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1.
BMC Pregnancy Childbirth ; 22(1): 304, 2022 Apr 10.
Article in English | MEDLINE | ID: covidwho-1779619

ABSTRACT

BACKGROUND: Expectant parents worldwide have experienced changes in the way they give birth as a result of COVID-19, including restrictions relating to access to birthing units and the presence of birthing partners during the birth, and changes to birth plans. This paper reports the experiences of women in England. METHODS: Data were obtained from both closed- and open-ended responses collected as part of the national COVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP) Study online survey (n = 477 families) between 15th July 2020 - 29th March 2021. Frequency data are presented alongside the results of a sentiment analysis; the open-ended data was analysed thematically. RESULTS: Two-thirds of expectant women reported giving birth via spontaneous vaginal delivery (SVD) (66.1%) and a third via caesarean section (CS) (32.6%) or 'other' (1.3%). Just under half (49.7%) of the CS were reported to have been elective/planned, with 47.7% being emergencies. A third (37.4%) of participants reported having no changes to their birth (as set out in their birthing plan), with a further 25% reporting COVID-related changes, and 37.4% reporting non-COVID related changes (e.g., changes as a result of birthing complications). One quarter of the sample reported COVID-related changes to their birth plan, including limited birthing options and reduced feelings of control; difficulties accessing pain-relief and assistance, and feelings of distress and anxiety. Under half of the respondents reported not knowing whether there could be someone present at the birth (44.8%), with 2.3% of respondents reporting no birthing partner being present due to COVID-related restrictions. Parental experiences of communication and advice provided by the hospital prior to delivery were mixed, with significant stress and anxiety being reported in relation to both the fluctuating guidance and lack of certainty regarding the presence of birthing partners at the birth. The sentiment analysis revealed that participant experiences of giving birth during the pandemic were predominately negative (46.9%) particularly in relation to the first national lockdown, with a smaller proportion of positive (33.2%) and neutral responses (19.9%). CONCLUSION: The proportion of parents reporting birthing interventions (i.e., emergency CS) was higher than previously reported, as were uncertainties related to the birth, and poor communication, leading to increased feelings of anxiety and high levels of negative emotions. The implications of these findings are discussed.


Subject(s)
COVID-19 , Cesarean Section , COVID-19/epidemiology , Cesarean Section/psychology , Communicable Disease Control , England/epidemiology , Female , Humans , Pandemics , Parturition/psychology , Pregnancy
2.
Fam Syst Health ; 40(1): 126-131, 2022 03.
Article in English | MEDLINE | ID: covidwho-1751688

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has impacted individuals across the world, and in particular, dramatically affected the experience of pregnancy and childbirth for many expectant mothers. The transition to parenthood is a time of increased risk for mental health problems, and maternal prenatal stress is associated with long-term maternal and infant health implications. The current study explored whether COVID-19 related changes to mothers' childbirth plans and prenatal health care experiences during the first wave of pandemic lockdowns in the U.S. were associated with self-reported depression, anxiety, and stress. METHOD: In spring 2020; we surveyed 641 pregnant women on their pregnancy and birth plans, as well as their mental health, during the COVID-19 pandemic. RESULTS: Women anticipating changes to the presence of their partner at birth also reported heightened symptoms of depression, anxiety, and stress. Additionally, women who anticipated changes to the timing of delivery reported both higher anxiety and higher perceived stress. DISCUSSION: These findings extend initial work suggesting increased risk for mental health problems in pregnant women during the COVID-19 pandemic by highlighting specific pandemic-related disruptions to pregnancy and birth that may have contributed to prenatal distress. Monitoring and intervention for these mothers and their infants are warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Pandemics , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , Communicable Disease Control , Female , Humans , Infant , Infant, Newborn , Parturition/psychology , Pregnancy
3.
Complement Ther Clin Pract ; 47: 101566, 2022 May.
Article in English | MEDLINE | ID: covidwho-1706147

