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Weinstock MW, Moyer S, Jallo N, Rider A, Kinser P. Perinatal meaning-making and meaning-focused coping in the COVID-19 pandemic. J Reprod Infant Psychol 2024; 42:896-914. [PMID: 37062943 DOI: 10.1080/02646838.2023.2203152] [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: 08/25/2022] [Accepted: 04/02/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION The COVID-19 pandemic caused unprecedented levels of stress amongst pregnant women and new mothers. The current qualitative study explored the ways in which perinatal women made meaning of their experiences during the COVID-19 pandemic. METHODS Data came from a parent study in which 54 perinatal (pregnant and postpartum) women in the United States completed semi-structured interviews from October 2021 to January 2022 describing their experiences during the COVID-19 pandemic. The data was interpreted using a hermeneutic, phenomenological approach to delve deeply into the concept of meaning-making. RESULTS Despite high levels of stress and challenging circumstances, participants reported engaging in meaning-making through finding connection, focusing on gratitude, and identifying openings for change. Unique forms of meaning-making amongst this population include a sense of connection to women throughout history, connection to their baby, and recognition of the need for systemic change for perinatal women. CONCLUSIONS Perinatal women coped with the stress of the COVID-19 pandemic by making meaning from their experiences. Future research should further explore the importance of these aspects of meaning-making to perinatal women and implement these findings to adapt prevention and treatment approaches to address perinatal stress, especially during times of crisis.
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Affiliation(s)
- Madison W Weinstock
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sara Moyer
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Nancy Jallo
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Amy Rider
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Patricia Kinser
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
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Abdul-Fatah A, Bezanson M, Lopez Steven S, Tippins E, Jones S, MacDonald H, Ysseldyk R. COVID-19 Public Health Restrictions and New Mothers' Mental Health: A Qualitative Scoping Review. QUALITATIVE HEALTH RESEARCH 2024:10497323241251984. [PMID: 39030700 DOI: 10.1177/10497323241251984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Public health restrictions to protect physical health during the COVID-19 pandemic had unintended effects on mental health, which may have disproportionately affected some potentially vulnerable groups. This scoping review of qualitative research provides a narrative synthesis of new mothers' perspectives on their mental health during COVID-19 pandemic restrictions through pregnancy to the postpartum period. Database searches in PubMed, CINAHL, and PsycINFO sought primary research studies published until February 2023, which focused on new mothers' self-perceived mental health during the pandemic (N = 55). Our synthesis found that new mothers' mental health was impacted by general public health restrictions resulting in isolation from family and friends, a lack of community support, and impacts on the immediate family. However, public health restrictions specific to maternal and infant healthcare were most often found to negatively impact maternal mental health, namely, hospital policies prohibiting the presence of birthing partners and in-person care for their infants. This review of qualitative research adds depth to previous reviews that have solely examined the quantitative associations between COVID-19 public health restrictions and new mothers' mental health. Here, our review demonstrates the array of adverse impacts of COVID-19 public health restrictions on new mothers' mental health throughout pregnancy into the postpartum period, as reported by new mothers. These findings may be beneficial for policy makers in future public health emergency planning when evaluating the impacts and unintended consequences of public health restrictions on new mothers.
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Affiliation(s)
| | - Michelle Bezanson
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Emily Tippins
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Sarah Jones
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Renate Ysseldyk
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
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Mollons M, Levasseur-Puhach S, Kaur J, Doyle J, Giesbrecht G, Lebel CA, Woods L, Tomfohr-Madsen L, Roos L. Mixed-methods study exploring health service access and social support linkage to the mental well-being of Canadian Indigenous pregnant persons during the COVID-19 pandemic. BMJ Open 2024; 14:e078388. [PMID: 38553054 PMCID: PMC11005712 DOI: 10.1136/bmjopen-2023-078388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/27/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study aimed to explore how the unprecedented stressors associated with the COVID-19 pandemic may have contributed to heightened levels of depression and anxiety among pregnant Indigenous persons, and identify protective individual-level factors. DESIGN The current study used a mixed-methods design including standardised questionnaires and open-ended response questions. Using hierarchical regression models, we examined the extent to which COVID-19-related factors of service disruption (ie, changes to prenatal care, changes to birth plans and social support) were associated with mental well-being. Further, through qualitative analyses of open-ended questions, we examined the coping strategies used by pregnant Indigenous persons in response to the pandemic. SETTING Participants responded to an online questionnaire consisting of standardised measures from 2020 to 2021. PARTICIPANTS The study included 336 self-identifying Indigenous pregnant persons in Canada. RESULTS Descriptive results revealed elevated rates of clinically relevant depression (52.7%) and anxiety (62.5%) symptoms among this population. 76.8% of participants reported prenatal care service disruptions, including appointment cancellations. Thematic analyses identified coping themes of staying informed, social and/or cultural connections and activities, and internal mental well-being strategies. Disruptions to services and decreased quality of prenatal care negatively impacted mental well-being of Indigenous pregnant persons during the COVID-19 pandemic. CONCLUSIONS Given the potential for mental well-being challenges to persist and long-term effects of perinatal distress, it is important to examine the quality of care that pregnant individuals receive. Service providers should advance policies and practices that promote relationship quality and health system engagement as key factors linked to well-being during the perinatal period for Indigenous persons.
