RSU researchers contribute to improving maternal and newborn care in Latvia

Several research teams from Rīga Stradiņš University (RSU) have significantly contributed to improving maternal and newborn care, both in Latvia and at the European level. By identifying gaps in maternity care, they have introduced data-driven solutions to enhance the experiences of young mothers and their childcare. Work is ongoing to continue supporting young mothers.

According to the latest data, 40% of young mothers have not received information about health signs requiring attention, and 30% have not received similar guidance for their babies. However, this represents a notable improvement since 2021.

Significant improvements

In the first survey conducted in 2021, women highlighted the need for greater attention and better communication. Over 2,000 young mothers were surveyed about their birth experiences and readiness to care for their newborns. The findings showed that 63% had not received warning signs regarding their health, and 75% had not received similar warnings about their baby’s health. Some women reported negative childbirth experiences: 32.7% lacked support with breastfeeding; 30.9% felt there was insufficient emotional support; and 17% experienced physical or emotional abuse.

'In Latvia, the study identified critical issues, such as the lack of emotional support, inadequate breastfeeding assistance, and instances of physical or emotional abuse during childbirth. Gathering women's perspectives was vital to raise awareness without placing blame,' said Elizabete Ārgale, research coordinator, gynaecologist, and lecturer at RSU.

The impact of COVID-19 restrictions disrupted access to healthcare services, particularly those related to pregnancy and the newborn period, threatening the quality and timeliness of maternal and newborn care. In response, RSU developed a curriculum for maternity staff and refined maternity care guidelines.

With improvements in childbirth care and staff training, the incidence of violence during childbirth has dropped significantly to 5.2%, based on preliminary data from the next study at the end of 2024. This figure is lower than in Scandinavian countries, such as Sweden (7%). Medical professionals are increasingly engaging in explanatory work with patients.

Positive outcomes

The study's results have had a positive impact on several groups. Firstly, expectant mothers are now better heard and prepared for childbirth. Women and their families are reporting improved childbirth experiences, with increased emotional support and greater awareness of their rights and proper care during childbirth. These improvements help to reduce fear and stress associated with future births. A positive first birth experience also promotes a sense of security, trust in care providers, and confidence in deciding to have more children.

Healthcare professionals, including doctors, midwives, and nurses, benefit from enhanced knowledge and improved working practices based on the study's findings and international examples. A better understanding of patients' needs leads to greater job satisfaction.

Maternity facilities—hospitals and maternity units—now have a clearer picture of care quality issues and solutions. This enables them to improve care organisation, communication with female patients, and the overall atmosphere in delivery rooms.

The study’s results and insights into the birth support environment have been presented to the Ministry of Health. Discussions have also focused on issues such as midwives' remuneration, reducing on-call hours, and improving working conditions. Through this process, RSU has helped to identify problems and improve maternal and child healthcare on a national scale.

Research is ongoing

The research continues through a new project, surveying women who gave birth from 2022 onward. So far, 2,700 responses have been collected in Latvia. Between the first and second studies, more focus has been placed on educating medical professionals.

Midwives, for example, have had the opportunity to participate in "Power of the Word" training, which helps them learn more about professional and respectful communication during childbirth, guided by psychology and psychotherapy specialists. This training also helps midwives better understand their own emotions.

Researchers continue to present the findings to healthcare professionals involved in childbirth care, raising awareness about the issues faced by women. Additionally, RSU has adapted a World Health Organization (WHO) questionnaire for Latvian women, which is now included in patient experience surveys by the National Centre for Disease Control and Prevention. This will ensure long-term monitoring of the situation.

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

About the research programme

Maternal and child health is a key focus of RSU's research programme, particularly given the need to improve Latvia’s demographic situation. RSU's first contribution was to the WHO study “Improving maternal and neonatal care in the European Region (Imagine EURO)"*, which took place in 2020-2021. This study collected and analysed data on the experiences of 2,079 Latvian women and compared it with results from other European countries using a unified questionnaire and methodology. More than 15 European countries participated in the study, which revealed significant issues in Latvia, such as insufficient emotional support (30.9%), difficulties with breastfeeding (32.7%), and instances of physical and emotional abuse (17%). Based on this data, RSU developed a curriculum for maternity staff and improved maternity care guidelines. The study, led by Prof. Dace Rezeberga, involved lecturers from the RSU Department of Obstetrics and Gynaecology.

The second study, which began in 2024, continues to survey young mothers who gave birth from 2022 onwards, with 2,700 responses collected so far. As mentioned, the situation has already improved significantly since 2021.

The third study, “Advancing Postpartum Depression Care in Latvia” (2024-2026), led by Prof. Elmārs Rancāns, focuses on identifying the prevalence and risk factors of postnatal depression, improving screening, diagnosis, and care. Since its launch, 193 women who gave birth have been surveyed, with 89 testing positive for postnatal depression and 12% diagnosed with anxiety. Psychiatrists involved in the project are conducting in-depth interviews with these women. Data will be collected until August 2025, with qualitative research beginning in September.

* Improving MAternal and Newborn carE in the EURO region