ABSTRACT

OBJECTIVE: This study aims to examine the effectiveness of a live online Mindfulness-Based Stress Reduction (MBSR) program in preventing distress, anxiety and childbirth fear in pregnant women diagnosed with COVID-19. MATERIAL AND METHODS: Designed as a randomized-controlled trial, this study was performed with the participation of pregnant women who were diagnosed with COVID-19. The sample comprised 84 pregnant women, including 42 in the experimental group and 42 in the control group. The online MBSR program composed of eight sessions and lasting four weeks was provided to the pregnant women in the experimental group, whereas such an initiative was not provided to the control group. The data were collected via the Revised Prenatal Distress Questionnaire (NuPDQ), the Beck Anxiety Inventory (BAI), and the Childbirth Attitudes Questionnaire (CAQ). RESULTS: After the MBSR program, the mean NuPDQ, BAI and CAQ scores of the pregnant women in the experimental group were significantly lower than the mean scores of those in the control group (p < 0.001). CONCLUSION: The online MBSR program may be utilized to reduce the distress, anxiety and childbirth fear levels of pregnant women diagnosed with COVID-19. By using the MBSR program, health professionals might improve the psychological well-being of pregnant women diagnosed with COVID-19.


Subject(s)
COVID-19 , Mindfulness , Anxiety/psychology , Depression/psychology , Fear , Female , Humans , Parturition/psychology , Pregnancy , Pregnant Women/psychology , Stress, Psychological/therapy
4.
Int J Environ Res Public Health ; 19(4)2022 02 10.
Article in English | MEDLINE | ID: covidwho-1690251

ABSTRACT

There has been concern about the impact of the COVID-19 outbreak on women's mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on the perinatal experiences (COPE-IS) during the second Italian wave. Overall, 1168 pregnant women, and 940 within the first six months after childbirth, were recruited in selected Italian Family Care Centers from October 2020 to May 2021. The prevalence of psychological distress symptoms during pregnancy was 12.1% and 9.3% in the postnatal group. Financial difficulties, a previous mood or anxiety disorder and lack of perceived social support and of support provided by health professionals were associated to psychological distress symptoms in both groups. A third of the women felt unsupported by their social network; 61.7% of the pregnant women experienced changes in antenatal care; 21.2% of those in the postnatal period gave birth alone; more than 80% of the participants identified access to medical and mental health care and self-help as important resources in the present context. Health services should assure enhanced support to the most vulnerable women who face the perinatal period during the pandemic.


Subject(s)
COVID-19 , Anxiety/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Pandemics , Parturition/psychology , Pregnancy , SARS-CoV-2 , Stress, Psychological/epidemiology
5.
Int J Environ Res Public Health ; 19(3)2022 01 29.
Article in English | MEDLINE | ID: covidwho-1686743

ABSTRACT

INTRODUCTION: Postpartum depression is commonly experienced by mothers worldwide and is associated with anxiety disorders, parenting stress, and other forms of distress, which may lead to a complex illness condition. Several studies have investigated the risk factors for this disorder, including biological and socio-demographic variables, medical and obstetric factors, and psychological and relational dimensions. The present study aimed to describe the psychological status of mothers up to 12 months postpartum, and to investigate the predictors of depressive symptoms at 12 months postpartum, considering obstetric factors along with psychological and relational variables. METHODS: A sample of 137 women completed a questionnaire composed of a sheet on anamnestic and obstetric information and the following scales: Wijma Delivery Experience Questionnaire; State-Trait Anxiety Inventory; Edinburgh Postnatal Depression Scale; Parenting Stress Index (Short Form); Dyadic Adjustment Scale; and Multidimensional Scale of Perceived Social Support. Data were collected at four assessment times: 2-3 days, 3 months, 6 months, and 12 months postpartum. RESULTS: Findings showed that the highest percentage of women with clinically significant symptoms of anxiety (state and trait) and depression was found at 12 months postpartum, which indicated that this was the most critical time. The quality of childbirth experience and trait anxiety at three months postpartum emerged as significant predictors of postpartum depression at 12 months. CONCLUSION: Our findings highlight the importance of providing stable programs (such as educational programs) to mothers in the first year postpartum. Furthermore, because the quality of the childbirth experience is one of the most important predictors of PPD at 12 months postpartum, effort should be made by healthcare professionals to guarantee a positive experience to all women to reduce possible negative long-term consequences of this experience.


