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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; 49:188-194. [PMID: 38512154 DOI: 10.1097/nmc.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [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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Salm Ward TC, Abu Zahra T, Payjapoh C, Oladebo T. Experiences of birthing people during the COVID-19 pandemic: Analysis of comments from the 2020 Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS). Birth 2024. [PMID: 38798170 DOI: 10.1111/birt.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/08/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic has taken a significant toll on the US population, with birthing people having special clinical needs. The Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based surveillance system for monitoring birthing people's experiences. Comment data from the PRAMS survey can provide further insight into birthing people's experiences. This study aims to use PRAMS data to describe pandemic-related experiences in a representative sample of birthing people in Wisconsin to help inform future emergency preparedness planning. METHODS This study analyzed 2020 Wisconsin PRAMS data for births in March or later. Content analysis of pandemic-related comment data was conducted, and quantitative data on demographic characteristics and pandemic-related experiences were examined. RESULTS Findings from 1406 respondents indicated that many birthing people were affected by the pandemic, including changes in healthcare visits and employment. One hundred respondents commented on pandemic-related experiences; four interrelated themes emerged from content analysis: changed nature and quality of healthcare, limited social support, increased anxiety, stress, or fear, and employment or financial burden. Most comments discussed negative impacts; some expressed positive aspects. DISCUSSION Findings suggest opportunities for improving support for birthing people during public health emergencies, for example, through developing healthcare policies and public health guidelines that prioritize the protective mechanisms of social support for birthing people, identifying additional and immediately accessible policy protections to support birthing and postpartum people (e.g., insurance and paid leave) during public health emergencies, and implementing additional screening and support to help address increased mental health needs during public health emergencies.
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Affiliation(s)
- Trina C Salm Ward
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Tuleen Abu Zahra
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Chuthamas Payjapoh
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Tinuola Oladebo
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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Simeone RM, Meghani M, Meeker JR, Zapata LB, Galang RR, Salvesen Von Essen B, Dieke A, Ellington SR. Differences in delivery hospitalization experiences during the COVID-19 pandemic by maternal race and ethnicity, Pregnancy Risk Assessment Monitoring System, 2020. J Perinatol 2024; 44:20-27. [PMID: 37660214 PMCID: PMC11197487 DOI: 10.1038/s41372-023-01763-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE We investigated maternal COVID-19 related experiences during delivery hospitalizations, and whether experiences differed by maternal race and ethnicity. STUDY DESIGN Data from the Pregnancy Risk Assessment Monitoring System among women with live births between April-December 2020 were used. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) estimated associations between maternal race and ethnicity and COVID-19 related delivery experiences. RESULTS Among 12,879 women, 3.6% reported infant separation and 1.8% reported not being allowed support persons. Compared with non-Hispanic White women, American Indian/Alaska Native (AI/AN) (aPR = 2.7; CI: 1.2-6.2), Hispanic (aPR = 2.2; CI: 1.5-3.1), non-Hispanic Black (aPR = 2.4; CI: 1.7-3.6), and non-Hispanic Asian (aPR = 2.8; CI: 1.6-4.9) women reported more infant separation due to COVID-19. Not being allowed support persons was more common among AI/AN (aPR = 5.2; CI: 1.8-14.8) and non-Hispanic Black (aPR = 2.3; CI: 1.3-4.1) women. CONCLUSIONS COVID-19 related delivery hospitalization experiences were unequally distributed among racial and ethnic minorities.
