RSU researchers contribute to improving maternal and newborn care in Latvia

Several teams of researchers from Rīga Stradiņš University (RSU) have made a significant contribution to improving the quality of maternal and newborn care in Latvia and at a European level. By identifying problems in maternity care in Latvia, data-based solutions have been introduced to improve the experience of young mothers and their childcare. Work is continuing to support young mothers.

According to the latest data, 40 % of young mothers have not received information on health signs that need attention, 30 % for a baby, and this is a significant improvement since 2021.

The situation has already improved significantly

In the first survey in 2021, women pointed to the need for more attention and communication. When surveying more than 2,000 young mothers about their birth experiences and readiness to care for their newborn, it was found that 63 % had not received warnings about their health and 75 % about their baby's health. Some women had experienced negative childbirth experiences: 32.7 % – insufficient help with breastfeeding issues; 30.9 % – lack of emotional support; 17 % – physical or emotional abuse.

“In Latvia, the study highlighted important problems such as insufficient emotional support and incomplete assistance in breastfeeding issues, as well as physical or emotional abuse in childbirth. Learning the views of women was important to create awareness, not to blame anyone," says Elizabete Ārgale, the research coordinator, RSU's lecturer and gynaecologist.

The impact of Covid-19 related restrictions hit access to medical services, particularly pregnancy and newborn period services, which threatened access to quality and timely maternal and newborn health care. Based on this data, RSU developed a curriculum for maternity staff and refined maternity care guidelines.

With improvements in childbirth care and staff training, the violence experienced in childbirth has already dropped significantly to 5.2 %, as the indicative data from the next study show at the end of 2024. It is even less than in Scandinavian countries (7 %), for example. Medical professionals are increasingly doing the explanatory work.

There are plenty of winners

The results of this study had a positive impact on different groups of society. First, mothers-to-be are heard and better prepared for childbirth. Women and their family members have improved childbirth experiences. Greater emotional support is provided and awareness of rights and proper care during childbirth is increased. Improving childbirth care and reducing the likelihood of negative experiences, women will experience less fear and stress related to future births. A positive experience during the first birth promotes a greater sense of security and trust in care providers, as well as facilitates the decision to have another child.

Health care professionals – doctors, midwives and nurses gain the opportunity to develop their knowledge and working practices based on the problems and international examples identified in the study. A more accurate understanding of a patient's needs improves their professional satisfaction.

Maternity facilities – hospitals and maternity units get a clear picture of care quality problems and their solutions. This helps to improve the care organization, staff communication with female patients and the overall atmosphere in delivery rooms.

The results of the study and aspects affecting the birth support environment were presented to the Ministry of Health. The remuneration of midwives, the need to reduce on-call hours and improve working conditions were also discussed. Summing up all of the above, RSU identified problems and improved maternal and child health care at a national level.

And that's far from it yet

The research is currently continuing in a new project, surveying women who gave birth as of 2022, and so far 2700 answers in Latvia have been compiled. Between the first and second studies, more has been invested in educating medical professionals.

Midwives, for example, had the opportunity to participate in “Power of the Word” training, where they could learn more about professional and respectful interaction and communication during childbirth from psychology and psychotherapy specialists, and better understand themselves and their emotions.

The authors continue to present the study to physicians and personnel involved in childbirth care which raises awareness among professionals about the situation and the needs of women. In addition, the adapted questionnaire by RSU researchers for Latvian women (the questionnaire was developed by the World Health Organisation) is also included in the patient experience surveys of the National Center for Disease Control and Prevention meaning that this topic will be monitored in the long term.

Finally, a team of RSU researchers led by Prof. Elmārs Rancans has launched a new study in 2024 “Improving screening and diagnostics of postpartum depression in women receiving outpatient postpartum care.”

About the research programme

maternal and child health is an important part of the RSU research programme. Its importance is also highlighted by the need to improve the demographic situation in Latvia. The first contribution of RSU researchers was participation in the WHO study “Improving maternal and neonatal care in the European Region (Imagine EURO)"* in 2020-2021, which collected and analysed data on the experiences of 2,079 Latvian women and compared with the results of other European countries using a single questionnaire and methodology. More than 15 European countries participated in this study. Problems in childbirth care were identified in Latvia, such as insufficient emotional support (30.9%) and difficulties in breastfeeding (32.7 %), physical and emotional abuse (17 %). Based on this data, a curriculum for maternity staff was developed and maternity care guidelines improved. The research led by Prof. Dace Rezeberga was conducted by lecturers of RSU Department of Obstetrics and Gynaecology.

The second study, started in 2024, following a methodology developed in the first project continues to survey young mothers who gave birth from 2022 onwards, with responses so far received from 2,700 respondents. As told above, the situation has already improved significantly compared to 2021.

The third study “Post-natal depression care in Latvia” (2024-2028), led by Prof. E. Rancans, identifies the prevalence and risk factors of postnatal depression, improves screening, diagnosis and care. During eight months since its launch, 193 women who gave birth have been surveyed, 89 of them tested positive for postnatal depression, 12 % diagnosed with anxiety. Psychiatrists involved in the project conduct in-depth interviews with those women. Data will be collected by August 2025 and qualitative research will begin in September.

* Improving MAternal and Newborn carE in the EURO region