Subject(s)
Depression, Postpartum , Anxiety/epidemiology , Anxiety/psychology , Depression/psychology , Depression, Postpartum/diagnosis , Female , Humans , Longitudinal Studies , Mothers/psychology , Parturition/psychology , Postpartum Period/psychology , Pregnancy , Psychiatric Status Rating Scales , Risk Factors , Surveys and Questionnaires
6.
BMC Pregnancy Childbirth ; 21(1): 664, 2021 Sep 30.
Article in English | MEDLINE | ID: covidwho-1448216

ABSTRACT

BACKGROUND: The outbreak of the COVID-19 pandemic caused great uncertainty about causes, treatment and mortality of the new virus. Constant updates of recommendations and restrictions from national authorities may have caused great concern for pregnant women. Reports suggested an increased number of pregnant women choosing to give birth at home, some even unassisted ('freebirth') due to concerns of transmission in hospital or reduction in birthplace options. During April and May 2020, we aimed to investigate i) the level of concern about coronavirus transmission in Danish pregnant women, ii) the level of concern related to changes in maternity services due to the pandemic, and iii) implications for choice of place of birth. METHODS: We conducted a nationwide cross-sectional online survey study, inviting all registered pregnant women in Denmark (n = 30,009) in April and May 2020. RESULTS: The response rate was 60% (n = 17,995). Concerns of transmission during pregnancy and birth were considerable; 63% worried about getting severely ill whilst pregnant, and 55% worried that virus would be transmitted to their child. Thirtyeight percent worried about contracting the virus at the hospital. The most predominant concern related to changes in maternity services during the pandemic was restrictions on partners' attendance at birth (81%). Especially nulliparous women were concerned about whether cancelled antenatal classes or fewer physical midwifery consultations would affect their ability to give birth or care for their child postpartum.. The proportion of women who considered a home birth was equivalent to pre-pandemic home birth rates in Denmark (3%). During the temporary discontinue of public home birth services, 18% of this group considered a home birth assisted by a private midwife (n = 125), and 6% considered a home birth with no midwifery assistance at all (n = 41). CONCLUSION: Danish pregnant womens' concerns about virus transmission to the unborn child and worries about contracting the virus during hospital appointments were considerable during the early pandemic. Home birth rates may not be affected by the pandemic, but restrictions in home birth services may impose decisions to freebirth for a small proportion of the population.


Subject(s)
Anxiety/psychology , Birth Setting , COVID-19/psychology , Maternal Health Services , Parturition/psychology , Pregnant Women/psychology , Adult , COVID-19/transmission , Cross-Sectional Studies , Denmark/epidemiology , Female , Humans , Midwifery , Pregnancy , SARS-CoV-2 , Spouses , Surveys and Questionnaires
8.
MCN Am J Matern Child Nurs ; 46(5): 284-292, 2021.
Article in English | MEDLINE | ID: covidwho-1360376

ABSTRACT

PURPOSE: The COVID-19 pandemic has disrupted health care delivery and services around the world causing rapid changes to maternity care protocols and pregnant women to give birth with tight restrictions and significant uncertainties. There is a gap in evidence about expectant and new mothers' experiences with birthing during the pandemic. We sought to describe and understand pregnant and new mothers' lived experiences during the COVID-19 pandemic using authentic birth stories. STUDY DESIGN AND METHODS: Using a narrative analysis framework, we extracted relevant YouTube birth stories using predetermined search terms and inclusion criteria. Mothers' birth stories were narrated in their second or third trimester or those who had recently given birth during the pandemic. Birth stories were analyzed using an inductive and deductive approach to capture different and salient aspects of the birthing experience. RESULTS: N = 83 birth stories were analyzed. Within these birth stories, four broad themes and 13 subthemes were identified. Key themes included a sense of loss, hospital experiences, experiences with health care providers, and unique experiences during birth and postpartum. The birth stories revealed that the COVID-19 pandemic brought unexpected circumstances, both positive and negative, that had an impact on mothers' overall birthing experience. CLINICAL IMPLICATIONS: Results provided a detailed description of women's lived experience with giving birth during the COVID-19 pandemic. Maternity nurses should try to provide clear communication and compassionate patient-centered care to relieve women's anxieties about uncertain and unpredictable policy changes on COVID-19 as the pandemic continues to evolve.