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Affiliation(s)
- Meghan Mollons
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Jasleen Kaur
- Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Jennifer Doyle
- Educational and Counselling Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Gerald Giesbrecht
- Alberta Children's Hospital Research Institute, Calgary, Province of Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Province of Alberta, Canada
| | - Catherine A Lebel
- Alberta Children's Hospital Research Institute, Calgary, Province of Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Province of Alberta, Canada
| | | | - Lianne Tomfohr-Madsen
- Educational and Counselling Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie Roos
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba Children's Hospital Research Institute, Winnipeg, Manitoba, Canada
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Rokicki S, Mackie TI, D'Oria R, Flores M, Watson A, Byatt N, Suplee P. A Qualitative Investigation of the Experiences of Women with Perinatal Depression and Anxiety during the COVID-19 Pandemic. Matern Child Health J 2024; 28:274-286. [PMID: 37943397 DOI: 10.1007/s10995-023-03809-y] [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] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has had significant impacts on maternal mental health. We explored the lived experiences of women with perinatal depression and anxiety to elucidate their perceptions of how the pandemic influenced their mental health and access to care. METHODS We conducted a qualitative descriptive study using semi-structured interviews. From March to October 2021, purposive sampling was used to recruit a socio-demographically diverse sample of women with self-reported perinatal depression or anxiety who were pregnant or within one year postpartum between March 2020 and October 2021. Interviews were conducted remotely and thematically analyzed. RESULTS Fourteen women were interviewed. Three major themes arose. Theme 1, Negative impacts of COVID-19 on symptoms of depression and anxiety, described how the pandemic magnified underlying symptoms of depression and anxiety, increased social isolation, generated anxiety due to fears of COVID-19 infection, and caused economic stress. In theme 2, Negative impacts of COVID-19 on access to and quality of health care, women described stressful and isolating delivery experiences, negative psychological impact of partners not being able to participate in their perinatal health care, interruptions and barriers to mental health treatment, and challenges in using telehealth services for mental health care. Theme 3, Positive impacts of COVID-19 on mental health, identified advantages of increased telehealth access and ability to work and study from home. CONCLUSIONS FOR PRACTICE The COVID-19 pandemic negatively affected women with perinatal depression and anxiety by magnifying underlying symptoms, increasing stress and social isolation, and disrupting access to mental health care. Findings provide support for policies and interventions to prevent and address social isolation, as well as optimization of telehealth services to prevent and address gaps in perinatal mental health treatment.
