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Skelton E, Cromb D, Smith A, Harrison G, Rutherford M, Malamateniou C, Ayers S. The influence of antenatal imaging on prenatal bonding in uncomplicated pregnancies: a mixed methods analysis. BMC Pregnancy Childbirth 2024; 24:265. [PMID: 38605314 PMCID: PMC11007968 DOI: 10.1186/s12884-024-06469-0] [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: 08/01/2023] [Accepted: 03/30/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Prenatal bonding describes the emotional connection expectant parents form to their unborn child. Research acknowledges the association between antenatal imaging and enhanced bonding, but the influencing factors are not well understood, particularly for fathers or when using advanced techniques like fetal magnetic resonance imaging (MRI). This study aimed to identify variables which may predict increased bonding after imaging. METHODS First-time expectant parents (mothers = 58, fathers = 18) completed a two-part questionnaire (QualtricsXM™) about their expectations and experiences of ultrasound (n = 64) or fetal MRI (n = 12) scans in uncomplicated pregnancies. A modified version of the Prenatal Attachment Inventory (PAI) was used to measure bonding. Qualitative data were collected through open-ended questions. Multivariate linear regression models were used to identify significant parent and imaging predictors for bonding. Qualitative content analysis of free-text responses was conducted to further understand the predictors' influences. RESULTS Bonding scores were significantly increased after imaging for mothers and fathers (p < 0.05). MRI-parents reported significantly higher bonding than ultrasound-parents (p = 0.02). In the first regression model of parent factors (adjusted R2 = 0.17, F = 2.88, p < 0.01), employment status (β = -0.38, p < 0.05) was a significant predictor for bonding post-imaging. The second model of imaging factors (adjusted R2 = 0.19, F = 3.85, p < 0.01) showed imaging modality (β = -0.53), imaging experience (β = 0.42) and parental excitement after the scan (β = 0.29) were significantly (p < 0.05) associated with increased bonding. Seventeen coded themes were generated from the qualitative content analysis, describing how scans offered reassurance about fetal wellbeing and the opportunity to connect with the baby through quality interactions with imaging professionals. A positive scan experience helped parents to feel excited about parenthood. Fetal MRI was considered a superior modality to ultrasound. CONCLUSIONS Antenatal imaging provides reassurance of fetal development which affirms parents' emotional investment in the pregnancy and supports the growing connection. Imaging professionals are uniquely positioned to provide parent-centred experiences which may enhance parental excitement and facilitate bonding.
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Affiliation(s)
- Emily Skelton
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, London, EC1V 0HB, UK.
| | - Daniel Cromb
- Perinatal Imaging and Health, King's College London, London, SE1 7EH, UK
- Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - Alison Smith
- Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - Gill Harrison
- Society and College of Radiographers, London, SE1 2EW, UK
| | - Mary Rutherford
- Perinatal Imaging and Health, King's College London, London, SE1 7EH, UK
| | - Christina Malamateniou
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, London, EC1V 0HB, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, EC1V 0HB, UK
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Neal S, Stone L, Moncrieff G, Matthews Z, Kingdon C, Topalidou A, Balaam MC, Cordey S, Crossland N, Feeley C, Powney D, Sarian A, Fenton A, Heazell AEP, de Jonge A, Severns A, Thomson G, Downe S. Assessing safe and personalised maternity and neonatal care through a pandemic: a case study of outcomes and experiences in two trusts in England using the ASPIRE COVID-19 framework. BMC Health Serv Res 2023; 23:675. [PMID: 37349751 DOI: 10.1186/s12913-023-09669-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 06/07/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in profound and far-reaching impacts on maternal and newborn care and outcomes. As part of the ASPIRE COVID-19 project, we describe processes and outcome measures relating to safe and personalised maternity care in England which we map against a pre-developed ASPIRE framework to establish the potential impact of the COVID-19 pandemic for two UK trusts. METHODS We undertook a mixed-methods system-wide case study using quantitative routinely collected data and qualitative data from two Trusts and their service users from 2019 to 2021 (start and completion dates varied by available data). We mapped findings to our prior ASPIRE conceptual framework that explains pathways for the impact of COVID-19 on safe and personalised care. RESULTS The ASPIRE framework enabled us to develop a comprehensive, systems-level understanding of the impact of the pandemic on service delivery, user experience and staff wellbeing, and place it within the context of pre-existing challenges. Maternity services experienced some impacts on core service coverage, though not on Trust level clinical health outcomes (with the possible exception of readmissions in one Trust). Both users and staff found some pandemic-driven changes challenging such as remote or reduced antenatal and community postnatal contacts, and restrictions on companionship. Other key changes included an increased need for mental health support, changes in the availability and uptake of home birth services and changes in induction procedures. Many emergency adaptations persisted at the end of data collection. Differences between the trusts indicate complex change pathways. Staff reported some removal of bureaucracy, which allowed greater flexibility. During the first wave of COVID-19 staffing numbers increased, resolving some pre-pandemic shortages: however, by October 2021 they declined markedly. Trying to maintain the quality and availability of services had marked negative consequences for personnel. Timely routine clinical and staffing data were not always available and personalised care and user and staff experiences were poorly captured. CONCLUSIONS The COVID-19 crisis magnified pre-pandemic problems and in particular, poor staffing levels. Maintaining services took a significant toll on staff wellbeing. There is some evidence that these pressures are continuing. There was marked variation in Trust responses. Lack of accessible and timely data at Trust and national levels hampered rapid insights. The ASPIRE COVID-19 framework could be useful for modelling the impact of future crises on routine care.