Subject(s)
COVID-19/psychology , Maternal Health Services , Mothers/psychology , Parturition/psychology , Physical Distancing , COVID-19/epidemiology , Female , Humans , Infant, Newborn , Pandemics , Pregnancy , Qualitative Research , SARS-CoV-2
10.
BMC Pregnancy Childbirth ; 21(1): 473, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1295448

ABSTRACT

BACKGROUND: In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. METHODS: We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. RESULTS: We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. CONCLUSIONS: The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage "home" physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.


Subject(s)
COVID-19/psychology , Life Style , Mental Health , Mothers/psychology , Parturition/psychology , Pregnant Women/psychology , Quarantine , Adult , Anxiety/epidemiology , Breast Feeding , Depression/epidemiology , Diet, Healthy , Exercise , Female , Health Services Accessibility , Humans , Italy/epidemiology , Middle Aged , Pregnancy , SARS-CoV-2 , Young Adult
11.
Sci Rep ; 11(1): 13535, 2021 06 29.
Article in English | MEDLINE | ID: covidwho-1287821

ABSTRACT

As the novel coronavirus (COVID-19) has spread globally, a significant portion of pregnant and delivering women were infected with COVID-19. While emerging studies examined birth outcomes in COVID-19 positive women, knowledge of the psychological experience of childbirth and maternal wellness remains lacking. This matched-control survey-based study included a sample of women recruited during the first wave of the pandemic in the US who gave birth in the previous six months. Women reporting confirmed/suspected COVID-19 (n = 68) during pregnancy or childbirth were matched on background factors with women reporting COVID-19 negativity (n = 2,276). We found nearly 50% of COVID positive women endorsed acute traumatic stress symptoms at a clinical level in response to childbirth. This group was more than twice as likely to endorse acute stress and to have no visitors during maternity hospitalization than COVID negative women; they were also less likely to room-in with newborns. The COVID positive group reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Our findings suggest COVID-19 affected populations are at increased risk for traumatic childbirth and associated risk for psychiatric morbidity. Attention to delivering women's wellbeing is warranted during the pandemic.


Subject(s)
COVID-19/psychology , Parturition/psychology , Pregnant Women/psychology , Stress Disorders, Post-Traumatic/diagnosis , Adult , Anxiety/diagnosis , Birth Weight , COVID-19/diagnosis , COVID-19/virology , Female , Hospitals , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Pain/pathology , Patient Admission/statistics & numerical data , Pregnancy , SARS-CoV-2/isolation & purification , Stress, Psychological , Surveys and Questionnaires
12.
Matern Child Health J ; 25(6): 860-869, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1204916

ABSTRACT

OBJECTIVE: To examine the impact of the COVID-19 pandemic on birth satisfaction and perceived health care discrimination during childbirth, and in turn, the influence of these birth experiences on postpartum health. STUDY DESIGN: We conducted a cross-sectional, bilingual web survey of 237 women who gave birth at two hospitals in New York City and assessed patient-reported experience and outcomes following the first wave of SARS-CoV-2 infections in the New York region. We ascertained SARS-CoV-2 status at delivery from the electronic medical record using participant-reported name and date of birth. We compared birth experience during the COVID-19 pandemic (March 15, 2020-May 11, 2020) to a pre-pandemic response period (January 1, 2020-March 14, 2020). We estimated risk ratios for associations between birth experience and anxiety, depressive symptoms, stress, birth-related PTSD, emergency department visits, timely postpartum visit, and exclusive breastfeeding. Multivariable models adjusted for age, race-ethnicity, insurance, education, parity, BMI, previous experience of maltreatment/abuse and cesarean delivery. RESULTS: Women who gave birth during the peak of the pandemic response, and those that were SARS-CoV-2 positive, Black, and Latina, had lower birth satisfaction and higher perceived health care discrimination. Women with lower birth satisfaction were more likely to report higher postpartum anxiety, stress, depressive symptoms, and lower exclusive breastfeeding. Experiencing one or more incident of health care discrimination was associated with higher levels of postpartum stress and birth-related PTSD. CONCLUSION: Hospitals and policy-makers should institute measures to safeguard against a negative birth experience during the ongoing COVID-19 pandemic, particularly among birthing people of color.