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Affiliation(s)
- Slawa Rokicki
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Thomas I Mackie
- Department of Health Policy and Management, School of Public Health, SUNY Downstate Health Sciences University School of Public Health, Brooklyn, NY, USA
| | - Robyn D'Oria
- Central Jersey Family Health Consortium, North Brunswick Township, New Jersey, USA
| | - Mariella Flores
- Central Jersey Family Health Consortium, North Brunswick Township, New Jersey, USA
| | - Ashley Watson
- Central Jersey Family Health Consortium, North Brunswick Township, New Jersey, USA
| | - Nancy Byatt
- Departments of Psychiatry, Obstetrics & Gynecology, and Population and Quantitative Health Sciences, UMass Chan Medical School / UMass Memorial Health, Shrewsbury, MA, USA
| | - Patricia Suplee
- Rutgers University, School of Nursing-Camden, Camden, NJ, USA
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Babu S, Park N, Woodland G, Garcia N, Page W, Page R. Maternal health applications: Qualitative findings of user needs. Digit Health 2024; 10:20552076241285422. [PMID: 39347510 PMCID: PMC11437584 DOI: 10.1177/20552076241285422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 09/03/2024] [Indexed: 10/01/2024] Open
Abstract
Objective This study sought to understand the current experiences and subsequent needs of digital maternal health application users based on an interdisciplinary analysis of features currently available in the digital marketplace (including mobile applications and mobile-friendly websites). Methods Following secondary analysis of previously collected interview and focus group data, we used qualitative thematic analysis to observe recurring themes within current maternal health applications and prospective augmentation of related technology for future development. Results Study findings suggested tailored features would best serve the target population, and eleven unique themes comprising additions and improvements to maternal health applications emerged. These included seven major areas: improved mental health support, need for forums and support groups, lack of lactation and breastfeeding support, lack of quality food and nutrition access and product finders, minimal financial literacy information, tailored culturally competent information, and need for localized information and resources. Findings also suggested four main improvements for digital offerings in the current maternal health space: increased emphasis on resources available for postpartum care, importance of minimizing the number of hubs used, need for making information more digestible by ensuring it is written, edited, and provided at appropriate reading levels by more coordinated interaction of words and graphics, and ensuring the trust and credibility of such applications. Conclusions Maternal health applications are improving; however, more features can be added in a localized manner. Additional improvements could be made to current offerings, maximizing the utility of applications, especially in hard-to-reach areas such as maternity care deserts. With the advent of artificial intelligence, developers are poised with the ability to make platforms more focused and tailored for their users.
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Affiliation(s)
- Suhas Babu
- College of Nursing, Texas A&M Health Science Center, Bryan, TX, USA
| | - Nicolas Park
- College of Nursing, Texas A&M Health Science Center, Bryan, TX, USA
- College of Arts and Sciences, Texas A&M University, College Station, TX, USA
| | - Gracie Woodland
- College of Nursing, Texas A&M Health Science Center, Bryan, TX, USA
| | - Nydia Garcia
- College of Nursing, Texas A&M Health Science Center, Bryan, TX, USA
| | - Walter Page
- College of Nursing, Texas A&M Health Science Center, Bryan, TX, USA
| | - Robin Page
- College of Nursing, Texas A&M Health Science Center, Bryan, TX, USA
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De Genna NM, Hossain F, Dwarakanath M, Balascio PM, Moore MM, Hill AV. Pandemic stressors and vaccine hesitancy among young, pregnant Black people: A qualitative study of health disparities during a global pandemic. Birth Defects Res 2023; 115:1912-1922. [PMID: 37807480 PMCID: PMC11061795 DOI: 10.1002/bdr2.2262] [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: 03/24/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The novel coronavirus 2019 (COVID-19) pandemic exacerbated existing health inequities in the United States, but no studies have focused on the lived experiences of younger Black birthing people. The goal of this qualitative study was to center the experiences of younger pregnant and birthing Black and Biracial people during the pandemic. METHODS We recruited 25 Black and Biracial pregnant and birthing people ages 16-23 for individual semi-structured interviews. Participants were asked about experiences with the healthcare system during the pandemic, and interviews were transcribed verbatim and coded for qualitative analysis using nVivo. We adhered to the Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS Participants identified pandemic-related stressors such as fears about infection, lack of support, and pressure to get vaccinated. Reasons for vaccine hesitancy included mistrust in the government and racism experienced during reproductive healthcare. Provider appeals highlighting patient autonomy and science were more effective in encouraging vaccine uptake than emotional appeals that made participants feel guilty about potentially infecting loved ones. CONCLUSIONS Restrictions on children and support people created barriers to timely prenatal care and reduced tangible support for young Black and Biracial birthing people during the pandemic. Their vaccine hesitancy was related to mistrust, concerns that the vaccines had not been tested enough prior to roll-out, and possible side effects of the vaccine including infection with the virus and pregnancy loss. Obstetric providers need to understand and recognize the ongoing impact of obstetric and scientific racism on health communication with younger Black and Biracial patients.