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Affiliation(s)
- Regina M Simeone
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Mehreen Meghani
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Jessica R Meeker
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service, Rockville, MD, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauren B Zapata
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service, Rockville, MD, USA
| | - Romeo R Galang
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Beatriz Salvesen Von Essen
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Ada Dieke
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sascha R Ellington
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jackson D, Aveyard H, Commodore-Mensah Y, Dale C, Noyes J, Smith GD, Sharps P, Timmins F, Yu D. The future is ours to shape: Nursing emerging from the pandemic with insight, optimism and courage. J Adv Nurs 2024; 80:1-3. [PMID: 37165794 DOI: 10.1111/jan.15706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Debra Jackson
- Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
| | - Helen Aveyard
- School of Nursing, Oxford Brookes University, Oxford, UK
| | | | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Phyllis Sharps
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, UK
| | - Doris Yu
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China
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Nguyen TT, Criss S, Kim M, De La Cruz MM, Thai N, Merchant JS, Hswen Y, Allen AM, Gee GC, Nguyen QC. Racism During Pregnancy and Birthing: Experiences from Asian and Pacific Islander, Black, Latina, and Middle Eastern Women. J Racial Ethn Health Disparities 2023; 10:3007-3017. [PMID: 36449130 PMCID: PMC9713108 DOI: 10.1007/s40615-022-01475-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Despite persistent racial disparities in maternal health in the USA, there is limited qualitative research on women's experiences of discrimination during pregnancy and childbirth that focuses on similarities and differences across multiple racial groups. METHODS Eleven focus groups with Asian American and Pacific Islander (AAPI), Black, Latina, and Middle Eastern women (N = 52) in the USA were conducted to discuss the extent to which racism and discrimination impact pregnancy and birthing experiences. RESULTS Participants across groups talked about the role of unequal power dynamics, discrimination, and vulnerability in patient-provider relationships. Black participants noted the influence of prior mistreatment by providers in their healthcare decisions. Latinas expressed fears of differential care because of immigration status. Middle Eastern women stated that the Muslim ban bolstered stereotypes. Vietnamese participants discussed how the effect of racism on mothers' mental health could impact their children, while Black and Latina participants expressed constant racism-related stress for themselves and their children. Participants recalled better treatment with White partners and suggested a gradient of treatment based on skin complexion. Participants across groups expressed the value of racial diversity in healthcare providers and pregnancy/birthing-related support but warned that racial concordance alone may not prevent racism and emphasized the need to go beyond "band-aid solutions." CONCLUSION Women's discussions of pregnancy and birthing revealed common and distinct experiences that varied by race, skin complexion, language, immigration status, and political context. These findings highlight the importance of qualitative research for informing maternal healthcare practices that reduce racial inequities.
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Affiliation(s)
- Thu T Nguyen
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, College Park, MD, 20742, USA.
| | - Shaniece Criss
- Department of Health Sciences, Furman University, Greenville, SC, 29613, USA
| | - Melanie Kim
- Department of Anthropology, Brown University, Providence, RI, 02912, USA
| | - Monica M De La Cruz
- School of Social Welfare, University of California, Berkeley, CA, 94720, USA
| | - Nhung Thai
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, 94720, USA
| | - Junaid S Merchant
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, College Park, MD, 20742, USA
| | - Yulin Hswen
- Department of Epidemiology and Biostatistics, Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA
| | - Amani M Allen
- Division of Epidemiology, University of California, Berkeley, CA, 94704, USA
- Division of Community Health Sciences, University of California, Berkeley, CA, 94704, USA
| | - Gilbert C Gee
- Department of Community Health Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Quynh C Nguyen
- Department of Epidemiology & Biostatistics, University of Maryland School of Public Health, College Park, MD, 20742, USA
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Macdonald D, Publow C, Ross-White A, Aston M, Snelgrove-Clarke E. Postpartum experiences of women, birthing people, and their families during COVID-19: a qualitative systematic review protocol. JBI Evid Synth 2023; 21:2446-2454. [PMID: 37641817 DOI: 10.11124/jbies-22-00453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The objective of the review is to explore and understand the postpartum experiences of birthing people and their families during COVID-19. INTRODUCTION Positive postpartum experiences are formative for the long-term health and well-being of parents and babies. However, the COVID-19 pandemic has complicated the transition to parenthood and existing postpartum challenges through evolving policies and practices, including visiting limitations, masking requirements, and reduced accessibility of supports. Understanding the impact of COVID-19 on the postpartum experiences of women, birthing people (people who give birth but may not identify as women), and their families through the synthesis of qualitative evidence can help inform public health and government directives in comparable future contexts. INCLUSION CRITERIA Studies including women, birthing people, and their families who experienced postpartum during the COVID-19 pandemic will be considered. This review will include studies published after January 2020 that explore postpartum experiences up to 1 year following birth. We will examine qualitative data, including, but not limited to, research designs such as phenomenology, ethnography, grounded theory, feminist research, and action research. METHODS The following databases will be searched: MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), and LitCovid. PsyArXiv and Google Scholar will be searched for gray literature. Studies will be assessed and appraised independently by 2 reviewers and disagreements will be resolved through discussion or with a third reviewer. Data extraction will be completed by 2 reviewers. The JBI tools and resources will be used for assessing confidence and meta-aggregation, including the creation of categories and synthesized findings. REVIEW REGISTRATION PROSPERO CRD42022364030.
