Becoming a mother during COVID-19: A national study on the experiences of pregnancy and childbirth in Portugal

ABSTRACT

Background Having a baby during the COVID-19 pandemic poses a number of challenges for mothers, which can seriously compromise their mental health. Aims and Objectives This study aims to describe the birth and postpartum experiences of a national sample of Portuguese postpartum mothers. It also aims to investigate the role of the negative emotional impact of the pandemic on mothers' mental health. Methods During December 2020, 1413 Portuguese mothers (70.8% primiparous) of infants with an average age of 2.5 months (SD = 1.32, range 0-6) completed an online survey that included a sociodemographic and obstetric form, questions about the perceived emotional impact of the pandemic, the Edinburgh Postnatal Depression Scale, and the Postpartum-Specific Anxiety Scale. Results Most mothers (75.5%) were on pregnancy leave due to an obstetrical complication (45.2%), to avoid COVID-19 infection (44.8%), or both (10%). 95.9% of mothers did a COVID test before labour, but only 1.1% tested positive. Women who did not have the delivery they desired (45.2%), who were unable to be with their baby shortly after birth (14.6%), and who did not perform skin-to-skin contact (33.4%) were significantly more anxious and depressed in the postpartum than those who had the delivery they desired, contacted with their baby after birth and performed skin-to-skin contact. Women who scored above the cut-off on EPDS (37.9%) and who reported that COVID-19 had a negative emotional impact during pregnancy (77.5%) and postpartum (80.1%) presented higher levels of postpartum anxiety and depression. Interpretation/Discussion Having a baby during COVID-19 seems to have a significant impact on postpartum mothers' mental health. In addition, a positive birth experience seems to be a key factor in women's psychological adjustment. Conclusions Despite the limitations imposed by the pandemic, it is essential to promote a positive birth experience and to ensure that women in the perinatal period can obtain psychological support whenever they need it.