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Affiliation(s)
- Natacha M. De Genna
- Department of Psychiatry and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Fahmida Hossain
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Megana Dwarakanath
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Phoebe Ms. Balascio
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Mikaela Ms. Moore
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
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Moyer SW, Kinser PA, Nunziatio JD, Holmes CM, Salisbury AL. Development of the Edinburgh Postnatal Depression Scale-United States: An Updated Perinatal Mental Health Screening Tool Using a Respectful Care and Trauma-Informed Approach. J Womens Health (Larchmt) 2023; 32:1080-1085. [PMID: 37582210 DOI: 10.1089/jwh.2023.0141] [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] [Indexed: 08/17/2023] Open
Abstract
Purpose: To present the development protocol of the Edinburgh Postnatal Depression Scale-United States (EPDS-US), an adapted version of the EPDS, that is inclusive and easy to understand for U.S. populations and incorporates a trauma-informed approach to perinatal mental health (PMH). Methods: Our team adapted the wording of the original EPDS to be more linguistically appropriate for current use with U.S. populations by incorporating principles from Trauma-Informed Care and the Cycle to Respectful Care. Results: Through small but impactful linguistic updates, the EPDS-US offers inclusive person-first language and eliminates confusing phrases or wording that may be perceived as judgmental. The goal of the adapted EPDS-US is to foster symptom disclosure in an environment of safety and trust. The EPDS-US removes preidentified barriers patients experience related to PMH screenings. Conclusions: The EPDS-US, a trauma-informed and respectful care screening tool, may lead to earlier recognition of symptoms, may allow for more person-focused treatment plans, and may serve as a platform for a culture change in addressing PMH, particularly when the screening tool is accompanied by open conversation, education, and resources. Validation studies are required at this time and this team welcomes direct communication with research and clinical sites interested in doing so.
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Affiliation(s)
- Sara W Moyer
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
| | - Patricia A Kinser
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
| | | | - Courtney M Holmes
- Virginia Commonwealth University, College of Health Professions, Richmond, Virginia, USA
| | - Amy L Salisbury
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
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Kinser PA, Bodnar-Deren S, Amstadter AB, Lapato DM, Thacker LR, Johnson JA, Aubry C, Johnson A, Gault C, Hill-Thomas A, Russell S, Lanni S, Freeman A. Study protocol for the Mindful Moms Study: A randomized controlled trial evaluating a mindful movement intervention for marginalized pregnant people experiencing depression. Contemp Clin Trials 2023; 132:107302. [PMID: 37500008 PMCID: PMC10529983 DOI: 10.1016/j.cct.2023.107302] [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: 03/31/2023] [Revised: 06/22/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
More than 1 in 5 pregnant people in the United States experience depressive symptoms. Although treatments exist, many people remain under- or un-treated due to concerns about stigma, side effects, and costs of medications or psychotherapy, particularly those who are marginalized (defined as those who are minoritized, low-income, or with low-educational attainment). Further, the standard depression treatments do not address social connectedness, which is a potentially modifiable factor involved in depressive symptom etiology. This protocol presents the rationale, design, and status of the two-arm longitudinal parallel group randomized controlled trial - the Mindful Moms Study - which aims to evaluate the effects and mechanisms of a group-based mindful physical activity (yoga) intervention in marginalized pregnant people with depressive symptoms (n = 200) compared to a prenatal education control group. The primary aim is to evaluate effects of group assignment on depressive symptom severity, anxiety, and perceived stress over time from baseline to six weeks postpartum. Secondary aims include understanding the role of social connectedness as a moderator of the effects and to identify genome-wide DNA methylation patterns associated with depressive symptoms and perceived social connectedness at postpartum. A focus on adequate symptom management through non-pharmacologic, accessible therapies that address social connectedness during pregnancy in marginalized women is an urgent clinical and research priority. The successful completion of this study will provide important insights into social connectedness as a mechanism to decrease depressive symptoms in a largely understudied population. Trial registration: NCT04886856.