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Affiliation(s)
- Danielle Macdonald
- School of Nursing, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Chelsea Publow
- School of Nursing, Queen's University, Kingston, ON, Canada
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- Queen's University Libraries, Queen's University, Kingston, ON, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change: A JBI Centre of Excellence, Halifax, NS, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
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Usher K, Jackson D, Fatema SR, Jones R. Domestic violence against women has increased during the COVID-19 pandemic: A perspective paper about the need for change to current and future practice. Int J Ment Health Nurs 2023; 32:1439-1445. [PMID: 37545040 DOI: 10.1111/inm.13200] [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: 02/28/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
The COVID-19 outbreak led to widespread disruption and stress to people's lives. Concern about the escalation of domestic violence (DV) rates and related mental health issues soon emerged following the implementation of strategies aimed at curbing the spread of the virus. This perspective paper presents an overview of the issues, argues for greater recognition of the link between DV against women and serious emotional distress, and the need for greater awareness and knowledge about DV among mental health professionals. While we acknowledge that men also experience DV, their rates are much lower than for women and in this paper our focus is on women.
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Affiliation(s)
- Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Debra Jackson
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Syadani Riyad Fatema
- School of Health, University of New England, Armidale, New South Wales, Australia
- Department of Sociology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Rikki Jones
- School of Health, University of New England, Armidale, New South Wales, Australia
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Macdonald D, Helwig M, Snelgrove-Clarke E. Experiences of women who have planned unassisted home births in high-resource countries: a qualitative systematic review. JBI Evid Synth 2023; 21:1732-1763. [PMID: 37114867 DOI: 10.11124/jbies-22-00246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE The aim of this review was to identify, appraise, and synthesize the qualitative evidence about the experiences of women in high-resource countries who have planned unassisted home births. INTRODUCTION Unassisted birth occurs when a woman chooses to give birth without the assistance of health care providers. These births are planned and usually occur in a woman's home. It is difficult to know the prevalence of unassisted birth because it occurs at the margins of health care systems, making data difficult to collect. Based on its lack of visibility in society, we assume that unassisted birth is not a common birth choice. Women who choose planned unassisted birth may face stigma for their decision and their experience of birth, which challenge accepted norms. Synthesizing qualitative evidence about women's experiences of planned unassisted birth can improve our understanding about women's birthing values and provide important clues about aspects of birthing care that may be missing in mainstream birthing services. INCLUSION CRITERIA Studies that explored the experiences of women who had planned unassisted home births without the support of health care providers in high-resource countries were included. Unassisted home births were defined as those that were planned not to be assisted by health care professionals. Study designs that focused on qualitative data were eligible for inclusion. METHODS MEDLINE (Ovid), Embase, CINAHL (EBSCO), Scopus, Web of Science, Sociological Abstracts (ProQuest), ProQuest Dissertations and Theses (ProQuest), and Nursing and Allied Health Database (ProQuest) were searched in 2022. Studies published in English since the databases' inception were considered for inclusion. A search of relevant websites for unpublished and gray literature was also undertaken in 2022. Two independent reviewers assessed the methodological quality of papers identified for inclusion. Qualitative research findings were extracted from papers that met the inclusion criteria and critical appraisal standard. Findings were extracted and categorized based on similarity of meaning. The categories were synthesized to create 2 synthesized findings, and the ConQul approach was used to grade the findings to establish confidence in the synthesized findings. RESULTS Six studies were included in the review. All the studies used interviews for data collection; other methods included surveys, email correspondence, posts on internet discussion boards and forums, and websites. The total sample size for interviews was 103 participants. Total survey sample size for surveys was 87 participants. Total sample size for email correspondence was 5. Internet data sources included more than 100,000 individual and forum posts and 127 birth stories. A total of 17 findings were extracted and grouped into 4 categories. The 4 categories were then synthesized into 2 synthesized findings: i) navigating tensions within self, and between self and systems, and ii) integrating and transcending physical experiences of birth. CONCLUSIONS More research is needed to better understand the experiences of women who have planned unassisted births. Improving understanding and increasing the awareness of planned unassisted birth are necessary steps for promoting inclusive, relational, and person-centered birthing experiences for everyone. Reflection about the differences between planned unassisted births and mainstream births may support needed reorientations of perinatal services. REVIEW REGISTRATION PROSPERO CRD42019125242. SUPPLEMENTAL DIGITAL CONTENT A French-language version of the abstract of this review is available [ http://links.lww.com/SRX/A9 ].
