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Brand RJ, Gartland CA. Basic psychological needs: A framework for understanding childbirth satisfaction. Birth 2024; 51:395-404. [PMID: 37997653 DOI: 10.1111/birt.12795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023]
Abstract
Women often report being dissatisfied with their childbirth experience, which in turn predicts negative outcomes for themselves and their children. Currently, there is no consensus as to what constitutes a satisfying or positive birth experience. We posit that a useful framework for addressing this question already exists in the form of Basic Psychological Needs Theory, a subtheory of Self-Determination Theory (Deci & Ryan, Can. Psychol., 49, 2008, 182). Specifically, we argue that the degree to which maternity care practitioners support or frustrate women's needs for relatedness, competence, and autonomy predicts their childbirth satisfaction. Using this framework provides a potentially powerful lens to better understand and improve the well-being of new mothers and their infants.
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Iobst SE, Breman RB, Black H, Edmonds JK. Nurses' Perceived Effects of Visitor Restrictions in Hospital Maternity Units. MCN Am J Matern Child Nurs 2024:00005721-990000000-00050. [PMID: 38512154 DOI: 10.1097/nmc.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE To explore how perinatal nurses perceive the effects of visitor restrictions on patient care within a hospital setting. STUDY DESIGN AND METHODS We distributed a cross-sectional survey online to perinatal nurses in May of 2022. Characteristics of respondents were analyzed using descriptive statistics. Responses to an open-ended question were analyzed via conventional content analysis. RESULTS Among our sample of 101 nurses, we identified seven codes representing positive effects and seven codes representing negative effects. The most frequently reported positive effects were ability to provide person-centered care (n = 36, 35.6%) and less patient stress and more rest (n = 29, 28.7%). The most frequently reported negative effects were limited patient support (n = 22, 21.8%) and emotional distress to the patient (n = 15, 14.9%). Fourteen percent (n = 14) of respondents cited both positive and negative effects. CLINICAL IMPLICATIONS Nurses perceived that visitor restrictions resulted in both positive and negative patient experiences. Balancing clinical needs and safety considerations with emotional needs of the childbearing individual requires careful consideration by maternity care clinicians and health care systems. Subsequent research is needed to determine optimal visitation policies during intrapartum and postpartum with consideration to hospital context and patient preferences for optimal care.
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Caffieri A, Gómez‐Gómez I, Barquero‐Jimenez C, De‐Juan‐Iglesias P, Margherita G, Motrico E. Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: An umbrella review and meta-analytic synthesis. Acta Obstet Gynecol Scand 2024; 103:210-224. [PMID: 38113292 PMCID: PMC10823409 DOI: 10.1111/aogs.14740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION The prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID-19 pandemic was assessed by several systematic reviews (SRs) and meta-analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID-19 pandemic. MATERIAL AND METHODS An umbrella review of SRs and meta-analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta-analyses reporting the prevalence of perinatal anxiety and depression during the COVID-19 pandemic were selected for eligibility. Primary studies extracted from eligible meta-analyses were included in the quantitative synthesis. The research protocol was registered on PROSPERO (CRD42020173125). RESULTS A total of 25 SRs (198 primary studies) and 12 meta-analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n = 55; 95% CI: 25%-33%) and 26% (n = 54; 95% CI: 23%-30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n = 44; 95% CI: 26%-37%; n = 16; 95% CI: 24%-39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium-high quality of the studies was observed. One SR assessed strength-of-evidence, reporting very low strength. CONCLUSIONS During the COVID-19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut-offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID-19 pandemic was the main factor that directly increased perinatal depression and anxiety during the past few years. Future studies should study other factors' impact.
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Affiliation(s)
- Alessia Caffieri
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | | | | | | | - Giorgia Margherita
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | - Emma Motrico
- Department of PsychologyUniversidad Loyola AndalucíaSevilleSpain
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Palgi-Hacker H, Sacks E, Landry M. Respectful maternity care in Israel during the Covid-19 pandemic: a cross-sectional study of associations between childbirth care practices and women's perceptions of care. BMC Pregnancy Childbirth 2024; 24:50. [PMID: 38200458 PMCID: PMC10777588 DOI: 10.1186/s12884-023-06030-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/26/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Respectful maternity care is a crucial part of quality care and is associated with better health outcomes. Early in the Covid-19 pandemic, reports from across the world indicated that infection containment measures were often implemented in ways that resulted in disrespectful care of women during facility-based childbirths in violation of evidence-based practices. This study aimed to explore the associations between childbirth care practices and perceptions of care as satisfactory and respectful among women who delivered in Israeli hospitals during the first six months of the Covid-19 pandemic. METHODS A cross-sectional self-administered online survey was conducted to explore women's perceptions of maternity care using an adapted version of the WHO Community Survey Tool for measuring how women are treated during facility-based childbirth. Multivariate logistic regression models evaluated the associations between sociodemographic characteristics, obstetric information, and measurements of childbirth experiences and women's perceptions of receiving respectful and satisfactory care. RESULTS The responses of 981 women were included in the analysis. While the majority of women perceived the care they received as both respectful (86.54%) and satisfactory (80.22%), almost 3 in 4 women (72.68%) reported experiencing at least one type of disrespectful care. Positive communication with the medical staff and respect for autonomy were associated with a more positive birth experience for women. Women were more likely to perceive their care as respectful if they did not feel ignored (AOR = 40.11;22.87-70.34). Perception of satisfactory care was more likely among women who had the opportunity to discuss preferences with the medical staff (AOR = 10.15; 6.93-14.86). Having Covid-19 procedures explained increased the likelihood of reporting respectful and satisfactory care (AOR = 2.89;1.91-4.36; AOR = 2.83;2.01-4). CONCLUSION Understanding which care practices are associated with women's perceptions of care at facility-based births is critical to ensuring quality care. The findings of this study can inform future work and research aimed at enhancing respectful maternity care during times of crisis and beyond.
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Affiliation(s)
- Hagar Palgi-Hacker
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C, 20052, USA.
| | - Emma Sacks
- Department of International Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, E8011, Baltimore, MD, 21205, USA
| | - Megan Landry
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C, 20052, USA
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Holdren S, Crook L, Lyerly A. Birth setting decisions during COVID-19: A comparative qualitative study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227363. [PMID: 38282515 PMCID: PMC10826375 DOI: 10.1177/17455057241227363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The COVID-19 pandemic resulted in an increased number of out-of-hospital births in the United States and other nations. While many studies have sought to understand the experiences of pregnant and birthing people during this time, few have compared experiences across birth locations. OBJECTIVE The purpose of this study is to compare the narratives and decision-making processes of those who gave birth in and out of hospitals during the pandemic. DESIGN We conducted semi-structured narrative interviews with 24 women who gave birth during the COVID-19 pandemic. METHODS Interviews were transcribed and coded, and a thematic narrative analysis was employed. Final themes and exemplary quotes were determined in discussion among the research team. RESULTS Results from narrative analysis revealed three themes that played into participants' birth location decisions: (1) birth efficacy and values, (2) diverse definitions of safety, and (3) childcare and other logistics. In each of these themes, participants who gave birth in birthing centers, at the hospital, and at home describe their individualized approach to achieving a supportive birth environment while mitigating the risk of labor complications and COVID-19 infection. CONCLUSION Our study suggests that for some childbearing people, the pandemic did not change birthing values or decisions but rather brought enhanced clarity to their individual needs during birth and perceived risks, benefits, and limitations of each birthing space. This study further highlights the need for improved structural support for birthing people to access a range of safe and supportive birthing environments.