Subject(s)
Anxiety/psychology , COVID-19 , Delivery of Health Care/organization & administration , Parturition/psychology , Personal Satisfaction , Adult , Cross-Sectional Studies , Female , Health Status , Humans , Pandemics , Postpartum Period , Pregnancy , SARS-CoV-2 , Young Adult
13.
BMJ Glob Health ; 5(Suppl 2)2021 01.
Article in English | MEDLINE | ID: covidwho-1203974

ABSTRACT

INTRODUCTION: Experiences of care and satisfaction are intrinsically linked, as user's experiences of care may directly impact satisfaction, or indirectly impact user's expectations and values. Both experiences of care and satisfaction are important to measure so that quality can be monitored and improved. Globally, women experience mistreatment during childbirth at facilities; however, there is limited evidence exploring the mistreatment and women's satisfaction with care during childbirth. METHODS: This is a secondary analysis of a cross-sectional survey within the WHO study 'How women are treated during facility-based childbirth' exploring the mistreatment of women during childbirth in Ghana, Guinea, Myanmar and Nigeria. Women's experiences of mistreatment and satisfaction with care during childbirth was explored. Multivariable logistic regression modelling was conducted to evaluate the association between mistreatment, women's overall satisfaction with the care they received, and whether they would recommend the facility to others. RESULTS: 2672 women were included in this analysis. Despite over one-third of women reporting experience of mistreatment (35.4%), overall satisfaction for services received and recommendation of the facility to others was high, 88.4% and 90%, respectively. Women who reported experiences of mistreatment were more likely to report lower satisfaction with care: women were more likely to be satisfied if they did not experience verbal abuse (adjusted OR (AOR) 4.52, 95% CI 3.50 to 5.85), or had short waiting times (AOR 5.12, 95% CI 3.94 to 6.65). Women who did not experience any physical or verbal abuse or discrimination were more likely to recommend the facility to others (AOR 3.89, 95% CI 2.98 to 5.06). CONCLUSION: Measuring both women's experiences and their satisfaction with care are critical to assess quality and provide actionable evidence for quality improvement. These measures can enable health systems to identify and respond to root causes contributing to measures of satisfaction.


Subject(s)
COVID-19 , Parturition/psychology , Personal Satisfaction , Women/psychology , Adult , Attitude of Health Personnel , Betacoronavirus , Child , Community-Based Participatory Research , Cross-Sectional Studies , Delivery, Obstetric , Female , Ghana , Guinea , Humans , Male , Maternal Health , Myanmar , Nigeria , Pandemics , Pregnancy , Quality of Health Care , SARS-CoV-2
14.
PLoS One ; 16(4): e0249780, 2021.
Article in English | MEDLINE | ID: covidwho-1197377

ABSTRACT

Pregnant and postpartum women face unique challenges during the COVID-19 pandemic that may put them at elevated risk of mental health problems. However, few large-scale and no cross-national studies have been conducted to date that investigate modifiable pandemic-related behavioral or cognitive factors that may influence mental health in this vulnerable group. This international study sought to identify and measure the associations between pandemic-related information seeking, worries, and prevention behaviors on perinatal mental health during the COVID-19 pandemic. An anonymous, online, cross-sectional survey of pregnant and postpartum women was conducted in 64 countries between May 26, 2020 and June 13, 2020. The survey, available in twelve languages, was hosted on the Pregistry platform for COVID-19 studies (https://corona.pregistry.com) and advertised in social media channels and online parenting forums. Participants completed measures on demographics, COVID-19 exposure and worries, information seeking, COVID-19 prevention behaviors, and mental health symptoms including posttraumatic stress via the IES-6, anxiety/depression via the PHQ-4, and loneliness via the UCLA-3. Of the 6,894 participants, substantial proportions of women scored at or above the cut-offs for elevated posttraumatic stress (2,979 [43%]), anxiety/depression (2,138 [31%], and loneliness (3,691 [53%]). Information seeking from any source (e.g., social media, news, talking to others) five or more times per day was associated with more than twice the odds of elevated posttraumatic stress and anxiety/depression, in adjusted models. A majority of women (86%) reported being somewhat or very worried about COVID-19. The most commonly reported worries were related to pregnancy and delivery, including family being unable to visit after delivery (59%), the baby contracting COVID-19 (59%), lack of a support person during delivery (55%), and COVID-19 causing changes to the delivery plan (41%). Greater worries related to children (i.e., inadequate childcare, their infection risk) and missing medical appointments were associated with significantly higher odds of posttraumatic stress, anxiety/depression and loneliness. Engaging in hygiene-related COVID-19 prevention behaviors (face mask-wearing, washing hands, disinfecting surfaces) were not related to mental health symptoms or loneliness. Elevated posttraumatic stress, anxiety/depression, and loneliness are highly prevalent in pregnant and postpartum women across 64 countries during the COVID-19 pandemic. Excessive information seeking and worries related to children and medical care are associated with elevated symptoms, whereas engaging in hygiene-related preventive measures were not. In addition to screening and monitoring mental health symptoms, addressing excessive information seeking and women's worries about access to medical care and their children's well-being, and developing strategies to target loneliness (e.g., online support groups) should be part of intervention efforts for perinatal women. Public health campaigns and medical care systems need to explicitly address the impact of COVID-19 related stressors on mental health in perinatal women, as prevention of viral exposure itself does not mitigate the pandemic's mental health impact.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Mental Disorders/epidemiology , Mental Health , Pregnancy/psychology , Adult , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Humans , Loneliness/psychology , Middle Aged , Pandemics , Parturition/psychology , Perinatal Care , Postpartum Period/psychology , SARS-CoV-2/isolation & purification , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Surveys and Questionnaires , Women's Health
15.
Birth ; 48(2): 242-250, 2021 06.
Article in English | MEDLINE | ID: covidwho-1119216