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Affiliation(s)
- Danielle Macdonald
- School of Nursing, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
| | - Melissa Helwig
- W.K. Kellogg Health Sciences Library, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
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Vanstone M, Correia RH, Howard M, Darling E, Bayrampour H, Carruthers A, Davis A, Hadid D, Hetherington E, Jones A, Kandasamy S, Kuyvenhoven C, Liauw J, McDonald SD, Mniszak C, Molinaro ML, Pahwa M, Patel T, Sadik M, Sanya N, Shen K, Greyson D. How do perceptions of Covid-19 risk impact pregnancy-related health decisions? A convergent parallel mixed-methods study protocol. PLoS One 2023; 18:e0288952. [PMID: 37561748 PMCID: PMC10414672 DOI: 10.1371/journal.pone.0288952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Pregnant people have a higher risk of severe COVID-19 disease. They have been disproportionately impacted by COVID-19 infection control policies, which exacerbated conditions resulting in intimate partner violence, healthcare access, and mental health distress. This project examines the impact of accumulated individual health decisions and describes how perinatal care and health outcomes changed during the COVID-19 pandemic. OBJECTIVES Quantitative strand: Describe differences between 2019, 2021, and 2022 birth groups related to maternal vaccination, perinatal care, and mental health care. Examine the differential impacts on racialized and low-income pregnant people.Qualitative strand: Understand how pregnant people's perceptions of COVID-19 risk influenced their decision-making about vaccination, perinatal care, social support, and mental health. METHODS AND ANALYSIS This is a Canadian convergent parallel mixed-methods study. The quantitative strand uses a retrospective cohort design to assess birth group differences in rates of Tdap and COVID-19 vaccination, gestational diabetes screening, length of post-partum hospital stay, and onset of depression, anxiety, and adjustment disorder, using administrative data from ICES, formerly the Institute for Clinical Evaluative Sciences (Ontario) and PopulationData BC (PopData) (British Columbia). Differences by socioeconomic and ethnocultural status will also be examined. The qualitative strand employs qualitative description to interview people who gave birth between May 2020- December 2021 about their COVID-19 risk perception and health decision-making process. Data integration will occur during design and interpretation. ETHICS AND DISSEMINATION This study received ethical approval from McMaster University and the University of British Columbia. Findings will be disseminated via manuscripts, presentations, and patient-facing infographics. TRIAL REGISTRATION Registration: Clinicaltrials.gov registration number: NCT05663762.