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Affiliation(s)
- Sarah Holdren
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Laura Crook
- Department of English and Comparative Literature, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anne Lyerly
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Hicks LE. Multiple Case Study Exploring the Impact of Visitor Restrictions in Hospitals on Childbirth Support during the COVID-19 Pandemic. REPRODUCTIVE, FEMALE AND CHILD HEALTH 2023; 2:271-278. [PMID: 38188699 PMCID: PMC10768814 DOI: 10.1002/rfc2.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/07/2023] [Indexed: 01/09/2024]
Abstract
Objective Childbirth is a life-changing experience for new mothers, birth partners, and families. The COVID-19 pandemic restricted laboring mothers' access to support in hospitals through visitor restrictions. The goal of this research was to describe childbirth support in hospitals during the COVID-19 pandemic. Methods A qualitative study using a multiple case study design describes childbirth support in hospitals during the COVID-19 pandemic from the perspectives of the new mother, birth partner, and obstetric hospital staff, including doulas, nurses, and obstetric providers. The setting was a large metropolitan area in South Texas. Sixteen participants were interviewed including four new mothers, three birth partners, three doulas, three obstetric nurses, and three obstetric providers. Results Themes that emerged from the data include: under a spotlight, unmet expectations, discovering serenity, and quality childbirth support. Conclusion During the pandemic, new mothers and birth partners experienced fewer distractions, better communication with the hospital staff, and had better opportunities to bond with the newborn during labor and after birth, but did report missing the presence of their family and friends. Doulas, obstetric nurses, and obstetric providers found they were able to provide better quality and safer care to laboring mothers and birth partners.
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Affiliation(s)
- Lauren E Hicks
- The University of North Carolina at Chapel Hill, North Carolina, 120 N. Medical Dr., #3601, Chapel Hill, North Carolina, 27514
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Silva-Fernandez CS, de la Calle M, Arribas SM, Garrosa E, Ramiro-Cortijo D. Factors Associated with Obstetric Violence Implicated in the Development of Postpartum Depression and Post-Traumatic Stress Disorder: A Systematic Review. NURSING REPORTS 2023; 13:1553-1576. [PMID: 37987409 PMCID: PMC10661273 DOI: 10.3390/nursrep13040130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
Postpartum depression (PPD) and post-traumatic stress disorder (PTSD) continue to be prevalent, and disabling women with mental disorders and obstetric violence (OV) may be a trigger for them, particularly during maternity. We aimed to analyze the association between manifestations of OV with the development of PPD and PTSD during pregnancy, childbirth, and postpartum. This systematic review was based on the PRISMA 2020 statement and explored original articles published between 2012 and 2022. A total of 21 articles were included in the analysis, and bias was assessed by the Effective Public Health Practice Project's Quality Assessment Tool. The highest rate of PPD symptoms appeared in women under 20 years old, multiparous, and with low education levels. The higher PTSD ratio was present in women under 35 years, primiparous, and with secondary studies. The mode of labor (instrumental or C-section) was identified as a major risk factor of PPD, being mediator variables of the informal coercion of health professionals and dissatisfaction with newborn healthcare. Instead, partner support during labor and high satisfaction with healthcare during birth were protective factors. Regarding PTSD, the mode of labor, several perineal tears, and the Kristeller technique were risk factors, and loss of autonomy and coercion modulated PTSD symptomatology. The protective factors for PTSD were respect for the labor plan, adequate communication with health professionals, social support during labor, and the skin-to-skin procedure. This systematic review provides evidence that OV contributes to PPD and PTSD, being important in developing standardized tools to prevent it. This study recommends changes in maternal healthcare policies, such as individualized healthcare assistance, humanized pregnancy protocols, and women's mental health follow-up, and improvements in the methodological quality of future research.
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Affiliation(s)
- Claudia Susana Silva-Fernandez
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
| | - Maria de la Calle
- Obstetric and Gynecology Service, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - Eva Garrosa
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
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Rao L, Rocca CH, Muñoz I, Chambers BD, Devaskar S, Asiodu IV, Stern L, Blum M, Comfort AB, Harper CC. "She should support me, she's my doctor:" Patient perceptions of agency in contraceptive decision-making in the clinical encounter in Northern California. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2023; 55:94-103. [PMID: 37216964 PMCID: PMC10537387 DOI: 10.1363/psrh.12226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Agency in contraceptive decision-making is an essential aspect of reproductive autonomy. We conducted qualitative research to investigate what agency means to patients seeking contraceptive care to inform the development of a validated measure of this construct. METHODOLOGY We held four focus group discussions and seven interviews with sexually-active individuals assigned female at birth, ages 16-29 years, recruited from reproductive health clinics in Northern California. We explored experiences in contraceptive decision-making during the clinic visit. We coded data in ATLAS.ti and by hand, compared codes across three coders, and used thematic analysis to identify salient themes. RESULTS The sample mean age was 21 years, with 17% of participants identifying as Asian, 23% as Black, 27% as Latinx, 17% as Multiracial/other, and 27% as white. Overall, participants reported active and engaged decision-making in their recent contraceptive visit but noted experiences that had undermined their agency in the past. They described how non-judgmental care allowed them to communicate openly, affirming their ability to make their own decisions. However, several mentioned how unexpected contraceptive side effects after the visit had reduced their sense of agency over their decision in retrospect. Several participants, including those who identified as Black, Latinx, and/or Asian, described prior experiences where pressure to use a contraceptive method had undermined their agency and where they had switched providers to regain agency over their contraceptive decisions. DISCUSSION Most participants were aware of their agency during contraceptive visits and how it varied in different experiences with providers and the healthcare system. Patient perspectives can help to inform measurement development and ultimately the delivery of care that supports contraceptive agency.
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Affiliation(s)
- Lavanya Rao
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Corinne H. Rocca
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA
- Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Isabel Muñoz
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA
- Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Brittany D. Chambers
- Department of Human Ecology, University of California, Davis, School of Agricultural and Environmental Sciences, Davis, California, USA
| | - Sangita Devaskar
- Planned Parenthood Northern California, Santa Rosa, California, USA
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Lisa Stern
- Coalition to Expand Contraceptive Access (CECA), San Francisco, California, USA
| | - Maya Blum
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Alison B. Comfort
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Cynthia C. Harper
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA
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Gong J, Fellmeth G, Quigley MA, Gale C, Stein A, Alderdice F, Harrison S. Prevalence and risk factors for postnatal mental health problems in mothers of infants admitted to neonatal care: analysis of two population-based surveys in England. BMC Pregnancy Childbirth 2023; 23:370. [PMID: 37217846 PMCID: PMC10201804 DOI: 10.1186/s12884-023-05684-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/07/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Previous research suggests that mothers whose infants are admitted to neonatal units (NNU) experience higher rates of mental health problems compared to the general perinatal population. This study examined the prevalence and factors associated with postnatal depression, anxiety, post-traumatic stress (PTS), and comorbidity of these mental health problems for mothers of infants admitted to NNU, six months after childbirth. METHODS This was a secondary analysis of two cross-sectional, population-based National Maternity Surveys in England in 2018 and 2020. Postnatal depression, anxiety, and PTS were assessed using standardised measures. Associations between sociodemographic, pregnancy- and birth-related factors and postnatal depression, anxiety, PTS, and comorbidity of these mental health problems were explored using modified Poisson regression and multinomial logistic regression. RESULTS Eight thousand five hundred thirty-nine women were included in the analysis, of whom 935 were mothers of infants admitted to NNU. Prevalence of postnatal mental health problems among mothers of infants admitted to NNU was 23.7% (95%CI: 20.6-27.2) for depression, 16.0% (95%CI: 13.4-19.0) for anxiety, 14.6% (95%CI: 12.2-17.5) for PTS, 8.2% (95%CI: 6.5-10.3) for two comorbid mental health problems, and 7.5% (95%CI: 5.7-10.0) for three comorbid mental health problems six months after giving birth. These rates were consistently higher compared to mothers whose infants were not admitted to NNU (19.3% (95%CI: 18.3-20.4) for depression, 14.0% (95%CI: 13.1-15.0) for anxiety, 10.3% (95%CI: 9.5-11.1) for PTS, 8.5% (95%CI: 7.8-9.3) for two comorbid mental health problems, and 4.2% (95%CI: 3.6-4.8) for three comorbid mental health problems six months after giving birth. Among mothers of infants admitted to NNU (N = 935), the strongest risk factors for mental health problems were having a long-term mental health problem and antenatal anxiety, while social support and satisfaction with birth were protective. CONCLUSIONS Prevalence of postnatal mental health problems was higher in mothers of infants admitted to NNU, compared to mothers of infants not admitted to NNU six months after giving birth. Experiencing previous mental health problems increased the risk of postnatal depression, anxiety, and PTS whereas social support and satisfaction with birth were protective. The findings highlight the importance of routine and repeated mental health assessments and ongoing support for mothers of infants admitted to NNU.
