Barrier measures implemented in French maternity hospitals during the COVID-19 pandemic: A cross-sectional survey

OBJECTIVES: The objectives of this survey were 1) to describe the changes over time of barrier measures in maternity units, specifically, co-parent visits and women wearing masks in birth rooms, and 2) to identify potential institutional determinants of these barrier measures. DESIGN: We used an online questionnaire to conduct a descriptive cross-sectional survey from May to July 2021. SETTING: All districts in mainland France. PARTICIPANTS: Midwife supervisor of each maternity unit. MEASUREMENTS: Primary outcomes were “banning of visits” in the postnatal department during the first lockdown (March–May 2020), and “mandated mask-wearing in birth rooms” during the survey period (May–July 2021); the independent variables were maternity unit characteristics and location in a crisis area. Co-parent visits were considered only during the first lockdown as they were mostly allowed afterwards, and the wearing of masks was studied only during the survey period, as masks were unavailable for the population during the first lockdown. RESULTS: We obtained 343 responses, i.e., 75.2% of French maternity units. Visits to the postnatal department were forbidden in 39.3% of the maternity units during the first lockdown and in none during the study period. Maternity hospitals with neonatal intensive care units were the most likely to ban co-parent hospital visits (adjusted OR 2.34 [1.12; 4.96]). However, those were the maternity units least likely to encourage or require women to wear masks while pushing (adjusted OR, 0.31; 95% confidence interval [CI], 0.11–0.77). Maternity units in crisis areas (i.e., with very high case counts) during the first lockdown banned visits significantly more often (adjusted OR, 1.68; 95% CI, 1.05–2.70). KEY CONCLUSIONS: Our study showed that barrier measures evolved during the course of the pandemic but remained extremely variable between facilities. IMPLICATIONS FOR PRACTICE: Maternity units implemented drastic barrier measures at the beginning of the pandemic but were able to adapt these measures over time. It is now time to learn from this experience to ensure that women and infants are no longer harmed by these measures.