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Affiliation(s)
- Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Rebecca H. Correia
- Health Research Methodology Graduate Program, McMaster University, Hamilton, Canada
| | - Michelle Howard
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Elizabeth Darling
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Hamideh Bayrampour
- Department of Family Practice, Midwifery Program, University of British Columbia, University Endowment Lands, Canada
| | - Andrea Carruthers
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Amie Davis
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Dima Hadid
- Health Policy PhD Program, McMaster University, Hamilton, Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada
| | - Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sujane Kandasamy
- Department of Child and Youth Health, Brock University, St. Catharines, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | - Jessica Liauw
- Department of Obstetrics and Gynecology, University of British Columbia, University Endowment Lands, Canada
| | - Sarah D. McDonald
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Department of Radiology, McMaster University, Hamilton, Canada
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Caroline Mniszak
- School of Population and Public Health, University of British Columbia, University Endowment Lands, Canada
| | | | - Manisha Pahwa
- Health Policy PhD Program, McMaster University, Hamilton, Canada
| | - Tejal Patel
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Marina Sadik
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Njideka Sanya
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Katrina Shen
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, University Endowment Lands, Canada
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Xie EB, Jung JW, Kaur J, Benzies KM, Tomfohr-Madsen L, Keys E. Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies. J Med Internet Res 2023; 25:e43219. [PMID: 37494086 PMCID: PMC10413237 DOI: 10.2196/43219] [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: 10/11/2022] [Revised: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers. OBJECTIVE This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum. METHODS A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool. RESULTS A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall. CONCLUSIONS New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.
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Affiliation(s)
| | - James Wonkyu Jung
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jasleen Kaur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Karen M Benzies
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- School of Nursing, The University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
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11
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Losing Connection: Experiences of Virtual Pregnancy and Postpartum Care During the COVID-19 Pandemic. J Perinat Neonatal Nurs 2023; 37:44-49. [PMID: 36707747 DOI: 10.1097/jpn.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION The rapid uptake of telehealth for perinatal care during the coronavirus disease-2019 (COVID-19) pandemic has led to mixed evidence as to its effectiveness, with limited research demonstrating satisfaction and appropriateness for communities at risk for poor birth outcomes. The purpose of this article is to describe the experiences of virtual care during pregnancy and postpartum among a diverse group of pregnant/birthing people in Washington State during the COVID-19 pandemic. METHODS We conducted a thematic analysis study exploring experiences of care during the COVID-19 pandemic for 15 pregnant and birthing people in Washington State. This secondary analysis utilized data specific to experiences receiving care via telehealth. RESULTS Three dominant themes were identified: loss of connection and relationships with providers; need for hands-on interactions for reassurance; and virtual care is good for some things but not all-desire for immediate, accessible care when appropriate. The majority of participants felt that it was subpar to in-person care due to a lack of connection and the inability to receive necessary tests and hands-on reassurance. DISCUSSION/CONCLUSIONS Our study findings encourage very judicious use of virtual care for communities that are at high risk for birth disparities to avoid impacting relationship building between patient and provider.
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Johnson TA, Jamieson DJ, Geary FH, Stanhope KK, Boulet SL. Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital. Womens Health Issues 2023; 33:10-16. [PMID: 36117075 PMCID: PMC9381428 DOI: 10.1016/j.whi.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION In response to the COVID-19 pandemic, health systems quickly implemented changes in care delivery with a goal of balancing patient-focused obstetric care with the need to protect pregnant persons and health care providers from infection. Yet, there is no consensus within the scientific community on the impact these measures have on obstetric outcomes in vulnerable populations. We aimed to assess the impact of the COVID-19 pandemic on rates of obstetric procedures and severe maternal morbidity (SMM) among births at an urban safety net institution. METHODS We used an interrupted time series design to calculate risk ratios (RRs) and 95% confidence intervals (CIs) comparing monthly rates of labor induction, cesarean births (overall and among nulliparous, term, singleton, vertex births), operative vaginal births, and SMM among births occurring at a public hospital before (March 1, 2016, to February 29, 2020) and during (March 1, 2020, to May 31, 2021) the COVID-19 pandemic. RESULTS There were 10,714 and 2,736 births in the prepandemic and postpandemic periods, respectively. Overall, the rates of obstetric interventions and SMM were constant over the two time periods. There were no significant differences in rates of labor induction (42% during prepandemic period vs. 45% during pandemic period; RR, 1.12; 95% CI, 0.93-1.34), operative vaginal births (5% vs. 6%; RR, 1.24; 95% CI, 0.88-1.76), cesarean births (28% vs. 33%; RR, 1.10; 95% CI, 0.94-1.28), or nulliparous, term, singleton, vertex cesarean births (24% vs. 31%; RR, 1.27; 95% CI, 0.92-1.74). Rates of SMM (7% vs. 8%; RR, 1.19; 95% CI, 0.86-1.65) were also unchanged. CONCLUSIONS Our findings indicate that the rapid implementation of measures to reduce viral transmission in the labor and delivery setting did not materially affect routine clinical management or rates of serious maternal complications.