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Affiliation(s)
- Jenny Gong
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, UK
| | - Gracia Fellmeth
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, UK
| | - Maria A Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, 369 Fulham Road, London, UK
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- African Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, UK
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, UK.
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Goyal D, Dol J, Leckey M, Naraine S, Dennis CL, Chan EK, Basu G. Scoping Review of Racial and Ethnic Representation of Participants in Mental Health Research Conducted in the Perinatal Period During the COVID-19 Pandemic. J Obstet Gynecol Neonatal Nurs 2023; 52:117-127. [PMID: 36462529 PMCID: PMC9710717 DOI: 10.1016/j.jogn.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To identify the racial and ethnic representation of participants in mental health research conducted in the perinatal period during the COVID-19 pandemic. DATA SOURCES MEDLINE, CINAHL, Cochrane Library, PsycINFO, Scopus, Web of Science. STUDY SELECTION We included peer-reviewed research articles in which researchers reported mental health outcomes of women during the perinatal period who were living in the United States or Canada during the COVID-19 pandemic. We included 25 articles in the final review. DATA EXTRACTION We extracted the citation, publication date, design, aim, country of origin, participant characteristics, sampling method, method of measurement of race and ethnicity, and mental health outcome(s). DATA SYNTHESIS The combined racial and ethnic representation of the 16,841 participants in the included studies was White (76.5%), Black (9.8%), other/multiracial (6.2%), Asian (3.9%), Hispanic/Latina (2.6%), Indigenous or Ethnic Minority Canadian (0.9%), and Native American or Alaska Native (0.1%). Most studies were conducted in the United States, used a cross-sectional design, and incorporated social media platforms to recruit participants. Depression, anxiety, and stress were the most frequently assessed mental health outcomes. CONCLUSION Relatively few women of color who were pregnant or in the postpartum period during the pandemic participated in mental health research studies. Future studies should develop intentional recruitment strategies to increase participation of women of color. Researchers should use updated guidance on reporting race and ethnicity to accurately represent every participant, minimize misclassification of women of color, and report meaningful results.
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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12
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Wouk K, Parry KC, Bridgman J, Palmquist AEL, Perkins M, Smetana A, Woods-Barr A, Sullivan CS. Evaluation of an Evidence-Based Prenatal Breastfeeding Education Curriculum Adapted for the COVID-19 Pandemic: Ready, Set, Baby Live COVID-19 Edition. J Perinat Educ 2023; 32:48-66. [PMID: 36632514 PMCID: PMC9822560 DOI: 10.1891/jpe-2021-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In response to the cessation of in-person prenatal education services during the COVID-19 pandemic, we adapted an evidence-based curriculum to a live virtual format entitled Ready, Set, Baby Live COVID-19 Edition (RSB Live). In a sample of 146 pregnant people, participation in RSB Live was associated with high levels of knowledge about the benefits of breastfeeding, early infant hunger cues, and recommended maternity care practices, as well as high levels of satisfaction with adaptations to the session's content and virtual delivery. Participation was also associated with a significant increase in prenatal breastfeeding intention, a known predictor of breastfeeding outcomes. This study supports live, virtual education with a standardized curriculum as an effective and acceptable means of providing prenatal education.
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13
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Jacob A, Thomas T, Antretter J. Perceptions of Postpartum Mothers of Their Experiences as a Patient During COVID-19 Crisis: A Phenomenological Study. J Patient Exp 2022; 9:23743735221147761. [PMID: 36601327 PMCID: PMC9806370 DOI: 10.1177/23743735221147761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19) pandemic led to drastic changes in in-hospital healthcare delivery causing major policy and protocol changes regarding labor and delivery and postpartum care of maternity patients. We strove to describe and understand the perceptions of laboring and postpartum mothers' care received through interviews in a hospital during the COVID-19 pandemic. Using a phenomenological study design, we interviewed 13 postpartum mothers. Five major themes and 10 subthemes were extracted. Major themes, both positive and negative, included genuine concern of caregivers, adverse breastfeeding experiences, feeling of being left alone, loss of expectations, and uncertainty. Primipara women had a major impact on their psychological well-being and breastfeeding experiences. Isolation and feelings of left alone adversely affect postpartum mothers' coping, newborn care, bonding, meeting basic needs of sleep and hygiene, breastfeeding experiences, and potential postpartum recovery and psychosocial well-being including fear of future pregnancies. Therefore, "partner presence" throughout the labor and delivery and postpartum period should be a "call to action" for the nurses, especially with first-time mothers.
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Affiliation(s)
- Ani Jacob
- Office of Chief Nurse Executive, Northwell Health, Lake Success, NY, USA,Adelphi University, Garden City, NY, USA,Ani Jacob, Institute for Nursing, Office of
the Chief Nurse Executive, Northwell Health 1111 Marcus Ave, New Hyde Park,
NY-11042, USA.
| | - Tesi Thomas
- North Shore University Hospital, Northwell Health, Manhasset, NY, USA
| | - Jessica Antretter
- Katz Women’s Hospital, North Shore University Hospital, Northwell Health, Manhasset, NY, USA
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14
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Suarez A, Yakupova V. The impacts of the COVID-19 pandemic on birth satisfaction and birth experiences in Russian women. Front Glob Womens Health 2022; 3:1040879. [PMID: 36619591 PMCID: PMC9810808 DOI: 10.3389/fgwh.2022.1040879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Women's satisfaction with their childbirth experiences has significant impacts on their health and the health of their children. Recently, childbirth and maternity care systems have been disrupted by the COVID-19 pandemic. This study aimed to investigate the association of birth satisfaction with mode of birth, medical interventions, support during labour, type of childbirth healthcare plan and antenatal education in the context of the COVID-19 pandemic in Russia. Methods 1,645 Russian women who gave birth during the first year of the COVID-19 pandemic and 611 matched controls who gave birth in the previous year participated in an anonymous Internet survey about their childbirth experience. The survey included questions regarding women's demographic and obstetric characteristics as well as their childbirth experiences. Birth satisfaction was measured using the Birth Satisfaction Scale Revised Indicator (BSS-RI). Results Birth satisfaction scores did not show notable changes before and during the pandemic (Pearson Chi-square = 19.7, p = 0.22). Women had lower BSS-RI scores if they tested positive for COVID-19 during labour (F = 9.18, p = 0.002), but not during pregnancy or postpartum (p > 0.32). In both cohorts women who had vaginal births rated birth satisfaction higher than those who had caesarean births. The more medical interventions there were, the lower were the BSS-RI scores (B = -0.234, 95% CI: -0.760; -0.506, p < 0.001), but only during the pandemic. Birth satisfaction was higher if women had a support person present during labour (F > 7.44, p < 0.001), which was not possible for over 70% of participants during the pandemic. In both cohorts birth satisfaction was associated with the childbirth healthcare plan (F > 5.27, p < 0.001), but not with antenatal education (F < 0.15, p > 0.43). Conclusions Our study highlights the significant impacts of the COVID-19 pandemic on the birth experiences of Russian women. Sustaining the rights of women to informed decisions during labour, respect for their preferred childbirth healthcare plan, presence of the birth team of choice and professional support for home birth are essential for higher birth satisfaction and better health outcomes for mothers and their infants.
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15
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van den Berg LMM, Akooji N, Thomson G, de Jonge A, Balaam MC, Topalidou A, Downe S. Making maternity and neonatal care personalised in the COVID-19 pandemic: Results from the Babies Born Better survey in the UK and the Netherlands. PLoS One 2022; 17:e0267415. [PMID: 36449488 PMCID: PMC9710753 DOI: 10.1371/journal.pone.0267415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic had a severe impact on women's birth experiences. To date, there are no studies that use both quantitative and qualitative data to compare women's birth experiences before and during the pandemic, across more than one country. AIM To examine women's birth experiences during the COVID-19 pandemic and to compare the experiences of women who gave birth in the United Kingdom (UK) or the Netherlands (NL) either before or during the pandemic. METHOD This study is based on analyses of quantitative and qualitative data from the online Babies Born Better survey. Responses recorded by women giving birth in the UK and the NL between June and December 2020 have been used, encompassing women who gave birth between 2017 and 2020. Quantitative data were analysed descriptively, and chi-squared tests were performed to compare women who gave birth pre- versus during pandemic and separately by country. Qualitative data was analysed by inductive thematic analysis. FINDINGS Respondents in both the UK and the NL who gave birth during the pandemic were as likely, or, if they had a self-reported above average standard of life, more likely to rate their labour and birth experience positively when compared to women who gave birth pre-pandemic. This was despite the fact that those labouring in the pandemic reported a lack of support and limits placed on freedom of choice. Two potential explanatory themes were identified in the qualitative data: respondents had lower expectations of care during the pandemic, and they appreciated the efforts of staff to give individualised care, despite the rules. CONCLUSION Our study implies that many women labouring during the COVID-19 pandemic experienced restrictions, but their experience was mitigated by staff actions. However, personalised care should not be maintained by the good will of care providers, but should be a priority in maternity care policy to benefit all service users equitably.