ABSTRACT

BACKGROUND: The COVID-19 pandemic introduced unparalleled uncertainty into the lives of pregnant women, including concerns about where it is the safest to give birth, while preserving their rights and wishes. Reports on the increased interest in community births (at home or in birth centers) are emerging. The purpose of this project was to quantitatively investigate psychological factors related to this birth preference. METHODS: This study included 3896 pregnant women from the COVID-19 Pregnancy Experiences (COPE) Study who were anticipating a vaginal birth. COPE Study participants were recruited online between April 24 and May 15, 2020, and completed a questionnaire that included preference with respect to place of birth and psychological constructs: fear of childbirth, basic beliefs about birth, pandemic-related preparedness stress, and pandemic-related perinatal infection stress. RESULTS: Women who preferred a community birth, on average, had less childbirth fear, had stronger beliefs that birth is a natural process, were less likely to see birth as a medical process, and were less stressed about being unprepared for birth and being infected with COVID-19. In multivariate models, higher stress about perinatal COVID-19 infection was associated with greater likelihood of preferring a community birth. The effect of perinatal infection stress on preference was stronger when preparedness stress was high. DISCUSSION: Women's birth preferences during the COVID-19 pandemic are associated with psychological processes related to risk perception. Community births are more appealing to women who view being in a hospital as hazardous because of the pandemic. Policies and prenatal care aimed to increase access to safe in-hospital and out-of-hospital birth services should be encouraged.


Subject(s)
Birthing Centers/statistics & numerical data , COVID-19 , Home Childbirth/statistics & numerical data , Parturition/psychology , Pregnancy Complications , Stress, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Fear , Female , Humans , Patient Preference/psychology , Patient Preference/statistics & numerical data , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Pregnant Women/psychology , SARS-CoV-2 , Social Perception , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Uncertainty
16.
Midwifery ; 92: 102877, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1023716

