaccine for the women in their care compared with 35% of doctors and 46% of midwifery students. More than half of the practitioners (54%) surveyed were willing to delay or not offer vaccination to pregnant women, with many citing a lack of information to scaffold supportive conversations with those in their care. CONCLUSION: This is the first study to explore the perceptions and intentions regarding COVID-19 vaccination from both the perspective of those who receive and those who provide maternity care in Australia. Findings have utility to support targeted public health messaging for these and other cohorts. In light of new evidence, critical discussion will reveal the complex and important public health role of midwives and doctors in national maternity vaccination programs.