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Affiliation(s)
- Lauri M. M. van den Berg
- Department of Midwifery Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Naseerah Akooji
- Lancashire Clinical Trials Units, University of Central Lancashire, Preston, United Kingdom
| | - Gill Thomson
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Ank de Jonge
- Department of Midwifery Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, The Netherlands
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Amsterdam Reproduction and Development, Quality of Care, Amsterdam, The Netherlands
| | - Marie-Clare Balaam
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Anastasia Topalidou
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Soo Downe
- Faculty of Health and Care, School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
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16
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Mena-Tudela D, Iglesias-Casas S, Cervera-Gasch A, Andreu-Pejó L, González-Chordá VM, Valero-Chillerón MJ. Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15737. [PMID: 36497811 PMCID: PMC9740849 DOI: 10.3390/ijerph192315737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Catalan legislation, a pioneer in Europe, has defined obstetric violence (OV) as "preventing or hindering access to truthful information, necessary for autonomous and informed decision-making". The definition also states that OV can affect physical and mental health, as well as sexual and reproductive health. Some authors have expressed concern about an increase in OV during the SARS-CoV-2 pandemic. During the pandemic, recommendations were also openly offered on the non-establishment and/or early abandonment of breastfeeding without scientific evidence to support them. Experiencing a traumatic childbirth can influence breastfeeding outcomes. Here, we conducted a cross-sectional study using a self-administered online questionnaire. The sample consisted of women who gave birth in Spain between March 2020 and April 2021. The mean age was 34.41 (±4.23) years. Of the women, 73% were employed, 78.2% had a university education, and almost all were Caucasian. Among the subjects, 3.3% were diagnosed with SARS-CoV-2 during pregnancy and 1% were diagnosed during delivery. Some of the women (1.6%) were advised to stop breastfeeding in order to be vaccinated. Women diagnosed with SARS-CoV-2 during delivery (p = 0.048), belonging to a low social class (p = 0.031), with secondary education (p = 0.029), or who suffered obstetric violence (p < 0.001) perceived less support and that the health care providers were less inclined to resolve doubts and difficulties about breastfeeding. Breastfeeding has been significantly challenged during the pandemic. In addition to all the variables to be considered that make breastfeeding support difficult, we now probably need to add SARS-CoV-2 diagnosis and OV.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - Susana Iglesias-Casas
- Department of Obstetrics, Hospital do Salnés, Villgarcía de Aurousa, 36619 Pontevendra, Spain
| | - Agueda Cervera-Gasch
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - Laura Andreu-Pejó
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - Victor Manuel González-Chordá
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - María Jesús Valero-Chillerón
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
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17
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Risk factors & perinatal outcomes of major depression during pregnancy: A population-based cross-sectional study during 2010–2020 in two major cities of Pakistan. Ann Med Surg (Lond) 2022; 84:104941. [DOI: 10.1016/j.amsu.2022.104941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/25/2022] [Accepted: 11/12/2022] [Indexed: 11/20/2022] Open
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18
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González-Morcillo M, Tiburcio-Palos E, Cordovilla-Guardia S, Santano-Mogena E, Franco-Antonio C. Childbirth Satisfaction during the COVID-19 Pandemic in a Hospital in Southwestern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9636. [PMID: 35954992 PMCID: PMC9367768 DOI: 10.3390/ijerph19159636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
Satisfaction, in relation to care received, is a good indicator of quality of care. The objective of this study was to analyze the degree of satisfaction with childbirth and postpartum care as reported by women from one hospital in southwestern Spain during the COVID-19 pandemic. Factors that influenced care were also examined. A cross-sectional study was carried out between the months of October 2020 and February 2021. Satisfaction was measured through the COMFORTS scale, validated in Spanish. A final sample of 116 women was included in the study. The mean age was 32.08 (±4.68) years. A total of 111 (95.69%) women were satisfied or very satisfied with the care received. The median satisfaction score was higher among multiparous women (187 (199-173)) than among primiparous women (174 (193-155.50)) (p = 0.003). Differences in satisfaction were found as a function of the use of epidural analgesia, being higher among women who had planned its use but ultimately did not use it (188 (172.50-199.75)) or who planned its use and did (186 (169.50-198)) than among those who had not planned to use epidural analgesia but ultimately received it (173.50 (187.50-146.25)) or those who did not use it, as planned, before childbirth (172 (157-185)) (p = 0.020). Overall satisfaction rate between SARS-CoV-2-negative women assisted was high. Parity and use of epidural analgesia were two factors influencing satisfaction scores in our sample.
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Affiliation(s)
| | | | - Sergio Cordovilla-Guardia
- Nursing Department, Nursing and Occupational Therapy College, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
- Health and Care Research Group (GISyC), Universidad de Extremadura, 10003 Cáceres, Spain
| | - Esperanza Santano-Mogena
- Nursing Department, Nursing and Occupational Therapy College, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
- Health and Care Research Group (GISyC), Universidad de Extremadura, 10003 Cáceres, Spain
| | - Cristina Franco-Antonio
- Nursing Department, Nursing and Occupational Therapy College, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
- Health and Care Research Group (GISyC), Universidad de Extremadura, 10003 Cáceres, Spain
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19
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Wright KQ. "It changed the atmosphere surrounding the baby I did have": Making sense of reproduction during the COVID-19 pandemic. JOURNAL OF MARRIAGE AND THE FAMILY 2022; 84:1105-1128. [PMID: 35935914 PMCID: PMC9347647 DOI: 10.1111/jomf.12851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examines the schemas that women employed during the COVID-19 pandemic to make sense of their reproductive desires. BACKGROUND Existing research on reproduction during epidemics suggests that there are variable population responses to periods of long-term social uncertainty. However, less is known about how individuals make sense of maintaining or adapting their reproductive desires during periods of social upheaval. METHOD Twenty-nine women aged 25-35 from a mid-sized Midwestern county in the United States were recruited and interviewed about their experiences during the first 8 months of the COVID-19 pandemic. They were asked about their daily lived experiences and their reproductive desires during in-depth interviews. These interviews were transcribed and analyzed using thematic coding. RESULTS Participants used three normative schemas to describe their reproductive desires during the COVID-19 pandemic. Heteronormative schemas were used by many participants to articulate their commitment to a heteronormative aged-staged timeline of life events. Schemas of social support around being pregnant and giving birth were used by participants, primarily those who were currently or recently pregnant, to express grief and loss over the relational experience of having a new baby. Medicalized schemas were expressed by most participants to describe feelings of fear and risk at real or imagined encounters with medical institutions. CONCLUSION The schemas that participants used to make sense of their reproductive desires demonstrate how sense-making during a profound event that affects everyday realities allows participants to (re)articulate commitments to existing narratives that reinforce heterosexual, social, and medicalized hierarchies in reproduction.
