UW News

December 8, 2020

Policies around pregnancy, birth during pandemic failing both patients and nurses

UW News

Molly Altman

Molly Altman

As an experienced nurse midwife, whose scientific research focuses on respectful and equitable care during pregnancy and childbirth, the University of Washington’s Molly Altman has been studying pregnancy and childbirth during the pandemic alongside colleagues across the UW and in affected communities.

While her work is being distilled into formal studies that will be submitted for peer review, Altman, an assistant professor in the UW School of Nursing, believes it is important to begin discussions for improving this area of health care during the ongoing crisis.

“We found that visitor restrictions and separation policies were harming families and nurses. The effects for patients included loneliness, isolation and mistrust, while nurses described mistrust and low morale. Importantly, both nurses and patients described how COVID amplified existing racially biased and disrespectful care experiences for Black women and birthing people, in part due to loss of protection and advocacy that support people provide,” Altman said.

While hospitals and health care systems were vastly unprepared to respond to the COVID-19 pandemic, Altman heard from patients and nurses that the changes enacted in response to COVID-19 often adversely affected their care or ability to provide that care.

“Nurses described being expected to take additional risks that other providers were not, which increased the risks of exposure for themselves and their families. Overwhelmingly, nurses in our study lost trust that their workplace would support them and keep them safe while providing care to others, and that loss of trust impacted how patients saw the care they received,” said Altman.

“While we recognize the enormous challenges the COVID-19 pandemic brings to the health care system, hospitals and clinics need to take action to make policies more equitable for both patients and nurses.”

Altman suggests the following actions:

  • Administrators need to collaborate on policy changes, particularly with communities that are directly affected by these changes
  • Consider extending visitor policies to include multiple support people for patients in labor, as a way to mitigate risk of disrespectful care for marginalized communities
  • Create educational resources to help patients understand policies that affect them and provide avenues for getting support and reassurance
  • Develop clear, organized and transparent communication pathways about policy changes at all levels: patient, nurse and management
  • Increase mental health assessment, support and services for both patients and nurses to help support well-being amid crisis
  • Include bedside nurses in decisions about care planning, risk management and patient care


For more information, contact Altman at mraltman@uw.edu.