1
|
Johnson MS, Skjerdingstad N, Ebrahimi OV, Hoffart A, Johnson SU. Fear of giving birth alone: Experiences of psychological distress, symptoms of anxiety and depression, and coping- strategies of childbearing women during COVID-19. Midwifery 2024; 131:103951. [PMID: 38402661 DOI: 10.1016/j.midw.2024.103951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 12/23/2023] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Psychological distress during pregnancy is a well-documented risk factor for adverse maternal outcomes. Distress related to the COVID-19 pandemic may further increase the vulnerability of pregnant women to negative mental health outcomes. AIM To explore the mental health experiences of pregnant women, focusing on mental health outcomes, challenges related to the pandemic, coping strategies, and factors buffering mental health factors during the restricted COVID-19 lockdown period. METHODS A mixed-methods survey study was conducted, examining symptoms of anxiety, depression, and burnout among 21 pregnant women. Qualitative data were gathered through open-ended questions about participants' experiences of challenges, coping strategies and buffering factors amid the pandemic. Symptoms of anxiety, depression and burnout were calculated, and qualitative data was thematically analyzed. RESULTS Approximately one-third (24 %) of the respondents reported clinically significant levels of depression, 19 % reported clinically significant levels of anxiety, and 43 % reported experiencing burnout. All participants reported distress and emotional burden, including fear, worry, stress and anxiety related to the pandemic. Specific concerns such as fear of giving birth alone, fear of the consequences due to lockdown restrictions, insufficient information, disruption of prenatal healthcare services, and fear of miscarriage were prevalent among the participants. Social support, financial stability, stable relationships, adherence to daily routines, reduced stress and social demands, a calmer daily life, physical activity, and less work-related stress including working from home, emerges as buffering factors that aided women in coping with pandemic-related distress. CONCLUSION Healthcare providers should prioritize stability, predictability, and minimizing disruptions to prenatal care. Broad-based screening is crucial to identify women at risk of depression, anxiety, and burnout. Recommendations for clinical pathways aimed at pregnant women are discussed.
Collapse
Affiliation(s)
- Miriam S Johnson
- Department of Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.
| | | | - Omid V Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| |
Collapse
|
2
|
Allegri B, Brenna V, Confalonieri L, Puzzini A, Nichelatti M, Piccinini G, Mazza U, Percudani ME. The impact of the second COVID-19 lockdown on anxiety and depressive symptoms in pregnant women: A case study of pregnant women in northern Italy. Brain Behav Immun Health 2023; 30:100633. [PMID: 37206958 PMCID: PMC10182657 DOI: 10.1016/j.bbih.2023.100633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/21/2023] Open
Abstract
Background the different lockdown phases due to COVID-19 may have negatively impacted pregnant women's mental health. Concerning antenatal stress, most studies focused more on the effect of pandemic onset than on the impact of the following phases and restrictions. Aim the present study aimed to assess levels of anxiety and depression in a group of Italian pregnant women during the second COVID-19 phase and possible risk factors. Method We recruited 156 pregnant women through our Perinatal Psychology Outpatient Clinic. We divided the sample into women recruited before the pandemic (N = 88) through a face-to-face antenatal class and pregnant women recruited during the second lockdown (Covid-19 study group) (November 2020-April 2021) through the same antenatal class via Skype (N = 68). To investigate depressive and anxiety symptoms, we administered the Edinburgh Postnatal Depression Scale (EPDS) and the State and Trait Anxiety Inventory (STAI-Y) scales; women's medical history and obstetric data were collected. Findings women belonging to the Covid-19 study group reported higher depressive and anxious levels than the pre-pandemic group. Moreover, during the second lockdown previous psychopathology and being close to childbirth were related to increased depression; a history of abortion was related to higher levels of trait anxiety instead. Conclusion recurrent restrictive measures due to COVID-19 negatively affected the antenatal mental well-being of pregnant women, particularly worsening depressive and anxious feelings. Pregnant women during the pandemic represented a vulnerable population to be monitored more closely and timely to prevent psychological problems in the postpartum period and their consequences on the child. Keywords anxiety, depression, pregnancy, COVID-19, mental health, lockdown.