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Affiliation(s)
- Kelsey Q. Wright
- Department of Sociology, Center for Demography and EcologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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20
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Molina RL, Tsai TC, Dai D, Soto M, Rosenthal N, Orav EJ, Figueroa JF. Comparison of Pregnancy and Birth Outcomes Before vs During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2226531. [PMID: 35960517 PMCID: PMC9375166 DOI: 10.1001/jamanetworkopen.2022.26531] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
IMPORTANCE Little is known about changes in obstetric outcomes during the COVID-19 pandemic. OBJECTIVE To assess whether obstetric outcomes and pregnancy-related complications changed during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included pregnant patients receiving care at 463 US hospitals whose information appeared in the PINC AI Healthcare Database. The relative differences in birth outcomes, pregnancy-related complications, and length of stay (LOS) during the pandemic period (March 1, 2020, to April 31, 2021) were compared with the prepandemic period (January 1, 2019, to February 28, 2020) using logistic and Poisson models, adjusting for patients' characteristics, and comorbidities and with month and hospital fixed effects. EXPOSURES COVID-19 pandemic period. MAIN OUTCOMES AND MEASURES The 3 primary outcomes were the relative change in preterm vs term births, mortality outcomes, and mode of delivery. Secondary outcomes included the relative change in pregnancy-related complications and LOS. RESULTS There were 849 544 and 805 324 pregnant patients in the prepandemic and COVID-19 pandemic periods, respectively, and there were no significant differences in patient characteristics between periods, including age (≥35 years: 153 606 [18.1%] vs 148 274 [18.4%]), race and ethnicity (eg, Hispanic patients: 145 475 [47.1%] vs 143 905 [17.9%]; White patients: 456 014 [53.7%] vs 433 668 [53.9%]), insurance type (Medicaid: 366 233 [43.1%] vs 346 331 [43.0%]), and comorbidities (all standardized mean differences <0.10). There was a 5.2% decrease in live births during the pandemic. Maternal death during delivery hospitalization increased from 5.17 to 8.69 deaths per 100 000 pregnant patients (odds ratio [OR], 1.75; 95% CI, 1.19-2.58). There were minimal changes in mode of delivery (vaginal: OR, 1.01; 95% CI, 0.996-1.02; primary cesarean: OR, 1.02; 95% CI, 1.01-1.04; vaginal birth after cesarean: OR, 0.98; 95% CI, 0.95-1.00; repeated cesarean: OR, 0.96; 95% CI, 0.95-0.97). LOS during delivery hospitalization decreased by 7% (rate ratio, 0.931; 95% CI, 0.928-0.933). Lastly, the adjusted odds of gestational hypertension (OR, 1.08; 95% CI, 1.06-1.11), obstetric hemorrhage (OR, 1.07; 95% CI, 1.04-1.10), preeclampsia (OR, 1.04; 95% CI, 1.02-1.06), and preexisting chronic hypertension (OR, 1.06; 95% CI, 1.03-1.09) increased. No significant changes in preexisting racial and ethnic disparities were observed. CONCLUSIONS AND RELEVANCE During the COVID-19 pandemic, there were increased odds of maternal death during delivery hospitalization, cardiovascular disorders, and obstetric hemorrhage. Further efforts are needed to ensure risks potentially associated with the COVID-19 pandemic do not persist beyond the current state of the pandemic.
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Affiliation(s)
- Rose L. Molina
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Thomas C. Tsai
- Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Surgery and Public Health, Boston, Massachusetts
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dannie Dai
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Mark Soto
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ning Rosenthal
- PINC AI Applied Sciences, Premier Inc, Charlotte, North Carolina
| | - E. John Orav
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jose F. Figueroa
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
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21
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Janevic T, Lieb W, Ibroci E, Lynch J, Lieber M, Molenaar NM, Rommel AS, de Witte L, Ohrn S, Carreño JM, Krammer F, Zapata LB, Snead MC, Brody RI, Jessel RH, Sestito S, Adler A, Afzal O, Gigase F, Missall R, Carrión D, Stone J, Bergink V, Dolan SM, Howell EA. The influence of structural racism, pandemic stress, and SARS-CoV-2 infection during pregnancy with adverse birth outcomes. Am J Obstet Gynecol MFM 2022; 4:100649. [PMID: 35462058 PMCID: PMC9022447 DOI: 10.1016/j.ajogmf.2022.100649] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Structural racism and pandemic-related stress from the COVID-19 pandemic may increase the risk of adverse birth outcomes. OBJECTIVE Our objective was to examine associations between neighborhood measures of structural racism and pandemic stress with 3 outcomes: SARS-CoV-2 infection, preterm birth, and delivering small-for-gestational-age newborns. Our secondary objective was to investigate the joint association of SARS-CoV-2 infection during pregnancy and neighborhood measures with preterm birth and delivering small-for-gestational-age newborns. STUDY DESIGN We analyzed data of 967 patients from a prospective cohort of pregnant persons in New York City, comprising 367 White (38%), 169 Black (17%), 293 Latina (30%), and 87 Asian persons (9%), 41 persons of other race or ethnicity (4%), and 10 of unknown race or ethnicity (1%). We evaluated structural racism (social/built structural disadvantage, racial-economic segregation) and pandemic-related stress (community COVID-19 mortality, community unemployment rate increase) in quartiles by zone improvement plan code. SARS-CoV-2 serologic enzyme-linked immunosorbent assay was performed on blood samples from pregnant persons. We obtained data on preterm birth and small-for-gestational-age newborns from an electronic medical record database. We used log-binomial regression with robust standard error for clustering by zone improvement plan code to estimate associations of each neighborhood measure separately with 3 outcomes: SARS-CoV-2 infection, preterm birth, and small-for-gestational-age newborns. Covariates included maternal age, parity, insurance status, and body mass index. Models with preterm birth and small-for-gestational-age newborns as the dependent variables additionally adjusted for SARS-CoV-2 infection. RESULTS A total of 193 (20%) persons were SARS-CoV-2-seropositive, and the overall risks of preterm birth and small-for-gestational-age newborns were 8.4% and 9.8%, respectively. Among birthing persons in neighborhoods in the highest quartile of structural disadvantage (n=190), 94% were non-White, 50% had public insurance, 41% were obese, 32% were seropositive, 11% delivered preterm, and 12% delivered a small-for-gestational-age infant. Among birthing persons in neighborhoods in the lowest quartile of structural disadvantage (n=360), 39% were non-White, 17% had public insurance, 15% were obese, 9% were seropositive, 6% delivered preterm, and 10% delivered a small-for-gestational-age infant. In adjusted analyses, structural racism measures and community unemployment were associated with both SARS-CoV-2 infection and preterm birth, but not small-for-gestational-age infants. High vs low structural disadvantage was associated with an adjusted relative risk of 2.6 for infection (95% confidence interval, 1.7-3.9) and 1.7 for preterm birth (95% confidence interval, 1.0-2.9); high vs low racial-economic segregation was associated with adjusted relative risk of 1.9 (95% confidence interval, 1.3-2.8) for infection and 2.0 (95% confidence interval, 1.3-3.2) for preterm birth; high vs low community unemployment increase was associated with adjusted relative risk of 1.7 (95% confidence interval, 1.2-1.5) for infection and 1.6 (95% confidence interval, 1.0-2.8) for preterm birth. COVID-19 mortality rate was associated with SARS-CoV-2 infection but not preterm birth or small-for-gestational-age infants. SARS-CoV-2 infection was not independently associated with birth outcomes. We found no interaction between SARS-CoV-2 infection and neighborhood measures on preterm birth or small-for-gestational-age infants. CONCLUSION Neighborhood measures of structural racism were associated with both SARS-CoV-2 infection and preterm birth, but these associations were independent and did not have a synergistic effect. Community unemployment rate increases were also associated with an increased risk of preterm birth independently of SARS-CoV-2 infection. Mitigating these factors might reduce the impact of the pandemic on pregnant people.
