Experiences of pregnant mothers using a social media based antenatal support service during the COVID-19 lockdown in the UK: findings from a user survey

Supporting patient decision-making in non-invasive prenatal testing: a comparative study of professional values and practices in England and France

BACKGROUND

Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women's reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how professionals' counselling values and practices may differ between these contexts.

METHODS

In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals.

RESULTS

Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a "principle" lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as "decision-facilitator" for patients. French interviewees described their approach through a "procedural" lens. Their focus was on formal consent, information, and the healthcare professional as "information-giver". Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice.

CONCLUSION

Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision.

Better safe than sorry: Exploring the collective sensemaking process in pregnancy virtual communities through thematic analysis

Physical symptoms induced by pregnancy are often perceived as a normal part of the physiological process and therefore not commonly discussed in clinical settings during prenatal care. This study aimed to explore how pregnant individuals adapt to physical symptoms related to their pregnancy, using the perspective of collective sensemaking. A retrospective study design with an inductive thematic analysis approach of qualitative data extracted from web-based forum posts was conducted. Among 574 initial posts and 2801 comments, three themes were identified: (i) awareness of changing pregnancy body, (ii) uncertainty about physical symptoms, and (iii) coping with discomforts associated with pregnancy. A shared identity as a group of individuals dealing with similar challenges enables pregnant individuals to develop a better comprehension of their experiences. Healthcare professionals should recognize the importance of individual and collective sensemaking in pregnancy forums and strive to provide a supportive and empathetic environment for pregnant individuals to share their experiences and seek guidance.

UK midwives' perceptions and experiences of using Facebook to provide perinatal support: Results of an exploratory online survey

Seeking support from Facebook groups during pregnancy is now widespread and social media has been widely used by the United Kingdom National Health Service (NHS) maternity services to communicate with service users during the COVID-19 pandemic. Despite this, little is currently known about midwives' attitudes towards, and experiences of social media in practice. Research is needed to understand barriers and solutions to meeting mothers' expectations of online support and to improve services. This study explored midwife involvement in Facebook groups, exploring experiences and perceptions of its use to communicate with and support mothers. An online survey consisting of open and closed questions was completed by 719 midwives and student during August- September 2020. Quantitative questionnaire data was analysed descriptively using SPSS v26. Qualitative data gathered from free text responses was analysed using reflexive thematic analysis. Few participants were involved in providing Facebook support, and most of these were unpaid. There was a consensus on a range of benefits for mothers, but widespread concern that engaging with mothers online was a personal and professional risk, underpinned by a lack of support. Experience of being involved in midwife moderation increased belief in its benefits and reduced fear of engaging online, despite a lack of renumeration and resources. Midwives and students felt they were discouraged from offering Facebook support and sought further training, guidance and support. Although limited, experiences of providing Facebook group support are positive. Perceptions of risk and a lack of support are significant barriers to midwives' involvement in using Facebook groups to support mothers. Midwives seek support and training to safely and effectively engage with mothers using Facebook. Engaging with mothers via social media is embedded in UK national policy and NHS digital strategy, and progress is needed to fulfil these, to improve services and meet mothers' expectations. Midwives' experiences suggest extending opportunities to provide Facebook support would benefit midwives, services and families. Consultation to revise local policy to support midwives and students in line with strategic goals is recommended.

Perinatal women's experiences of childbirth and parenting during the COVID-19 pandemic: A qualitative descriptive study

In this study, we described perinatal women's experiences of childbirth and parenting during the COVID-19 pandemic, guided by the qualitative descriptive methodology. We interviewed 14 women who gave birth during the pandemic. Data were analyzed using inductive qualitative content analysis. Our results showed that perinatal women experienced fear of COVID-19 infection, depression, and difficulties related to childbirth and parenting. They believed that online services and sharing information through social networking were helpful. They were looking forward to participating in outdoor activities to promote children's development and suggested enforcing untact (no contact) services for perinatal women in the post-COVID-19 era.