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Affiliation(s)
- Patricia A Kinser
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
| | - Susan Bodnar-Deren
- Department of Sociology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Dana M Lapato
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Leroy R Thacker
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennifer A Johnson
- Department of Sociology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Christine Aubry
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Anisa Johnson
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Candice Gault
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Ariel Hill-Thomas
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Sally Russell
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Susan Lanni
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Mohanraj L, Kolonich J, Naz F, Abouassali S, deBruler I, Kinser PA. Hematopoietic Stem Cell Transplantation Patients Are Skilled at Adapting to "Out of the Ordinary" Situations: A Qualitative Study. Semin Oncol Nurs 2023; 39:151465. [PMID: 37353359 DOI: 10.1016/j.soncn.2023.151465] [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: 03/14/2023] [Revised: 05/01/2023] [Accepted: 05/30/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE Blood cancers can potentially be cured by hematopoietic stem cell transplantation (HCT), but HCT recipients can remain immunocompromised for extended periods of time and require caregiver support. Though the COVID-19 pandemic has globally affected the livelihood and well-being of all individuals, it has affected certain populations in unique ways, HCT recipients being one of them. This study intends to understand the lived experience of HCT recipients and HCT-eligible patients during the COVID-19 pandemic. DATA SOURCES This qualitative study enrolled participants (N=25) from a parent study that recruited transplant patients (HCT eligible or HCT recipients) between May and October 2020. Participants were invited to participate on a one-on-one interview via an electronic platform. A phenomenologic qualitative approach was used to identify emerging themes and subthemes. CONCLUSION Three themes were developed: a) the pandemic experience was influenced by the transplant journey; b) participants found ways to thrive despite the odds and access support in unique ways; and c) participants described challenges during the pandemic regarding non-transplant care, vaccine considerations, and distrust in media. IMPLICATIONS FOR NURSING PRACTICE Results from this study highlighted that HCT recipients were uniquely prepared for "out of the ordinary" situations during the pandemic and underscored challenges faced by them during this time, identifying areas for improvement in the health care system. Nurses in their unique role can initiate and lead process changes to address barriers such as lack of access to reliable information, poor communication, and inadequate resources for accessing non-transplant care especially during uncertain times.
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Affiliation(s)
- Lathika Mohanraj
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, Virginia.
| | - Jessica Kolonich
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, Virginia
| | - Falik Naz
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, Virginia
| | - Sarah Abouassali
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Isabelle deBruler
- School of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Patricia Anne Kinser
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, Virginia
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Jackson C, Brawner J, Ball M, Crossley K, Dickerson J, Dharni N, Rodriguez DG, Turner E, Sheard L, Smith H. Being pregnant and becoming a parent during the COVID-19 pandemic: a longitudinal qualitative study with women in the Born in Bradford COVID-19 research study. BMC Pregnancy Childbirth 2023; 23:494. [PMID: 37403018 PMCID: PMC10320984 DOI: 10.1186/s12884-023-05774-4] [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: 11/27/2022] [Accepted: 06/10/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Uncertainty around the risk of COVID-19 to pregnant women and their babies prompted precautionary restrictions on their health and care during the pandemic. Maternity services had to adapt to changing Government guidance. Coupled with the imposition of national lockdowns in England and restrictions on daily activities, women's experiences of pregnancy, childbirth and the postpartum period, and their access to services, changed rapidly. This study was designed to understand women's experiences of pregnancy, labour and childbirth and caring for a baby during this time. METHODS This was an inductive longitudinal qualitative study, using in-depth interviews by telephone with women in Bradford, UK, at three timepoints during their maternity journey (18 women at timepoint one, 13 at timepoint two and 14 at timepoint three). Key topics explored were physical and mental wellbeing, experience of healthcare services, relationships with partners and general impact of the pandemic. Data were analysed using the Framework approach. A longitudinal synthesis identified over-arching themes. RESULTS Three longitudinal themes captured what was important to women: (1) women feared being alone at critical points in their maternity journey, (2) the pandemic created new norms for maternity services and women's care, and (3) finding ways to navigate the COVID-19 pandemic in pregnancy and with a baby. CONCLUSIONS Modifications to maternity services impacted significantly on women's experiences. The findings have informed national and local decisions about how best to direct resources to reduce the impact of COVID-19 restrictions and the longer-term psychological impact on women during pregnancy and postnatally.