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Affiliation(s)
- Tatyana A Johnson
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Denise J Jamieson
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Franklyn H Geary
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia
| | - Kaitlyn K Stanhope
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Sheree L Boulet
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia.
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Elling C, Sleutel MR, Wells J, Newcomb P, Valdez E, Walker K, Nguyen T. Women's and Nurses' Perceptions of Visitor Restrictions After Childbirth During the COVID-19 Pandemic. Nurs Womens Health 2022; 26:278-287. [PMID: 35697080 PMCID: PMC9187511 DOI: 10.1016/j.nwh.2022.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/08/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the perceptions of labor and delivery (L&D) nurses and childbearing women in the postpartum period regarding a restricted visitor policy during the COVID-19 pandemic. DESIGN Descriptive mixed-methods survey and open-ended questions. SETTING/LOCAL PROBLEM One hospital in the southwestern United States. There is limited evidence regarding recently imposed visitor restrictions related to COVID-19. PARTICIPANTS Individuals who were pregnant and self-identified as women who gave birth during October 2020 through March 2021 (n = 674) and L&D nurses (n = 47). INTERVENTION/MEASUREMENTS Participants who had given birth with visitor restrictions completed an online survey, and L&D nurses completed a paper survey. RESULTS Childbearing women had positive and negative views; they valued a more intimate familial bonding and recovery without visitors and appreciated decreased pressure to accommodate family/friends. They were also disappointed with sibling restrictions and were sad and frustrated with visitor limitations, especially in special circumstances (e.g., NICU admission or extended stays). Nurses expressed that visitor restrictions allowed more time for higher-quality nursing care/patient teaching and decreased distractions in emergencies, leading to safer care. Women and nurses reported that visitor restrictions allowed women more rest and relaxation as well as less worry and strain from juggling family and friends who wanted to visit, but they also identified that there was decreased family support when it was needed. CONCLUSION Women's responses were mixed, with some preferring support from many visitors, while others appreciated the intimate focus of just their partner. Most nurses preferred fewer visitors but could empathize with women.
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Affiliation(s)
- Debra Jackson
- Sydney Nursing School, University of Sydney, Sydney, Victoria, Australia
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Acker K, Eagen-Torkko M, Riley LE, Saiman L. COVID-19 Infection, Prevention, and Control Considerations in the Obstetric Environment. Clin Obstet Gynecol 2022; 65:134-147. [PMID: 35045036 PMCID: PMC8767917 DOI: 10.1097/grf.0000000000000666] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pregnancy increases the risk of severe illness due to coronavirus disease 2019 (COVID-19). Thus, prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in all obstetrical health care settings requires consistent implementation of multiple evidence-based practices and consideration of local epidemiology, local regulations for COVID-19, and guidance from the Centers for Disease Control and Prevention and Professional Societies. COVID-safe practices should be implemented for patients, visitors/support persons, and health care personnel and include screening, appropriate personal protective equipment, and transmission precautions. Vaccination of all health care personnel, pregnant people, and their support persons remains the best strategy to prevent COVID-19.
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Affiliation(s)
- Karen Acker
- Departments of Pediatrics
- Department of Infection Prevention and Control, NewYork-Presbyterian Hospital
| | - Maria Eagen-Torkko
- Department of Infection Prevention and Control, NewYork-Presbyterian Hospital
| | | | - Lisa Saiman
- Department of Infection Prevention and Control, NewYork-Presbyterian Hospital
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
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