Exploring the antenatal care challenges faced during the COVID-19 pandemic in rural areas of Indonesia: a qualitative study

INTRODUCTION

The COVID-19 pandemic affected almost all healthcare services in Indonesia, including antenatal care (ANC). Pregnant women were a vulnerable group during the pandemic since the Indonesian government's policies at the time influenced the delivery of ANC services, particularly in rural areas. Investigating the ANC challenges faced during the pandemic from the perspectives of pregnant women and healthcare providers is important for our understanding of ANC provision. This study, therefore explores barriers to ANC appointments faced during the COVID-19 pandemic in rural areas of Indonesia from the perspectives of pregnant women and health care providers.

METHODS

This was a qualitative exploratory descriptive study involving 31 participants, consisting of 25 pregnant women and six healthcare providers who were selected via a purposive sampling method. Thadeus and Maine's Three Delays Model was used as the theoretical framework. Data were collected between March and August 2021, through two focus group discussions (FGDs), ten in-depth interviews, and field notes. Data were analyzed using a thematic analysis method.

RESULTS

Three themes describing barriers to ANC during the COVID-19 pandemic in rural areas of Indonesia emerged from this study. Those themes were: (1) The fear of being infected with COVID-19, related to anxiety, perceived vulnerability, and the desire to protect oneself and loved ones; (2) The stay-at-home policy, related to transport barriers and restricted social activity; and (3) Re-designed ANC services, related to ANC adjustments, high-risk pregnancies, insufficient information, and adherence to COVID-19 preventive behaviors.

CONCLUSION

Based on the Three Delays Model, several challenges to carrying out ANC during the COVID-19 pandemic in rural areas of Indonesia were identified. These findings demonstrate the need to formulate and implement ANC packages to facilitate pregnant women's access to health care services.

Impact of Facebook on Social Support and Emotional Wellbeing in Perinatal Women during Three Waves of the COVID-19 Pandemic in Mexico: A Descriptive Qualitative Study

The COVID-19 pandemic affected the mental health of pregnant and postpartum women in unique, unprecedented ways. Given the impossibility of delivering face-to-face care, digital platforms emerged as a first-line solution to provide emotional support. This qualitative study sought to examine the role that a closed Facebook group (CFG) played in providing social support for Mexican perinatal women and to explore the concerns they shared during the COVID-19 pandemic. A thematic analysis of all the posts in the CFG yielded nine main categories: (1) COVID-19 infections in participants and their families; (2) fear of infection; (3) infection prevention; (4) health services; (5) vaccines; (6) concerns about non-COVID-19-related health care; (7) effects of social isolation; (8) probable mental health cases; and (9) work outside the home. Participants faced stressful situations and demands that caused intense fear and worry. In addition to household tasks and perinatal care, they were responsible for adopting COVID-19 preventive measures and caring for infected family members. The main coping mechanism was their religious faith. The CFG was found to be a useful forum for supporting perinatal women, where they could share concerns, resolve doubts, and obtain information in a warm, compassionate, and empathetic atmosphere. Health providers would be advised to seek new social media to improve the quality of their services.

[Digital midwifery care during the COVID-19 pandemic in Germany-acceptance of mothers]

BACKGROUND

To ensure outpatient midwifery care during the COVID-19 pandemic, digital midwifery services were enabled for the first time in Germany in March 2020. The aim of the survey "Digital midwifery care in the context of the Covid-19 pandemic" was to conduct an initial evaluation of the newly introduced digital services from the perspective of the midwives and the users. This publication presents the results of the mothers' survey.

METHOD

In February and March 2021, a cross-sectional study with an online survey was conducted. Women insured with BARMER who gave birth to a healthy child between May and November 2020 were surveyed anonymously throughout Germany using an exploratively developed online questionnaire on the utilization, satisfaction, and potential of digital midwifery care in pregnancy and the postpartum period.

RESULTS

Feedback was provided by 1821 mothers. Around one third of the responding women had used digital midwifery services during pregnancy and/or the postpartum period and rated these services positively by over 80%. From the respondents' point of view, courses and counselling are very well suited whereas postpartum care often requires the midwife's presence. Advantages were seen in infection control and in saving time and travel.