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Affiliation(s)
- Cath Jackson
- Valid Research Ltd, Sandown House, Sandbeck Way, Wetherby, LS22 7DN, UK.
| | | | - Matthew Ball
- Justice Studio, 10 Portfleet Place, De Beauvoir Road, London, N1 5SZ, UK
| | - Kirsty Crossley
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Nimarta Dharni
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Ella Turner
- Justice Studio, 10 Portfleet Place, De Beauvoir Road, London, N1 5SZ, UK
| | - Laura Sheard
- York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD, York, UK
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11
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Nguyen A, Arteaga S, Mystic MI, Cuentos A, Armstead M, Arcara J, Jackson AV, Marshall C, Gomez AM. Supporting Birthing People and Supporting Doulas: The Impact of the COVID-19 Pandemic on a Community-Based Doula Organization in San Francisco. Health Equity 2023; 7:356-363. [PMID: 37351531 PMCID: PMC10282965 DOI: 10.1089/heq.2022.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 06/24/2023] Open
Abstract
Background Beginning in March 2020, health care systems in the United States restricted the number of support people who could be present during pregnancy-related care to reduce the spread of COVID-19. We aimed to describe how SisterWeb, a community-based doula organization that employs Black, Pacific Islander, and Latinx doulas in San Francisco, California, adapted to the COVID-19 pandemic. Methods As part of process and outcome evaluations conducted through an academic-community partnership, we interviewed SisterWeb doulas, mentors, and leaders in 2020, 2021, and 2022 (n=26 interviews). We identified preliminary themes using the Rapid Assessment Process and then conducted thematic analysis of data related to COVID-19. Results SisterWeb leadership remained committed to safeguarding doulas by shifting to virtual support until doulas were onboarded as benefitted employees. Doulas reported hospital policies impacted clients' pregnancy-related care. Initially, doulas adapted to virtual support by connecting with clients more frequently through phone and text. When permitted to meet in person, doulas adjusted to client preference. Finally, as the pandemic impacted doulas' well-being, they turned to mentors for emotional support. Discussion and Health Equity Implications This analysis contributes to a growing body of literature describing doulas' experiences during the pandemic. By shifting to virtual support, SisterWeb leaders prioritized the health, safety, and financial stability of doulas, who were members of communities disproportionately impacted by COVID-19. Our findings suggest that public health guidance, organizational COVID-19 precautions, and hospital policies hindered SisterWeb's goal of ensuring clients receive equitable medical care. In addition, we found that emotional support for doulas is vital to their work.
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Affiliation(s)
- Ashley Nguyen
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Stephanie Arteaga
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California, USA
| | - Marlee-I Mystic
- SisterWeb San Francisco Community Doula Network, San Francisco, California, USA
| | - Alli Cuentos
- SisterWeb San Francisco Community Doula Network, San Francisco, California, USA
| | - Marna Armstead
- SisterWeb San Francisco Community Doula Network, San Francisco, California, USA
| | - Jennet Arcara
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California, USA
| | - Andrea V. Jackson
- Department of Obstetrics, Gynecology and Family Planning, Maternal, Child, and Adolescent Health Program, University of California, San Francisco, San Francisco, California, USA
| | - Cassondra Marshall
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Anu Manchikanti Gomez
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California, USA
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Holmes C, Iwanaga K. Parental Burnout, Quality of Life,
and Pregnancy During COVID-19. FAMILY JOURNAL (ALEXANDRIA, VA.) 2023:10664807231173693. [PMCID: PMC10170250 DOI: 10.1177/10664807231173693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background: Parents may be at greater risk to experience parental burnout after experiencing challenges during the COVID-19 pandemic. Given the unique experiences of parents with young children during the first two years of the pandemic, this study explored the relationship between parental burnout, quality of life (QOL), and perceived threat of COVID-19 among a sample of adults who parented at least one child under the age of five. Method: A brief survey was conducted through convenience sampling (N = 48) and included the Brief Parental Burnout Scale, The QOL Scale, and a perceived COVID threat scale. Results: Logistic regression analysis found that pregnancy was a significant predictor of burnout risk even after controlling other effects on burnout risk. Conclusion: Findings suggest that the pandemic negatively impacted parental burnout and pregnancy during the first 2 years of the pandemic increased risk for burnout. Awareness is important for appropriate assessment and intervention by clinicians.
