Doctoral study finds Estonia’s maternity care lacks coordination

Services for pregnancy, childbirth and the period after birth do not form a unified system in Estonia, and access to support can depend on where a woman lives and how well specialists work together, ERR reports. A recently defended doctoral thesis calls for closer cooperation between health and social care services so women and families receive continuous support.

Silja Mets-Oja, head of the Centre for Health Education at Tallinn Health Care College, examined how maternity care services develop where health care and social welfare meet, and how people’s experiences and cooperation between different parties affect those services. She defended her thesis at Tallinn University.

Because health care and social welfare operate as separate systems in Estonia, continuity of support depends on cooperation between professionals in the two fields, Mets-Oja said. Families may need health care, counselling and other support during pregnancy, childbirth and after birth, including help with mental wellbeing and everyday life.

The thesis focused in particular on regions where maternity wards have closed or are at risk of closure. Pregnancy care may take place at one institution, childbirth at another hospital and postnatal follow-up somewhere else, leaving women to navigate the services themselves. Mets-Oja said this can make access unequal.

Maternity wards in Valga and Põlva closed in 2018, prompting strong local opposition. Mets-Oja said the concern was not so much the closures themselves as how the decisions were communicated and justified. Interviews with women found that a maternity ward represented more than a single service: its presence also gave communities a sense of security and belonging.