Collapse
Affiliation(s)
- Beatrice Allegri
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Valeria Brenna
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Linda Confalonieri
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Alessandra Puzzini
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Michele Nichelatti
- Biostatistics Service, Department of Hematology, Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Gianluca Piccinini
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Umberto Mazza
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Mauro Emilio Percudani
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| |
Collapse
|
3
|
Huynh T, Boise C, Kihntopf ME, Schaefer AA, Schafer M. "Fear and anxiety is what I recall the best.": A phenomenological examination of mothers' pregnancy experiences during COVID-19 in the United States. Midwifery 2023; 122:103700. [PMID: 37099827 PMCID: PMC10112943 DOI: 10.1016/j.midw.2023.103700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVE The purpose of this phenomenological study is to understand mothers' lived pregnancy experiences during the COVID-19 pandemic. DESIGN A qualitative, phenomenological study SETTING: Participants completed the demographic survey online and semi-structured interviews, via video conferencing between November and December 2021 PARTICIPANTS: A sample of 28 mothers who were pregnant during the COVID-19 pandemic participated in the study. METHODS AND RESULTS An inductive, thematic approach was used to analyze the data. Two central themes and eight subthemes emerged from the six-phase thematic analysis. The first central theme, Depth of Knowledge About COVID-19, included the following subthemes: 1) Vaccines and 2) Uncertainty for Exposure. The second central theme, Impacts of COVID-19, had six subthemes: 1) Types of Support Received, 2) COVID-19 Restrictions, 3) Childcare, 4) Mental Health, 5) Spending More Time at Home, and 6) Isolation. CONCLUSIONS Findings of this study revealed mothers experienced a significant amount of stress and anxiety related to the coronavirus pandemic during their pregnancy. IMPLICATIONS FOR PRACTICE Our findings highlight the need to provide pregnant mothers comprehensive care, including mental health services, adequate access to social support, and providing clear information regarding COVID-19 vaccination and its impacts on pregnancy.
Collapse
Affiliation(s)
- Tuyen Huynh
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
| | | | | | | | - Morgan Schafer
- University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
4
|
Lalor JG, Sheaf G, Mulligan A, Ohaja M, Clive A, Murphy-Tighe S, Ng ED, Shorey S. Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review. Women Birth 2023; 36:e203-e212. [PMID: 35973917 PMCID: PMC9364727 DOI: 10.1016/j.wombi.2022.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, pregnant women were identified as a high-risk and vulnerable group. To reduce risk of transmission, maternity healthcare services were modified to limit exposure but maintain services for pregnant women. However, the change in hospital practice may have compromised quality maternal care standards. Therefore, this review aims to explore parental experiences and views with maternity care received from healthcare institutions during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. Six electronic databases (Medline, CINAHL, Embase, PsycInfo, Web of Science, and Maternity and Infant Care) were searched for qualitative, observational, and mixed method studies from the year 2019 to February 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Quantitative findings were converted to narrative findings. Data was synthesised thematically using a convergent synthesis design. RESULTS Fifty-eight articles were included. Four themes were generated: (1) Distress associated with COVID-19 regulations (perception of hospital restrictions, confusion with ever changing policies), (2) adaptability with maternity services (prenatal: changes in birth plans, prenatal: altered antenatal appointments, education, and care, intrapartum: medicalization of birth, postpartum: varied views on care received and Breastfeeding woes, postpartum: skin-to-skin contact and mother infant bonding) (3) importance of support persons, and (4) future direction for maternity services. CONCLUSIONS Parental experiences highlighted how maternity care during the COVID-19 pandemic did not adhere to WHO standards of quality maternity care. This calls for healthcare institutions to continuously appraise the implementation of restrictive practices that deviate from evidence-based frameworks underpinning quality care.
Collapse
Affiliation(s)
- Joan Gabrielle Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin 2, Ireland
| | - Andrea Mulligan
- School of Law, Trinity College Dublin, House 39, New Square, Dublin 2, Ireland
| | - Magdalena Ohaja
- School of Nursing and Midwifery, National University of Ireland Galway, Ireland
| | - Ashamole Clive
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | | | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore.
| |
Collapse
|
5
|
Colaceci S, Anderson G, Ricciuto V, Montinaro D, Alazraki G, Mena-Tudela D. Experiences of Birth during COVID-19 Pandemic in Italy and Spain: A Thematic Analysis. Int J Environ Res Public Health 2022; 19:ijerph19127488. [PMID: 35742741 PMCID: PMC9223415 DOI: 10.3390/ijerph19127488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 12/02/2022]
Abstract
Becoming parents during the pandemic of coronavirus disease 2019 (COVID-19) has been a challenge. The purpose of this study was to describe the impact of the pandemic on new and expectant parents in both Italy and Spain. A descriptive qualitative study was carried out by collecting social media posts written by parents between March 2020 and April 2021. The posts were inserted in a data collection form and assessed separately by two authors. The coding was performed manually using the long table analysis method and a thematic analysis was performed. Three main themes were identified: (1) care; (2) overcoming difficulties and problem-solving strategies; and (3) legislation and anti-COVID-19 measures. The main issues for parents were the limited access of partners to antenatal care services and mother–newborn separation. Due to restrictive measures, many parents adopted different coping skills. Some hospitals were able to maintain high standards of care; however, a lot of discretion in legislation and the application of anti-COVID-19 measures in healthcare services was perceived by parents. The COVID-19 pandemic has heavily affected the way parents experienced pregnancy and birth. Becoming parents during the pandemic has exacerbated some fears that usually characterize this event, but it has also triggered new ones, especially in the first months.