CONCLUSION

The COVID-19 pandemic has become a catalyst for digitalization in midwifery care. The digital services were quickly implemented by freelance midwives and well accepted by women and can usefully complement the care provided in the presence of the midwife. The opportunity to utilize and further develop these offers should be taken.

"Tell us what's going on": Exploring the information needs of pregnant and post-partum women in Australia during the pandemic with 'Tweets', 'Threads', and women's views

INTRODUCTION

The provision of maternity services in Australia has been significantly disrupted in response to the COVID-19 pandemic. Many changes were initiated quickly, often with rapid dissemination of information to women. The aim of this study was to better understand what information and messages were circulating regarding COVID-19 and pregnancy in Australia and potential information gaps.

METHODS

This study adopted a qualitative approach using social media and interviews. A data analytics tool (TIGER-C19) was used to extract data from social media platforms Reddit and Twitter from June to July 2021 (in the middle of the third COVID-19 wave in Australia). A total of 21 individual semi-structured interviews were conducted with those who were, or had been, pregnant in Australia since March 2020. Social media data were analysis via inductive content analysis and interview data were thematically analysed.

RESULTS

Social media provided a critical platform for sharing and seeking information, as well as highlighting attitudes of the community towards COVID-19 vaccines in pregnancy. Women interviewed described wanting further information on the risks COVID-19 posed to themselves and their babies, and greater familiarity with the health service during pregnancy, in which they would labour and give birth. Health providers were a trusted source of information. Communication strategies that allowed participants to engage in real-time interactive discussions were preferred. A real or perceived lack of information led participants to turn to informal sources, increasing the potential for exposure to misinformation.

CONCLUSION

It is vital that health services communicate effectively with pregnant women, early and often throughout public health crises, such as the COVID-19 pandemic. This was particularly important during periods of increased restrictions on accessing hospital services. Information and communication strategies need to be clear, consistent, timely and accessible to reduce reliance on informal and potentially inaccurate sources.

Social Networking Services as a Tool for Support of Mothers: A Literature Review

BACKGROUND

Difficulties experienced by mothers in raising their children can be resolved using social networking services (SNSs). Being aware of issues associated with SNSs in such situations may be useful for supporting mothers. We herein review the issues associated with using SNSs to support mothers.

METHODS

This review was conducted using an electronic search engine to search for articles that described issues associated with using SNSs to support mothers, and which were published up to August 2022.

RESULTS

After screening, a total of 19 articles were included. We thematically categorized the contents into three major issues associated with using SNSs for support of mothers: (1) issues on the management side, (2) issues on the user side, and (3) social and environmental issues. The mainly discussed issues were the safety of using SNSs and/or securing and training human resources on the management side, busyness of mothers on the user side, as well as sociocultural and communication environment-related limitations as social and environmental issues.

CONCLUSIONS

The issues we detected would aid in developing the use of SNSs as a tool to support mothers. Further research on these issues is needed.

Mothers' experiences of using Facebook groups for local breastfeeding support: Results of an online survey exploring midwife moderation

It is established that access to ongoing informational, emotional and social support from trained health professionals including midwives assists mothers in meeting their breastfeeding goals. Social media is increasingly being used to offer this support. Research has demonstrated that support via platforms such as Facebook can improve maternal knowledge and self-efficacy and ultimately breastfeeding duration. One specific form of support that is under researched is the use of Breastfeeding Support Facebook (BSF) groups that are aimed at supporting women in specific local areas, often with links to face to face support. Initial research highlights that mothers' value these groups but the role that midwives play in offering support to local mothers through these groups has not been examined. The aim of this study was therefore to examine mothers' perceptions of midwifery support for breastfeeding delivered through these groups, specifically when midwives played an active role in being a group 'moderator' or leader. An online survey was completed by 2028 mothers who were part of local BSF groups comparing the experiences of those participating in groups moderated by midwives versus other moderators such as peer supporters. Moderation was an important factor in mothers' experiences, with trained support associated with greater engagement and more frequent visits, impacting on perceptions of group ethos, reliability and inclusivity. Midwife moderation was uncommon (5% of groups) but valued: midwife moderators offered a high level of support to mothers in their groups, with 87.5% having received midwife support often or sometimes and 97.8% rating this useful or very useful. Access to a midwife moderated group was also associated with viewing local face to face midwifery support for breastfeeding more positively. This is a significant finding, highlighting that online support complements face-to-face support in local settings (67% of groups were linked to a physical group), and improves continuity of care (14% of mothers who had midwife moderators received care from them). As such midwife moderated or supported groups have the potential to add value to local face to face services and improve breastfeeding experiences in communities. The findings have important implications to support the development of integrated online interventions to improve public health.