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Affiliation(s)
- Teresa Janevic
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan); Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic, Lieb, Bergink, and Dolan); Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb and Ms Lynch).
| | - Whitney Lieb
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan); Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic, Lieb, Bergink, and Dolan); Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb and Ms Lynch)
| | - Erona Ibroci
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Jezelle Lynch
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb and Ms Lynch)
| | - Molly Lieber
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Nina M Molenaar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Lotje de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Sophie Ohrn
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr. Carreño, Krammer Serology Core Study Group, and Dr Krammer)
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr. Carreño, Krammer Serology Core Study Group, and Dr Krammer)
| | - Lauren B Zapata
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA (Drs Zapata and Snead)
| | - Margaret Christine Snead
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA (Drs Zapata and Snead)
| | - Rachel I Brody
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr Brody)
| | - Rebecca H Jessel
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Stephanie Sestito
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Alan Adler
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Omara Afzal
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Frederieke Gigase
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Roy Missall
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Daniel Carrión
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (Dr Carrión)
| | - Joanne Stone
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan)
| | - Veerle Bergink
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan); Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic, Lieb, Bergink, and Dolan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Ms Ibroci, Drs Molenaar, Rommel, and de Witte, Ms. Gigase, Mr. Missall, and Dr Bergink)
| | - Siobhan M Dolan
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic and Lieb, Ms Lieber, Ms. Ohrn, Dr Jessel, Ms Sestito, and Drs Adler, Afzal, Stone, Bergink, and Dolan); Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Janevic, Lieb, Bergink, and Dolan)
| | - Elizabeth A Howell
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (Dr Howell)
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- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr. Carreño, Krammer Serology Core Study Group, and Dr Krammer)
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22
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McCarthy K, Maru S, Nowlin S, Ram P, Glazer KB, Janevic T. The validity of self-reported SARS-CoV-2 results among postpartum respondents. Paediatr Perinat Epidemiol 2022; 36:518-524. [PMID: 35257392 PMCID: PMC9115458 DOI: 10.1111/ppe.12874] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Rapid and reliable health data on SARS-CoV-2 infection among pregnant individuals are needed to understand the influence of the virus on maternal health and child development, yet the validity of self-reported COVID-19 testing and diagnosis remains unknown. OBJECTIVES We assessed the validity of self-reported COVID-19 polymerase chain reaction (PCR) testing and diagnosis during delivery among postpartum respondents as well as how diagnostic accuracy varied by respondent characteristics. METHODS We validated receipt of a COVID-19 PCR test and test results by comparing self-reported results obtained through an electronic survey to electronic medical record data (gold standard) among a cross-sectional sample of postpartum respondents who delivered at four New York City hospitals between March 2020 and January 2021. To assess validity, we calculated each indicator's sensitivity, specificity and the area under the receiver-operating curve (AUC). We examined respondent characteristics (age, race/ethnicity, education level, health insurance, nativity, pre-pregnancy obesity and birth characteristics) as predictors of reporting accuracy using modified Poisson regression. RESULTS A total of 276 respondents had matched electronic record and survey data. The majority, 83.7% of respondents received a SARS-CoV-2 PCR test during their delivery stay. Of these, 12.1% had detected SARS-CoV-2. Among those tested, sensitivity (90.5%) and specificity (96.5%) were high for SARS-CoV-2 detection. The adjusted risk ratio (aRR) of accurate result reporting was somewhat lower among Hispanic women relative to white non-Hispanic women (aRR 0.90, 95% CI 0.90, 1.00) and among those who had public or no insurance vs. private (aRR 0.91, 95% CI 0.82, 1.01), controlling for recall time. CONCLUSION(S) High recall accuracy result reporting for COVID-19 PCR tests administered during labour and delivery suggest the potential for population-based surveys as a rapid mechanism to obtain accurate data on COVID-19 diagnostic history. Additional psychometric research is warranted to ensure accurate recall across respondent subgroups.
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Affiliation(s)
- Katharine McCarthy
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew York CityUSA,Blavatnik Family Women’s Health Research InstituteIcahn School of Medicine at Mount SinaiNew York CityUSA
| | - Sheela Maru
- Department of Obstetrics, Gynecology, and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew York CityUSA,Department of Health System Design and Global HealthArnhold Institute for Global HealthIcahn School of Medicine at Mount SinaiNew York CityUSA,New York City Health + Hospitals/ElmhurstNew York CityUSA
| | - Sarah Nowlin
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew York CityUSA,Department of NursingCenter for Nursing Research & InnovationIcahn School of Medicine at Mount SinaiNew York CityUSA
| | - Payal Ram
- Department of Health System Design and Global HealthArnhold Institute for Global HealthIcahn School of Medicine at Mount SinaiNew York CityUSA,Global Health InstituteElmhurst Hospital CenterNew York CityUSA
| | - Kimberly B. Glazer
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew York CityUSA,Blavatnik Family Women’s Health Research InstituteIcahn School of Medicine at Mount SinaiNew York CityUSA,Department of Obstetrics, Gynecology, and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew York CityUSA
| | - Teresa Janevic
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew York CityUSA,Blavatnik Family Women’s Health Research InstituteIcahn School of Medicine at Mount SinaiNew York CityUSA,Department of Obstetrics, Gynecology, and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew York CityUSA
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23
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Depression in pregnant and postpartum women during COVID-19 pandemic: systematic review and meta-analysis. Obstet Gynecol Sci 2022; 65:287-302. [PMID: 35754363 PMCID: PMC9304439 DOI: 10.5468/ogs.21265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) emerged as a global pandemic in March 2020 and caused a big crisis, especially the health crisis. Pregnant and postpartum women experienced significant physical, social, and mental changes that put them at higher risk for several conditions during the pandemic. This study aimed to report the prevalence of depression in pregnant and postpartum women during the COVID-19 pandemic. Eligible studies were identified using several databases. Prevalence analysis was conducted using MedCalc ver. 19.5.1. This systematic review and meta-analysis was registered in PROSPERO on July 12, 2021 with registration number CRD42021266976. We included 54 studies with 95.326 participants. The overall prevalence of depression was 32.60% among pregnant and postpartum women during the COVID-19 pandemic. The rate was higher among pregnant women (31.49%) compared to postpartum women (27.64%). The prevalence of depression among pregnant and postpartum women increased during the COVID-19 pandemic.
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24
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A Trauma-informed Approach to Postpartum Care. Clin Obstet Gynecol 2022; 65:550-562. [PMID: 35708976 DOI: 10.1097/grf.0000000000000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Distressing or traumatic perinatal experiences and adverse health outcomes can lead to particularly challenging postpartum experiences for patients and families. By adopting a trauma-informed care approach, the health care team can provide much-needed support, prevent additional harm, and promote healing. We propose practical communication, behavioral, and procedural considerations for integrating trauma-informed care principles into routine postpartum care, with attention to populations that have been marginalized. We see postpartum care as a critical component of holistic patient recovery and an opportunity to facilitate posttraumatic growth so that all families can thrive.
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25
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Riley T, Nethery E, Chung EK, Souter V. Impact of the COVID-19 pandemic on perinatal care and outcomes in the United States: An interrupted time series analysis. Birth 2022; 49:298-309. [PMID: 34957595 DOI: 10.1111/birt.12606] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/08/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hospitals quickly adapted perinatal care to mitigate SARS-CoV-2 transmission at the onset of the COVID-19 pandemic. The objective of this study was to estimate the impact of pandemic-related hospital policy changes on perinatal care and outcomes in one region of the United States. METHODS This interrupted time series analysis used retrospective data from consecutive singleton births at 15 hospitals in the Pacific Northwest from 2017 to 2020. The primary outcomes were those hypothesized to be affected by pandemic-related hospital policies and included labor induction, epidural use, oxytocin augmentation, mode of delivery, and early discharge (<48 hours after cesarean and <24 hours after vaginal births). Secondary outcomes included preterm birth, severe maternal morbidity, low 5-minute Apgar score, neonatal intensive care unit (NICU) admission, and 30-day readmission. Segmented Poisson regression models estimated the outcome level shift changes after the pandemic onset, controlling for underlying trends, seasonality, and stratifying by parity. RESULTS No statistically significant changes were detected in intrapartum interventions or mode of delivery after onset of the pandemic. Early discharge increased for all births following cesarean and vaginal birth. Newborn readmission rates increased but only among nulliparas (aRR: 1.49, 95%CI: 1.17, 1.91). Among multiparas, decreases were observed in preterm birth (aRR: 0.90, 95%CI: 0.84, 0.96), low 5-minute Apgar score (aRR: 0.75, 95%CI: 0.68, 0.81), and term NICU admission rates (aRR: 0.85, 95%CI: 0.80, 0.91). CONCLUSIONS Increases in early discharge and newborn readmission rates among nulliparas suggest a need for more postpartum support during the pandemic. Decreases in preterm birth and term NICU admission among multiparas may have implications beyond the pandemic and deserve further study.
