Impact of COVID-19 on pregnancy worry in the United States.

BACKGROUND: Several recent studies confirm that the COVID-19 pandemic has increased symptoms of stress, anxiety, and depression in pregnant persons around world. In this study, we aimed to uncover the impact of COVID-19 on worry during pregnancy. METHODS: This study used a cross-sectional descriptive research design. A link to a survey was emailed to users of the Ovia Pregnancy app. Participants (N = 253) completed the survey, which included the Cambridge Worry in Pregnancy Scale, and answered several free text questions. The free-text questions were included to capture worries not listed on the scale and to allow participants the opportunity to more clearly describe COVID-19-related worries. Descriptive statistics were reported, and content analysis performed to determine themes. RESULTS: Overall, respondents reported they were quite or very worried about having their partner with them at birth (31.7%, n = 80), giving birth (28.2%; n = 71), and something being wrong with the baby (27.3%; n = 69). Results on worries also differed by participants' race, parity, and trimester. When comparing White to other racial groups, other racial groups had statistically significantly higher median scores for questions on worries about employment (P = .001), going to the hospital (P = .002), and internal examinations (P = .03). Content analysis revealed isolation, loss of support, anxiety/stress, and grief as major themes. DISCUSSION: The worry, isolation, loss of support, anxiety, and grief reported by pregnant persons during the COVID-19 pandemic may impact maternal pre- and postnatal mental health and are not borne equally. Birthing persons of color appear disproportionately impacted. Prenatally, maternity care providers should assess for worry and provide individualized education and resources to pregnant patients, centering individuals and communities made most vulnerable by structural inequality.

Giving birth during the COVID-19 pandemic, perspectives from a sample of the United States birthing persons during the first wave: March-June 2020.

BACKGROUND: The COVID-19 pandemic forced hospitals in the United States to adjust policy and procedure in order to provide safe care and prevent the spread of disease. At the beginning of the pandemic, media and case reports described pressure for medical interventions, visitor restrictions, separation from newborns, and an increase in patient demand for community birth (home and birth center). The purpose of this study was to describe birth experiences during the COVID-19 pandemic centering the birthing person's perspective. METHODS: A survey was e-mailed to users of the Ovia Pregnancy app reaching a national convenience sample who gave birth between March 1, 2020, and June 11, 2020. Survey topics included birth location, the Mothers on Respect index, and open-ended questions capturing patient perspectives on the pandemic's effect on their birth experiences. Differences were assessed based on state-level COVID rate and by race. Content analysis was performed to analyze open-ended responses. RESULTS: Respondents from highly impacted COVID-19 states more frequently changed or considered changing their birth location. Racial differences were also found with Black respondents reporting significantly more preterm births and lower respect scores when compared to White respondents. Six themes emerged from the content analysis: Institutional Policies, Changes in Care, Hospital Staff Interactions, Sub-par Care, Issues of Support, and Mental Health. DISCUSSION: The health care community must continue to adapt policies and procedures to best support birthing patients during the COVID-19 pandemic. The community must also continue to address the reality that Black patients receive less respectful care compared with White patients.

Pregnant Women's Reports of the Impact of COVID-19 on Pregnancy, Prenatal Care, and Infant Feeding Plans.

PURPOSE: The aim of this study is to describe how the COVID-19 (coronavirus) pandemic has affected pregnancy, prenatal maternity care practices, and infant feeding plans among pregnant persons in the United States. STUDY DESIGN: Cross-sectional descriptive study using an app-based survey. METHODS: A link to the survey was sent via email to users of the Ovia Pregnancy app on May 20, 2020 and was open for 1 week. Participants were asked to complete the survey as it applied to their pregnancy, breastfeeding, and maternity care received during the COVID-19 pandemic, beginning approximately February 2020 through the time of the survey. There were 258 respondents who completed the survey. RESULTS: The majority (96.4%; n = 251) of pregnant women felt they received safe prenatal care during this time period. Slightly less 86.3% (n = 215) felt they received adequate prenatal care during this time period. 14.2% (n = 33) reported changing or considering changing the location where they planned to give birth due to COVID-19. Of those who reported they had begun purchasing items for their baby, 52.7% reported that the COVID-19 pandemic has affected their ability to get items they need for their baby. CLINICAL IMPLICATIONS: Although it is imperative to implement policies that reduce risk of transmission of COVID-19 to pregnant women and health care providers, it is necessary for health care providers and policy makers to listen to the collective voices of women during pregnancy about how COVID-19 has affected their birth and infant feeding plans and their perception of changes in prenatal care.