Improving prenatal care during lockdown: Comparing telehealth and in-person care for low-risk pregnant women in the PROTECT pilot study

Objective

to compare telehealth and in-person care during the COVID-19 lockdown in a population of low-risk pregnant women for prenatal care received and perinatal outcome.

Methods

This single-center study began during the first French lockdown in 2020. Women with at least one telehealth (remote) prenatal care visit were compared with those who received care only in person. Data include results from self-administered surveys and perinatal outcomes. The main outcome was the prenatal care experience, assessed by the 5-point Quality of Prenatal Care Questionnaire (QPCQ) score. Exploratory analyses sought to identify connections between perinatal outcomes and any of their levels of QPCQ score, health/eHealth literacy, stress, and social deprivation scores .

Results

The experimental group included 55 women and the control group 52. Maternal and neonatal outcomes were similar in both groups. The mean QPCQ scores did not support any difference between the mothers' experience of prenatal care in each group: 4.15±0.52 in the telehealth and 4.26±0.63 in the in-person groups. Similarly, levels of social deprivation, stress, and health and eHealth literacy did not differ between the groups.

Conclusion

Regardless of social deprivation or literacy level, both telehealth and in-person monitoring appeared to provide equivalent and good-quality prenatal care experiences during the pandemic, ClinicalTrial.gov registration NCT04368832 (30^th April 2020)

Expectant, anxious and excited: the information journey of Chinese first-time mothers

Purpose

The purpose of this study is to explore the information needs and behaviors of Chinese first-time mothers from the perspective of information journey theory.

Design/methodology/approach

This study uses the popular coding language Python to write a program to extract 366 posts published by first-time mothers in the Babytree community of China's largest maternal and infant platform. Content analysis is used to analyze and encode the collected data.

Findings

This study summarizes the information needs of first-time mothers in China specifically, which includes six aspects of health, pregnancy care, postpartum parenting, socialization, self-actualization, and entertainment. Then, based on its hierarchical and stage characteristics, more flexible information needs matrix for Chinese first-time mothers has been developed to reflect their changing 15 types of information needs more fully. Finally, it constructs the information journey model of Chinese first-time mothers including five stages.

Originality/value

This is the first time that information journey theory has been applied to the research on information needs and behaviors of first-time mothers. The authors have also further expanded the information seeking and acquisition phases and found new gaps in the phases to further refine the information journey model. This study can help us better understand the online information needs and behaviors of Chinese first-time mothers and provide support for organizations and online health community managers to develop new information services or improve the quality of existing services.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-10-2021-0538.

Healthy lifestyle during pregnancy: Uncovering the role of online health information seeking experience

In the new era, many people seek their health-related information through the Internet due to the increasing access to this technology. Searching online health information can affect the health behavior. This study aimed to investigate the correlation between online health information-seeking behavior and a healthy lifestyle during pregnancy in a sample of Iranian pregnant women. This cross-sectional study was conducted among pregnant women admitted to health centers of Eghlid city, Fars province, Iran in 2019. A total of 193 women participated in the study. The required data were gathered using two validated questionnaires to measure the online health information-seeking behavior and the healthy lifestyle practices of the participants. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 22. Online health information experience and its subscales showed no statistical correlation with a healthy lifestyle. Age and education did not correlate with online health information-seeking behavior. Age had a statistical correlation with a healthy lifestyle, but education had the same correlation only with some subscales of a healthy lifestyle. The findings were surprising, suggesting that online health information-seeking behavior does not affect the lifestyle of pregnant women. These finding and probable explanations are discussed, but due to the limited literature on the subject, further studies are recommended to be conducted.

Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

AIM

Social distancing guidelines implemented with the COVID-19 pandemic impacted health-care utilisation and disrupted critical social supports. Resurgence of highly transmissible strains has resulted in revisiting restrictions with potential impacts on newborn health. With concerns for inadequate post-partum support, we sought to determine if social distancing correlated with increased rates of readmission for hyperbilirubinaemia.

METHODS

Retrospective chart review identified all readmissions for hyperbilirubinaemia between 1/18 and 4/20 in Western New York. Infant/maternal demographics and data on hospital course were collected on control (1/1/18-31/1/20) and social distancing (1/2/20-30/4/20) cohorts. Nineteen outpatient clinics were surveyed regarding lactation support.

RESULTS

Monthly readmissions for hyperbilirubinaemia nearly tripled during social distancing (0.90 ± 0.91 vs. 2.63 ± 2.29 per 1000 births during early COVID, P = 0.015). Comparable severity of disease at readmission was observed with no difference in the need for therapies (phototherapy, intravenous immunoglobulin or exchange transfusion) or length of hospital stay. Mothers were younger (25.8 ± 3.3 vs. 31.3 ± 4.7 years; P = 0.005) with higher rates of primiparity and exclusive breastfeeding than national norms, however not significantly higher than controls in our small cohort (62.5 vs. 37.0% for primiparity; 87.5 vs. 81.5% for breastfeeding). Of 19 clinics surveyed, only six confirmed a telemedicine option for lactation support.

CONCLUSIONS

Rates of readmission for hyperbilirubinaemia increased during social distancing. Younger maternal age with high rates of primiparity and exclusive breastfeeding raise concern for inadequate social and/or lactation support. Proactive identification of mothers at risk and expansion of remote lactation services may be indicated with recurrent waves of the pandemic.

Analysis of online antenatal education class use via a mobile terminal app during the COVID-19 pandemic

OBJECTIVE

To understand the use of online antenatal education classes accessed via the Mother and Child Health Handbook app during the COVID-19 pandemic in order to provide a basis and suggestions for optimizing Internet education during pregnancy under public health emergencies.

METHODS

We compared and analyzed the use of online antenatal education classes via the Mother and Child Health Handbook app in Hangzhou in 2019 and 2020 (during the COVID-19 pandemic).

RESULTS

Between January 1, 2019, and December 31, 2020, a total of 229,794 pregnant women created files and registered for the app, including 124,273 women in 2019 and 105,521 women in 2020. More pregnant women participated in online antenatal education learning (n = 36,379/34.5% vs. 29,226/23.5%, p = 0.000) in 2020 than in 2019. The proportion of pregnant women in the 18-34-year-old group who participated in online learning was higher than that in the advanced age group, and the difference was statistically significant (2019: 24.3% vs. 18.8%, p = 0.000) (2020: 35.7% vs. 27.4%, p = 0.000). More pregnant women accessed online antenatal education during early pregnancy (n = 13,463/37.0% vs. 9088/31.1%, p = 0.000) in 2020 than in 2019. Similar percentages of pregnant women participated in online antenatal education during mid-pregnancy (n = 15,426/52.8% vs. 19,269/53.0%, p = 0.639) in 2019 and 2020. Fewer pregnant women accessed online antenatal education during late pregnancy (n = 10,246/28.2% vs. 9476/32.4%, p = 0.000) in 2020 than in 2019. Fewer pregnant women choose to take 'Puerperal Health' courses in 2020 than in 2019 (early pregnancy: 36.20% vs. 42.79%, p = 0.000; mid-pregnancy: 41.65% vs. 48.19%, p = 0.000; late pregnancy: 55.31% vs. 58.41%, p = 0.000). Fewer pregnant women choose to take 'Psychological Adjustment' courses in 2020 than in 2019 (early pregnancy: 21.59% vs. 29.60%, p = 0.000; mid-pregnancy: 26.20% vs. 40.50%, p = 0.000; late pregnancy: 12.79% vs. 42.53%, p = 0.000). More pregnant women choose to study 'Nutrition and Exercise' in 2020 than in 2019 (early pregnancy: 44.48% vs. 25.95%, p = 0.000; mid-pregnancy: 47.77% vs. 40.75%, p = 0.000; late pregnancy: 55.94% vs. 42.99%, p = 0.000). "Pregnancy Care and Fetal Development" was the most selected course by pregnant women in early pregnancy (2019: 67.50%; 2020: 71.39%) and middle pregnancy (2019: 67.01%; 2020: 82.05%), and the proportion in 2020 was higher than it was in 2019. "Baby care" was the most selected course by pregnant women in late pregnancy, and the proportion in 2020 was higher than it was in 2019 (78.31% vs. 72.85%).