ABSTRACT

AIM: This study aims to examine pregnancy and birth planning during COVID-19 and the effects of a tele-education offered to pregnant women for this planning process on prenatal distress and pregnancy-related anxiety. METHOD: The population of this quasi-experimental study was composed of pregnant women who applied for the antenatal education class of a public hospital in the east of Turkey during their past prenatal follow-ups and wrote their contact details in the registration book to participate in group trainings. The sample of the study consisted of a total of 96 pregnant women, including 48 in the experiment and 48 in the control groups, who were selected using power analysis and non-probability random sampling method. The data were collected between April 22 and May 13, 2020 using a "Personal Information Form", the "Revised Prenatal Distress Questionnaire (NuPDQ)" and the "Pregnancy Related Anxiety Questionnaire-Revised 2 (PRAQ-R2)". An individual tele-education (interactive education and consultancy provided by phone calls, text message and digital education booklet) was provided to the pregnant women in the experiment group for one week. No intervention was administered to those in the control group. The data were statistically analyzed using descriptive statistics (frequency, percentage, mean, standard deviation, min-max values) and t-test in dependent and independent groups. RESULTS: The posttest NuPDQ total mean scores of pregnant women in the experiment and control groups were 8.75±5.10 and 11.50±4.91, respectively, whereby the difference between the groups was statistically significant (t=-2.689, p=0.008). Additionally, the difference between their mean scores on both PRAQ-R2 and its subscales of "fear of giving birth" and "worries of bearing a physically or mentally handicapped child" was statistically significant (p<0.05), where those in the experiment group had lower anxiety, fear of giving birth and worries of bearing a physically or mentally handicapped child. CONCLUSION: The tele-education offered to the pregnant women for pregnancy and birth planning during COVID-19 decreased their prenatal distress and pregnancy-related anxiety.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Parturition/psychology , Pregnancy Complications/psychology , Pregnant Women/psychology , Telemedicine/methods , Adult , Anxiety/prevention & control , Case-Control Studies , Female , Humans , Pregnancy , Pregnancy Complications/prevention & control , Surveys and Questionnaires , Turkey
17.
Int J Gynaecol Obstet ; 153(1): 83-88, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-995959

ABSTRACT

OBJECTIVE: To understand how giving birth during the coronavirus disease 2019 (COVID-19) pandemic affected women based on birth parameters (gestational age, type of birth and body weight at birth), satisfaction with childbirth, and development of postpartum depression. METHODS: This is a cross-sectional study of 162 Spanish women. They were divided into two groups: those who gave birth before the pandemic (n = 82; from September 1, 2019 to March 1, 2020) and during the pandemic (n = 75; from April 1, 2020 to July 1, 2020). They were assessed using psychological instruments for postpartum childbirth satisfaction and postpartum depression. RESULTS: It was found that women who gave birth during the pandemic suffered higher levels of stress during childbirth (U = 2652.50; P = 0.040) and gave a worse rating of the quality of care received (U = 2703.50; P = 0.041). In addition, the percentage of postpartum depression was much higher in women who gave birth during the pandemic (χ2  = 4.31; P  = 0.038). CONCLUSION: Giving birth during the COVID-19 pandemic could have an impact on greater dissatisfaction with childbirth, as well as increasing the risk of postpartum depression.


Subject(s)
COVID-19 , Delivery, Obstetric , Depression, Postpartum , Parturition/psychology , Stress, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Cross-Sectional Studies , Delivery, Obstetric/methods , Delivery, Obstetric/psychology , Delivery, Obstetric/statistics & numerical data , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Female , Gestational Age , Humans , Personal Satisfaction , Postpartum Period/psychology , Pregnancy , SARS-CoV-2 , Spain/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology
18.
BMJ Open ; 10(12): e043057, 2020 12 10.
Article in English | MEDLINE | ID: covidwho-972718

ABSTRACT

INTRODUCTION: The absence of companionship during childbirth is known to be responsible for negative emotional birth experience, which can increase the risk of postpartum depression and post-traumatic stress disorder. The context of COVID-19 epidemic and the related confinement could increase the rate of negative experience and mental disorders. The main objective is to compare, in immediate post partum, the maternal sense of control during childbirth between a group of women who gave birth during confinement ('confinement' group) versus a group of women who gave birth after confinement but in the context of epidemic ('epidemic' group) versus a group of control women ('control' group; excluding confinement and epidemic context). METHODS AND ANALYSIS: This is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 927 women in a period of 16 months. Women will be recruited immediately in post partum during three different periods constituting the three groups: 'confinement'; 'epidemic' and 'control' group. The maternal sense of control will be evaluated by the Labour Agentry Scale questionnaire completed immediately in post partum. Postnatal depression (Edinburgh Postnatal Depression Scale), post-traumatic stress disorder (Impact of Event Scale-Revised) and breast feeding (evaluative statement) will be evaluated at 2 months post partum. ETHICS AND DISSEMINATION: The study was approved by the French Ethics Committee, the CPP (Comité de Protection des Personnes) SUD OUEST ET OUTRE-MER IV on 16th of April 2020 with reference number CPP2020-04-040. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences. TRIAL REGISTRATION NUMBER: NCT04348929.