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Affiliation(s)
- Taylor Riley
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Elizabeth Nethery
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Esther K Chung
- Department of Pediatrics, University of Washington School of Medicine, and Seattle Children's Hospital, Seattle, Washington, USA
| | - Vivienne Souter
- Obstetrical Care Outcomes Assessment Program, Seattle, Washington, USA.,Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
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26
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Turner S, McGann B, Brockway M’M. A review of the disruption of breastfeeding supports in response to the COVID-19 pandemic in five Western countries and applications for clinical practice. Int Breastfeed J 2022; 17:38. [PMID: 35570307 PMCID: PMC9107585 DOI: 10.1186/s13006-022-00478-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has significantly altered how breastfeeding support is provided, resulting in mixed breastfeeding outcomes and experiences for mothers. The World Health Organization has consistently supported breastfeeding from the beginning of the pandemic. However, recommendations from obstetrical and gynaecological societies within individual countries have varied in their alignment with this guidance, resulting in inconsistent recommendations. It is unknown how breastfeeding guidelines, maternal breastfeeding experiences, and breastfeeding initiation and duration compared across five Western countries. The current study is comprised of two parts, each with a different objective. Part One objective: to review pandemic-related changes in professional society guidelines on breastfeeding support in Australia, New Zealand, Canada, the United Kingdom, and the United States; and Part Two objective: to conduct a narrative review to summarize the evidence of how the pandemic has changed breastfeeding initiation, duration, and mothers’ breastfeeding experiences during the pandemic in these five countries and provide recommendations for clinical lactation support. Methods We searched for indicators that are impactful on breastfeeding outcomes: skin-to-skin contact, rooming in, direct breastfeeding and breast washing, in the five countries mentioned above and compared these to the recommendations from the World Health Organization. Next, we conducted a narrative review of the literature from these five countries to explore how the pandemic altered breastfeeding outcomes and used this information to provide suggestions for clinical practice moving forward. Results Recommendations on the four practices above differed by country and were not always in alignment with the World Health Organization recommendations. Mother-infant separation after birth in the United States was associated with a lower prevalence of breastfeeding initiation and duration. While some mothers reported positive breastfeeding experiences during the pandemic, many mothers indicated negative experiences related to decreased social and professional support. Conclusions The pandemic can inform practice recommendations and can be viewed as an opportunity to permanently modify existing methods to support breastfeeding families. The use of virtual care increased during the pandemic and should continue with specific considerations for prioritizing in-person care. This will help to provide more timely and accessible support for breastfeeding mothers.
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27
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Prater C, Cohen L, Chau E, Carter EB, Kuebee B, Tepe M, Keegan M. Perceived Discrimination During Prenatal Care at a Community Health Center. J Racial Ethn Health Disparities 2022; 10:1304-1309. [PMID: 35486348 PMCID: PMC9053117 DOI: 10.1007/s40615-022-01315-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Abstract
Introduction Discrimination in healthcare is associated with fetal growth restriction, preterm birth, and postpartum depression. A community-based participatory research study was designed to measure perceived discrimination and healthcare quality during prenatal care and delivery by a community health center, where the majority of patients served belong to historically marginalized ethnic and racial groups. Methods A 34-question phone survey was administered to women 18 years and older who received prenatal care at the study site during 2020–2021. The primary outcome was perceived discrimination during obstetric care, measured by the 7-question Discrimination in the Medical Setting (DMS) survey. Secondary outcomes included the association of race with perceived discrimination, quality of care, trust of healthcare providers, and perceived control over medical choices. Results Ninety-seven women completed the survey, 95 of whom were women of color. The sample was dichotomized into Black (n = 49) and non-Black (n = 46). Perceived discrimination for all participants was 21% (20/95), with 31% (15/49) of Black women reporting any discrimination during prenatal care and delivery. Compared to other women of color, Black women reported higher rates of perceived discrimination (31% vs 11%, aOR 3.9 [1.2–12.1], p < 0.05), lower control over health choices (84% vs 98%, aOR 0.1 [0.0–0.8], p < 0.05), and were more likely to perceive lack of respect (12% vs 2%, p = 0.045). Conclusion Although perceived discrimination at this community health center was low compared to prior studies, Black women experienced higher rates of discrimination than other women of color. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-022-01315-5.
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Affiliation(s)
- Christopher Prater
- Department of Medicine, Division of General Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Lily Cohen
- Washington University in St. Louis, St. Louis, MO, USA
| | | | - Ebony B Carter
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Blessing Kuebee
- St. Louis University College for Public Health and Social Justice, St. Louis, MO, USA
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28
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Glazer KB, Vieira L, Weber E, Stone J, Stern T, Bianco A, Wagner B, Nowlin S, Dolan SM, Howell EA, Janevic T. COVID-19 pandemic-related change in racial and ethnic disparities in exclusive breastmilk feeding during the delivery hospitalization: a differences-in-differences analysis. BMC Pregnancy Childbirth 2022; 22:225. [PMID: 35305590 PMCID: PMC8934049 DOI: 10.1186/s12884-022-04570-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Exclusive breastmilk feeding during the delivery hospitalization, a Joint Commission indicator of perinatal care quality, is associated with longer-term breastfeeding success. Marked racial and ethnic disparities in breastfeeding exclusivity and duration existed prior to COVID-19. The pandemic, accompanied by uncertainty regarding intrapartum and postpartum safety practices, may have influenced disparities in infant feeding practices. Our objective was to examine whether the first wave of the COVID-19 pandemic in New York City was associated with a change in racial and ethnic disparities in exclusive breastmilk feeding during the delivery stay. METHODS We conducted a cross-sectional study of electronic medical records from 14,964 births in two New York City hospitals. We conducted a difference-in-differences (DID) analysis to compare Black-white, Latina-white, and Asian-white disparities in exclusive breastmilk feeding in a pandemic cohort (April 1-July 31, 2020, n=3122 deliveries) to disparities in a pre-pandemic cohort (January 1, 2019-February 28, 2020, n=11,842). We defined exclusive breastmilk feeding as receipt of only breastmilk during delivery hospitalization, regardless of route of administration. We ascertained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection status from reverse transcription-polymerase chain reaction tests from nasopharyngeal swab at admission. For each DID model (e.g. Black-white disparity), we used covariate-adjusted log binomial regression models to estimate racial and ethnic risk differences, pandemic versus pre-pandemic cohort risk differences, and an interaction term representing the DID estimator. RESULTS Exclusive breastmilk feeding increased from pre-pandemic to pandemic among white (40.8% to 46.6%, p<0.001) and Asian (27.9% to 35.8%, p=0.004) women, but not Black (22.6% to 25.3%, p=0.275) or Latina (20.1% to 21.4%, p=0.515) women overall. There was an increase in the Latina-white exclusive breastmilk feeding disparity associated with the pandemic (DID estimator=6.3 fewer cases per 100 births (95% CI=-10.8, -1.9)). We found decreased breastmilk feeding specifically among SARS-CoV-2 positive Latina women (20.1% pre-pandemic vs. 9.1% pandemic p=0.013), and no change in Black-white or Asian-white disparities. CONCLUSIONS We observed a pandemic-related increase in the Latina-white disparity in exclusive breastmilk feeding, urging hospital policies and programs to increase equity in breastmilk feeding and perinatal care quality during and beyond this health emergency.
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Affiliation(s)
- Kimberly B Glazer
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Luciana Vieira
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Ellerie Weber
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Joanne Stone
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Toni Stern
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Angela Bianco
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Brian Wagner
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Sarah Nowlin
- Center for Nursing Research & Innovation, Department of Nursing, Mount Sinai Hospital, New York, NY, USA
| | - Siobhan M Dolan
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Elizabeth A Howell
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Teresa Janevic
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
- The Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
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29
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Kemp KA, Fairie P, Steele BJ, Santana MJ. Adult Experiences with Hospitalization in Alberta, Canada During the COVID-19 Pandemic: A Comparative Cross-Sectional Study. J Patient Exp 2022; 9:23743735221077518. [PMID: 35136834 PMCID: PMC8819556 DOI: 10.1177/23743735221077518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Little is known about the experiences of those hospitalized during the COVID-19 pandemic in Canada. Our aims were to (a) report on the experiences, (b) compare with historical results, and (c) assess for potential monthly differences of patients hospitalized in the early months of the COVID-19 across Alberta. A random sample of adults was surveyed within 6 weeks of discharge from 93 hospitals, using a modified version of the Canadian Patient Experiences Survey – Inpatient Care (CPES-IC). Discharges from April to September 2020 comprised the “during COVID-19 pandemic” cohort, while April to September 2019 formed the historical one. Results were reported as percent in “top box”, indicative of the most positive answer choice. Odds of reporting a “top box” response were calculated while controlling for demographic and clinical features. In total, 23,412 surveys (11,344 during COVID-19, 12,068 historical) were obtained. Those hospitalized during COVID-19 had higher odds of “top box” ratings on 17 of 39 questions examined, and lower odds on 2 questions (information about the admission process, inclusion of family/friends in care decisions). The remaining 20 questions showed no difference between the 2 cohorts. Our results indicate that respondents hospitalized during the early months of the pandemic had experiences that were largely better or comparable to pre-pandemic. This speaks to the dedication and resilience of staff who provided care during challenging circumstances. Our findings may assist in mitigating fears among those who are hesitant to seek medical care during future pandemics or public health emergencies, including subsequent waves of COVID-19.