CONCLUSION

During the COVID-19 pandemic, online antenatal education was well-used by pregnant women. More women participated in the online antenatal education modules during the COVID-19 pandemic than during 2019.The proportion of choosing different courses for pregnant women before and after the COVID-19 epidemic varied, and the learning course needs of pregnant women in different trimesters were different.

Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies

Background

The COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time.

Objectives

This study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis.

Methods

We administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants' characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges.

Results

Among 50 women, the median age was 28 years (interquartile range 24-34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support.

Conclusion

SNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.

Digitized Prenatal Newsletter: Impact on Obstetric Patient Satisfaction and Loyalty

The high demand for health information from pregnant women has encouraged the creation of an informative program through a weekly digital newsletter. The objective of this study is to evaluate its quality as a digital communication medium, in terms of satisfaction and loyalty to the pregnancy follow-up and delivery service. A cross-sectional, prospective study was carried out, surveying 179 patients by means of an online self-referral questionnaire including variables related to humanization, information needs, perceived accompaniment and satisfaction, as well as factors related to its influence on their decision to remain loyal to the center. A total of 81.2% of the participants showed high levels of satisfaction with the program. Satisfaction among nulliparous patients was significantly lower in several aspects. The resolution of doubts and the perception of peace of mind following the information received was positive for 54.8%. Of the patients in the program, 88.8% finally remained at the center, showing a strong influence of the program on their decision (mean value 75 on 1 to 100 scale). A weekly digital newsletter with specific information reduced the demand for information from pregnant women, generating high levels of satisfaction and positively influencing the decision to remain loyal to the Center.

Saying the unsayable: The online expression of mothers’ anger during a pandemic

This article investigates key triggers for mothers’ anger during the COVID-19 pandemic and some of the positive and negative consequences of its expression online. It uses the UK online parenting forum Mumsnet as a research context and source of data. Our findings support previous research into mothers’ anger during COVID-19 that suggests that the pandemic has both exacerbated longstanding sources of conflict and created new ones within their homes. This anger is frequently repressed because women need to continue to work and cohabit with the colleagues and family members who have caused this anger. However, we also identify a further trigger for mothers’ anger – their frustration at the government's perceived inaction and mis- or even dis-information about the pandemic. This anger can be exacerbated by mainstream media reports and also the sharing of suspicions and complaints on online forums such as Mumsnet. Mumsnet therefore offers a safe space for the venting of women's anger during lockdown, but also a place where feelings of anger can be perpetuated and perhaps even aroused.

Stigma, guilt and motherhood: Experiences of pregnant women with COVID-19 in Brazil

BACKGROUND

The COVID-19 pandemic raises health issues worldwide. Infected pregnant women may have negative mental health outcomes, but little is known about their emotional experiences.

AIM

We aimed to understand the experience of women infected with COVID-19 during pregnancy, regarding their feelings, their relationships, and the influence of social media.

METHODS

We conducted a qualitative study among 22 women infected with COVID-19 during pregnancy, from a tertiary hospital during the first wave of the pandemic in Brazil (May-August 2020). We applied semi-directed interviews, sociodemographic and health data sheets, and field diaries. We built the sample purposefully. Interviews were audio-recorded and transcribed verbatim. We used thematic analysis and discussed data considering the health psychology framework.