Subject(s)
COVID-19/psychology , Parturition/psychology , Physical Distancing , Postpartum Period/psychology , Depression, Postpartum/etiology , Female , France , Humans , Pregnancy , Prospective Studies , Psychiatric Status Rating Scales , Research Design , Stress Disorders, Post-Traumatic/etiology , Surveys and Questionnaires , Time Factors
19.
Pan Afr Med J ; 37: 62, 2020.
Article in English | MEDLINE | ID: covidwho-948197

ABSTRACT

The pandemic of COVID-19 has proved to be a global catastrophe. Pregnant females could be more vulnerable to the infection owing to the immune modulation. According to the World Health Organization (WHO), pregnant females including those with COVID-19 suspicion or confirmed status have right to 'safe and positive childbirth experience' which includes a companion. The birth companion, is present at all times with the patient, from the initiation of labor till breastfeeding. The COVID-19 crisis has taken its toll on the healthcare system. The number of infected antenatal females are expected to increase. If a birth companion is trained in basic intrapartum and postpartum observation and care, he/she can be utilised to minimize unnecessary patient-clinician interface and optimize manpower in this critical time.


Subject(s)
COVID-19/epidemiology , Pandemics , Parturition/psychology , SARS-CoV-2 , Visitors to Patients/psychology , Asymptomatic Infections , COVID-19/prevention & control , Cesarean Section , Clinical Protocols , Female , Humans , Informed Consent , Male , Milk, Human , Patient Isolation , Pregnancy , Pregnancy Complications, Infectious , Pregnant Women , Quarantine , Visitors to Patients/education
20.
BMC Pregnancy Childbirth ; 20(1): 703, 2020 Nov 18.
Article in English | MEDLINE | ID: covidwho-934262

ABSTRACT

BACKGROUND: Trauma, natural and man-made catastrophic events can be predictors of postpartum psychological distress. In a public health response due to coronavirus disease 2019 outbreak, the Italian government imposed a lockdown from March 9 to May 3. This extraordinary situation may have been challenging for maternal psychological health. The aim of this study was to investigate the prevalence of depressive and post-traumatic stress symptoms in women giving birth during the Covid-19 pandemic and its associations with quarantine measures, obstetrical factors, and relational attachment style. METHODS: Women who gave birth in a high-volume obstetric/gynaecological medical centre located in an epidemic area during the Covid-19 pandemic (March 8 to June 15) were asked to complete an online survey about their childbirth experience and the perceived effect of the pandemic. The Edinburgh Postnatal Depression Scale (EPDS), the Impact of Event Scale-Revised (IES-R), and the Relationship Questionnaire (RQ) were administered to assess levels of postpartum depressive and post-traumatic stress symptoms (PTSS) and relational style of attachment, respectively. Multivariate analysis was applied to identify associations between quarantine measures, childbirth experience, attachment style, and EPDS and IES-R scores. RESULTS: The survey was completed by 163 women (response rate 60.8%). The prevalence of depressive symptoms was 44.2% (EPDS cut-off score ≥ 11) and the PTSS rate was 42.9% (IES-R cut-off score ≥ 24). Dismissive and fearful avoidant attachment styles were significantly associated with the risk of depression and PTSS, respectively. Perceived pain during birth was a risk factor for postpartum depression. Perceived support provided by healthcare staff was a protective factor against depression and PTSS. Another protective factor against PTSS was quiet on the ward due to the absence of hospital visitors. CONCLUSION: This study reports a high prevalence of postpartum depressive and PTSS in women who gave birth during the Covid-19 pandemic. Postnatal psychological distress seemed to be associated more with the prenatal experience and other individual factors than with the pandemic hospital restrictions. Early detection during pregnancy of an insecure attachment style is fundamental to provide targeted preventive and therapeutic psychological interventions.


Subject(s)
Coronavirus Infections/psychology , Depression, Postpartum , Pneumonia, Viral/psychology , Postpartum Period/psychology , Pregnant Women/psychology , Psychological Distress , Quarantine/psychology , Adult , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cross-Sectional Studies , Depression, Postpartum/epidemiology , Depression, Postpartum/etiology , Depression, Postpartum/prevention & control , Female , Humans , Italy/epidemiology , Pandemics/prevention & control , Parturition/psychology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pregnancy , Prevalence , Psychology , Psychosocial Support Systems , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/prevention & control
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