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Affiliation(s)
- Kyle A Kemp
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient Oriented Research, Calgary, Alberta, Canada
| | - Paul Fairie
- Patient Engagement Platform, Alberta Strategy for Patient Oriented Research, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Brian J Steele
- Patient Engagement Platform, Alberta Strategy for Patient Oriented Research, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Maria J Santana
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND 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] [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.
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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.)
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Quality and satisfaction with care following changes to the structure of obstetric care during the COVID-19 pandemic in a safety-net hospital in Georgia: Results from a mixed-methods study. J Natl Med Assoc 2022; 114:94-103. [PMID: 35039177 PMCID: PMC8759626 DOI: 10.1016/j.jnma.2021.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/13/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022]
Abstract
Objective To understand perceived quality of obstetric care following changes to the structure of care in a safety-net institution during the COVID-19 pandemic. Methods We conducted a mixed-methods study including a web-based survey (n = 67) and in-depth interviews (n = 16) between October 2020 and January 2021. We present a descriptive analysis of quantitative results and key qualitative themes on reactions to changes and drivers of perceived quality. Results Reported quality was high for in-person and phone visits (median subscale responses: 5/5). Respondents were willing to include phone visits in care for a future pregnancy (77.8% (49)) but preferred in-person visits (84.1% (53)). In interviews, provider communication was the key driver of quality. Respondents found changes to care to be inconvenient but acceptable. Conclusions To improve satisfaction with changes to care, health systems should ensure that relationship building remains a priority and offer patients information about the reason behind changes.
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Hernandez-Castro I, Toledo-Corral CM, Chavez T, Habre R, Grubbs B, Al-Marayati L, Lerner D, Lurvey N, Lagomasino I, Eckel SP, Dunton GF, Farzan SF, Breton CV, Bastain TM. Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221125103. [PMID: 36148937 PMCID: PMC9511002 DOI: 10.1177/17455057221125103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION AND OBJECTIVES Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic. METHODS The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as "pre-pandemic" (N = 128), between March 2020 and July 2020 as "early pandemic" (N = 38), and between August 2020 and November 2021 as "later pandemic" (N = 21). Average PIPES subscale scores were dichotomized into "higher" and "lower" groups (⩽median, >median) and logistic regression models were performed. RESULTS Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods. CONCLUSION Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.
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Affiliation(s)
- Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Isabel Lagomasino
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Yakupova V, Suarez A, Kharchenko A. Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:335. [PMID: 35010595 PMCID: PMC8751046 DOI: 10.3390/ijerph19010335] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/25/2021] [Accepted: 12/26/2021] [Indexed: 05/25/2023]
Abstract
The aim of the study is to investigate the changes in the maternal healthcare system during the pandemic and their associations with maternal mental health in Russia. A sample of Russian women who gave birth during the first year of the COVID-19 pandemic (n = 1645) and matched controls, i.e., women who gave birth before the COVID-19 pandemic (n = 611), completed an anonymous Internet survey about recent childbirth. They were assessed for childbirth-related posttraumatic stress disorder (PTSD) and postpartum depression (PPD). Clinically relevant symptoms of PPD and PTSD were high before the pandemic and showed no significant change during the pandemic (p = 0.48 and p = 0.64, respectively). We found a notable increase in the frequency of obstetric violence (p = 0.015) during the pandemic, which, in turn, has a strong correlation with birth-related PTSD and PPD. The problem of ethical communication with patients among maternal healthcare professionals is acute in Russia, and it has been exacerbated by the pandemic. Family and doula support during labor can be a potential protective factor against obstetric violence.
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Affiliation(s)
- Vera Yakupova
- Faculty of Psychology, Lomonosov Moscow State University, 125009 Moscow, Russia; (A.S.); (A.K.)
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Preis H, Mahaffey B, Heiselman C, Lobel M. The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women. Women Birth 2021; 35:458-465. [PMID: 34736888 PMCID: PMC8501233 DOI: 10.1016/j.wombi.2021.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 02/03/2023]
Abstract
PROBLEM Birth satisfaction is an important health outcome that is related to postpartum mood, infant caretaking, and future pregnancy intention. BACKGROUND The COVID-19 pandemic profoundly affected antenatal care and intrapartum practices that may reduce birth satisfaction. AIM To investigate the extent to which pandemic-related factors predicted lower birth satisfaction. METHODS 2341 women who were recruited prenatally in April-May 2020 and reported a live birth between April-October 2020 were included in the current analysis. Hierarchical linear regression to predict birth satisfaction from well-established predictors of birth satisfaction (step 1) and from pandemic-related factors (step 2) was conducted. Additionally, the indirect associations of pandemic-related stress with birth satisfaction were investigated. FINDINGS The first step of the regression explained 35% of variance in birth satisfaction. In the second step, pandemic-related factors explained an additional 3% of variance in birth satisfaction. Maternal stress about feeling unprepared for birth due to the pandemic and restrictions on companions during birth independently predicted lower birth satisfaction beyond the non-pandemic variables. Pandemic-related unpreparedness stress was associated with more medicalized birth and greater incongruence with birth preference, thus also indirectly influencing birth satisfaction through a mediation process. DISCUSSION Well-established contributors to birth satisfaction remained potent during the pandemic. In addition, maternal stress and restriction on accompaniment to birth were associated with a small but significant reduction in birth satisfaction. CONCLUSION Study findings suggest that helping women set flexible and reasonable expectations for birth and allowing at least one intrapartum support person can improve birth satisfaction.
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Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States.
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, United States
| | - Cassandra Heiselman
- Department of Obstetrics and Gynecology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, United States
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States
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Mollard E, Kupzyk K. Birth Satisfaction During the Early Months of the COVID-19 Pandemic in the United States. MCN Am J Matern Child Nurs 2021; 47:6-12. [PMID: 34559088 PMCID: PMC8647528 DOI: 10.1097/nmc.0000000000000777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose: The purpose of this study was to describe birth satisfaction in women who gave birth in U.S. hospitals during the earliest months of the COVID-19 pandemic (March–July 2020). Study Design and Methods: A cross-sectional survey of 747 postpartum women who gave birth in the United States during the early COVID-19 pandemic was conducted. Participants in the United were recruited via social media. They completed a questionnaire that included demographic, health, and obstetric experience questions, and the Birth Satisfaction Scale-Revised. Descriptive statistics, t-tests, analysis of variance (ANOVA) models, and nonparametric correlations were performed. Results: Higher birth satisfaction scores were associated with higher income, marriage, white race, vaginal birth, having a birth partner present, and sufficient support during birth. Factors negatively associated with birth satisfaction were separation from infant, unplanned cesarean birth, neonatal intensive care unit admission, hypertension, preeclampsia, hemorrhage, depression, and anxiety. Clinical Implications: Presence of birth partners, sufficient birth support, and minimizing separation of mother and infant improve birth satisfaction. Obstetric complications, including unplanned cesarean birth, negatively affect birth satisfaction. There are racial disparities in birth satisfaction. It is critical to develop further interventions to end racism in maternal health care. During the early months of the COVID-19 pandemic, there were many restrictive changes to childbirth practices in the inpatient setting geared toward reducing viral spread and keeping patients and health care workers safe. In this study 747 women who gave birth in the United States during the first several months of the pandemic offer their perspectives on how these changes affected their childbirth experience and overall satisfaction.
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