RESULTS

We created five categories following a timeline perspective, from before infection to the experience after recovering. Pregnant women were resistant to believing the diagnosis. They described a fear of serious symptoms or death, concerns about the fetus, sorrow from being isolated, and worries about stigma. Family relationships were ambiguous, generating either support or tension. The attachment to the health team through telemedicine or support during hospitalization produced a feeling of security.

CONCLUSIONS

Participants psychologically denied the COVID-19 diagnosis and did not accomplish isolation properly, even upon medical recommendations. The illness may produce a traumatic experience, regardless of mild or severe symptoms, but family/friend support and contact with the health team helped them to cope. We offer important insights for the clinical approach and future research, emphasizing that infected pregnant women require emotional support.

Factors Associated with the Implementation of Non-Pharmaceutical Interventions for Reducing Coronavirus Disease 2019 (COVID-19): A Systematic Review

There has been much discussion recently about the importance of implementing non-pharmaceutical interventions (NPIs) to protect the public from coronavirus disease 2019 (COVID-19) infection. Different governments across the world have adopted NPIs (e.g., social distancing, quarantine, isolation, lockdowns, curfews, travel restrictions, closures of schools and colleges). Two fundamental strategies, namely a strict containment strategy-also called suppression strategy-and a mitigation strategy have been adopted in different countries, mainly to reduce the reproduction number (R0) to below one and hence to reduce case numbers to low levels or eliminate human-to-human transmission, as well as to use NPIs to interrupt transmission completely and to reduce the health impact of epidemics, respectively. However, the adoption of these NPI strategies is varied and the factors impacting NPI are inconsistent and unclear. This study, therefore, aimed to review the factors associated with the implementation of NPIs (social distancing, social isolation and quarantine) for reducing COVID-19. Following PRISMA guidelines, we searched for published and unpublished studies, undertaking a systematic search of: MEDLINE, EMBASE, Allied and Complementary Medicine, COVID-19 Research, WHO database on COVID-19, and Google Scholar. Thirty-three studies were included in the study. Seven descriptive themes emerged on enablers and barriers to NPIs: the positive impact of NPIs, effective public health interventions, positive change in people's behaviour and concerns about COVID-19, the role of mass media, physical and psychological impacts, and ethnicity/age associated with COVID-19. This study has highlighted that the effectiveness of NPIs in isolation is likely to be limited, therefore, a combination of multiple measures e.g., SD, isolation and quarantine, and workplace distancing appeared more effective in reducing COVID-19. Studies suggest that targeted approaches alongside social distancing might be the way forward, and more acceptable. Further research to promote country- and context-specific adoption of NPIs to deliver public health measures is needed. Studies comparing the effectiveness of interventions and strategies will help provide more evidence for future pandemics.

Becoming a mother in the 'new' social world in Australia during the first wave of the COVID-19 pandemic

BACKGROUND

Substantial public health measures occurred in Australian society during the COVID-19 pandemic to reduce the risk of community transmission. Little was known about the impact of these changes on childbearing women.

AIM

To describe childbearing women's experiences of becoming a mother during the COVID-19 pandemic in Australia.

METHODS

A qualitative exploratory design using semi-structured interviews was used. Women were recruited through social media and self-nominated to participate in an interview. Maximum variation sampling was used. A total of 27 interviews were conducted with women across Australia. Data were analysed thematically.

FINDINGS

The thematic analysis resulted in four primary themes and ten sub-themes. The themes were 'going it alone - having a baby was an isolating experience' ('receiving maternity care alone', 'dealing with government restrictions', and 'desiring social support'), 'advocating for self or others' ('seeking reliable information', 'valuing peersupport', and 'having to be resourceful'), 'finding a way through' ('a changed experience for all', 'managing stress and anxiety', 'requiring constant adjustments', and 'managing fear mongering'), and 'keeping safe'.

CONCLUSION

Becoming a mother during the COVID-19 pandemic in Australia was a profound experience for the women. Following the public health initiatives which resulted in physical distancing restrictions, isolation, and the need to provide and receive social and peer support were common experiences. Whilst public health initiatives are implemented to keep people safe, the social and emotional toll on childbearing women should be considered by healthcare professionals. Childbearing women need to be safe but also require support and reassurance.