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Affiliation(s)
- Courtney Holmes
- Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, VA, USA
| | - Kanako Iwanaga
- Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, VA, USA
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13
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Rousseau A, Dubel-Jam M, Schantz C, Gaucher L. Barrier measures implemented in French maternity hospitals during the COVID-19 pandemic: A cross-sectional survey. Midwifery 2023; 118:103600. [PMID: 36680960 PMCID: PMC9839455 DOI: 10.1016/j.midw.2023.103600] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/12/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The objectives of this survey were 1) to describe the changes over time of barrier measures in maternity units, specifically, co-parent visits and women wearing masks in birth rooms, and 2) to identify potential institutional determinants of these barrier measures. DESIGN We used an online questionnaire to conduct a descriptive cross-sectional survey from May to July 2021. SETTING All districts in mainland France. PARTICIPANTS Midwife supervisor of each maternity unit. MEASUREMENTS Primary outcomes were "banning of visits" in the postnatal department during the first lockdown (March-May 2020), and "mandated mask-wearing in birth rooms" during the survey period (May-July 2021); the independent variables were maternity unit characteristics and location in a crisis area. Co-parent visits were considered only during the first lockdown as they were mostly allowed afterwards, and the wearing of masks was studied only during the survey period, as masks were unavailable for the population during the first lockdown. RESULTS We obtained 343 responses, i.e., 75.2% of French maternity units. Visits to the postnatal department were forbidden in 39.3% of the maternity units during the first lockdown and in none during the study period. Maternity hospitals with neonatal intensive care units were the most likely to ban co-parent hospital visits (adjusted OR 2.34 [1.12; 4.96]). However, those were the maternity units least likely to encourage or require women to wear masks while pushing (adjusted OR, 0.31; 95% confidence interval [CI], 0.11-0.77). Maternity units in crisis areas (i.e., with very high case counts) during the first lockdown banned visits significantly more often (adjusted OR, 1.68; 95% CI, 1.05-2.70). KEY CONCLUSIONS Our study showed that barrier measures evolved during the course of the pandemic but remained extremely variable between facilities. IMPLICATIONS FOR PRACTICE Maternity units implemented drastic barrier measures at the beginning of the pandemic but were able to adapt these measures over time. It is now time to learn from this experience to ensure that women and infants are no longer harmed by these measures.
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Affiliation(s)
- A. Rousseau
- Midwifery Department, EA 7285, Versailles Saint Quentin University, F-78180 Montigny-le-Bretonneux, France,Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, F-78300 Poissy, France,Université Paris-Saclay, UVSQ, Inserm, Équipe Epidémiologie clinique, CESP, 78180 Montigny le Bretonneux, France,Corresponding author at: UFR Simone Veil-Santé - 2 avenue de la Source de la Bièvre, F-78180 Montigny-le-Bretonneux, France
| | - M. Dubel-Jam
- Midwifery Department, EA 7285, Versailles Saint Quentin University, F-78180 Montigny-le-Bretonneux, France,Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, F-78300 Poissy, France
| | - C. Schantz
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France
| | - L. Gaucher
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland,Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, F-69008 Lyon, France,Hospices Civils de Lyon, Hôpital Femme Mère-Enfant, F-69500 Bron, France
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14
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Henke RM. Knowing Well, Being Well: well-being born of understanding: The COVID-19 Pandemic and Children: Implications for Future Health. Am J Health Promot 2023; 37:263-288. [PMID: 36646664 DOI: 10.1177/08901171221140641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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15
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Witt WP, Harlaar N, Palmer A. The Impact of COVID-19 on Pregnant Women and Children: Recommendations for Health Promotion. Am J Health Promot 2023; 37:282-288. [PMID: 36646662 DOI: 10.1177/08901171221140641e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
COVID-19 continues to have severe repercussions on children and pregnant women. The repercussions include not only the direct impact of COVID-19 (ie, children getting infected by COVID-19) but also indirect impacts (eg, safeguarding from child maltreatment, obesogenic behaviors, language and socioemotional development, educational consequences [eg, interrupted learning]; social isolation; mental health; behavioral health [eg, increased substance use in adolescence]; health and economic impact of COVID-19 on caregivers and family relationships. It has also shed light on long-standing structural and socioeconomic issues, including equity in nutrition and food security, housing, childcare, and internet access. Using a socioecological, life course, and population health approach, we discuss the implications for pregnant women and children's health and well-being and give recommendations for mitigating the short and long-term deleterious impact COVID- 19 on women, children, and their families.
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