Collapse
Affiliation(s)
- Sofia Colaceci
- Department Faculty of Medicine and Surgery, Saint Camillus International University (UniCamillus), Via di Sant’Alessandro 8, 00131 Rome, Italy;
- Correspondence: ; Tel.: +39-06-400640
| | - Gloria Anderson
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy;
| | - Veronica Ricciuto
- Department Faculty of Medicine and Surgery, Saint Camillus International University (UniCamillus), Via di Sant’Alessandro 8, 00131 Rome, Italy;
| | - Denise Montinaro
- Associazione Rinascere al Naturale, Via Umberto I, n. 42, 73021 Calimera, Italy;
| | | | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, Avenida de Vicent Sos Baynat, s/n, 12071 Castellón de la Plana, Spain;
| |
Collapse
|
6
|
Affiliation(s)
- Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| |
Collapse
|
7
|
Wells MB, Svahn J, Svedlind K, Andersson E. A qualitative study of Swedish fathers’ experiences of becoming a father during the COVID-19 pandemic. Eur J Midwifery 2022; 6:15. [PMID: 35434537 PMCID: PMC8951515 DOI: 10.18332/ejm/146082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/03/2022] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Expectant fathers want to participate in perinatal care. COVID-19 policies restrict their access to care, but it is unknown how these policies have affected them. The aim of this study is to explore the perinatal care given to and wanted by expectant and new fathers during the COVID-19 pandemic in Sweden. METHODS The current study used an inductive qualitative design where 14 expectant or new fathers participated in a video- or telephone-based semi-structured interview. Interviews lasted 20 minutes, on average. The collected data were analyzed using content analysis. RESULTS Two main themes were reported: 1) ‘Being left out, but trying to remain positive’, and 2) immediate consequences related to restrictions. Expectant fathers were not able to attend as many perinatal visits as they wanted to, due to the COVID-19 restrictions on non-birthing parents. Expectant fathers regretted and felt discouraged that they could not support their partner during visits and not follow their baby’s growth and development. Furthermore, they faced uncertainties and stress regarding whether or not they could attend the birth of their child. Fathers reported how their exclusion negatively impacted the entire family. CONCLUSIONS Expectant and new fathers felt that their level of participation in prenatal care was negatively impacted by the Swedish policies imposed on them during the COVID-19 pandemic. Fathers were physically and emotionally excluded, resulting in receiving little direct care support, and lacked companionship with other parents. Fathers provided suggestions and alternatives on how to increase their participation with individual midwives and from an organizational level.
Collapse
Affiliation(s)
- Michael B. Wells
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Joline Svahn
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Karolina Svedlind
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Ewa Andersson
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
8
|
Schmiedhofer M, Derksen C, Dietl JE, Häussler F, Louwen F, Hüner B, Reister F, Strametz R, Lippke S. Birthing under the Condition of the COVID-19 Pandemic in Germany: Interviews with Mothers, Partners, and Obstetric Health Care Workers. Int J Environ Res Public Health 2022; 19:ijerph19031486. [PMID: 35162509 PMCID: PMC8835455 DOI: 10.3390/ijerph19031486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic and the necessary containment measures challenge obstetric care. Support persons were excluded while protection measures burdened and disrupted the professionals' ability to care and communicate. The objective of this study was to explore the first-hand experience of the impact of the COVID-19 pandemic on mothers, their partners, and obstetric professionals regarding birth and obstetric care in a university hospital. METHODS To answer the descriptive research questions, we conducted a qualitative content analysis using a data triangulation approach. We carried out 35 semi-structured interviews with two stratified purposive samples. Sample one consisted of 25 mothers who had given birth during the pandemic and five partners. Sample two included 10 obstetric professionals whose insights complemented the research findings and contributed to data validation. Participants were recruited from the study sample of a larger project on patient safety from two German university hospitals from February to August 2021. The study was approved by two ethics committees and informed consent was obtained. RESULTS Mothers complied with the rules, but felt socially isolated and insecure, especially before transfer to the delivery room. The staff equally reported burdens from their professional perspective: They tried to make up for the lack of partner and social contacts but could not live up to their usual professional standards. The exclusion of partners was seen critically, but necessary to contain the pandemic. The undisturbed time for bonding in the maternity ward was considered positive by both mothers and professionals. CONCLUSION The negative effects of risk mitigation measures on childbirth are to be considered carefully when containment measures are applied.
Collapse
Affiliation(s)
- Martina Schmiedhofer
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
- Correspondence:
| | - Christina Derksen
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
| | - Johanna Elisa Dietl
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
| | - Freya Häussler
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
| | - Frank Louwen
- Department of Gynecology and Obstetrics, Division of Obstetrics and Prenatal Medicine, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany;
| | - Beate Hüner
- Department of Gynecology and Obstetrics, University Hospital Ulm, 89070 Ulm, Germany; (B.H.); (F.R.)
| | - Frank Reister
- Department of Gynecology and Obstetrics, University Hospital Ulm, 89070 Ulm, Germany; (B.H.); (F.R.)
| | - Reinhard Strametz
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
- Wiesbaden Business School, Rhein Main University of Applied Science, 65183 Wiesbaden, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
| |
Collapse
|