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Affiliation(s)
- Sarah Neal
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK.
| | - Lucy Stone
- Faculty of Medicine, Health & Life Sciences, Swansea University Medical School, Swansea University, Swansea, UK
| | - Gill Moncrieff
- ReaCH Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Zoë Matthews
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Carol Kingdon
- ReaCH Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Anastasia Topalidou
- ReaCH Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Marie-Clare Balaam
- ReaCH Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Sarah Cordey
- ReaCH Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Nicola Crossland
- MAINN Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Claire Feeley
- Nursing, Midwifery & Palliative Care, Methodologies Division, King's College London, London, UK
| | - Deborah Powney
- School of Justice, University of Central Lancashire, Preston, PR1, UK
| | - Arni Sarian
- School of Medicine, University of Central Lancashire, Preston, UK
| | - Alan Fenton
- Newcastle Neonatal Service, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Alexander E P Heazell
- Maternal and Fetal Health Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Ank de Jonge
- Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Gill Thomson
- MAINN Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Soo Downe
- ReaCH Group, School of Community Health and Midwifery, Faculty of Health and Care, University of Central Lancashire, Preston, UK
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Dennehy R, Hennessy M, Dhubhgain JU, Lucey C, O Donoghue K. 'An extra level of kind of torment': Views and experiences of recurrent miscarriage care during the initial phases of COVID-19 in Ireland-A qualitative interview study. Health Expect 2023. [PMID: 37300364 DOI: 10.1111/hex.13791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION Maternity services underwent much change during the COVID-19 pandemic. Research on the impact on miscarriage care and experiences during this time is sparse. Within a national evaluation of recurrent miscarriage care, we qualitatively explored stakeholder views and experiences of recurrent miscarriage services in Ireland. This study describes the impact of the COVID-19 pandemic on those experiences and perceptions of care. METHODS People with professional and lived experience of recurrent miscarriage and service engagement were actively involved in this qualitative study from idea generation to analysis and reporting. We recruited women and men with two or more consecutive first-trimester miscarriages, and people involved in the management/delivery of recurrent miscarriage services and supports. We used purposive sampling to ensure that perspectives across disciplinary or lived experience, geographical, and health service administrative areas, were included. We conducted semi-structured interviews, virtually all due to COVID-19 restrictions, between June 2020 and February 2021. These were audio-recorded, and data were transcribed, and subsequently analyzed using reflexive thematic analysis. RESULTS We interviewed 42 service providers and 13 women and 7 men with experience of recurrent miscarriage. We actively generated two central themes during data analysis. The first-'Disconnected'-describes how many women navigated miscarriage diagnosis and management and care in subsequent pregnancies alone; many felt that this resulted in increased trauma. At the same time, men struggled with not being present to support their partners and described feeling disconnected. The second theme highlighted 'The perceived dispensability of recurrent miscarriage services and supports'. Some service providers felt that service reduction and redeployment demonstrated a lack of value in the service. Virtual clinics facilitated access to services, but a preference for in-person care was highlighted. CONCLUSION Our analysis provides rich insights into the significant impacts that the COVID-19 pandemic has had on the way recurrent miscarriage care is provided and experienced, with important implications for early pregnancy, miscarriage and recurrent miscarriage care. Services have undergone significant changes and, while these may be temporary, how services should be delivered in the future requires consideration, particularly given the deficits in care and care experiences highlighted prepandemic. PATIENT OR PUBLIC CONTRIBUTION Members of the multidisciplinary RE:CURRENT Project Research Advisory Group (including four parent advocates, two of whom are co-authors on this article) were actively involved throughout the study, including the generation of topic guides and the refining of themes.
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Affiliation(s)
- Rebecca Dennehy
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Marita Hennessy
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Jennifer Ui Dhubhgain
- RE:CURRENT Research Advisory Group, Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Miscarriage Association of Ireland, Carmichael Centre, Dublin, Ireland
| | - Con Lucey
- RE:CURRENT Research Advisory Group, Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Keelin O Donoghue
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
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Skelton E, Smith A, Harrison G, Rutherford M, Ayers S, Malamateniou C. The effect of the COVID-19 pandemic on UK parent experiences of pregnancy ultrasound scans and parent-fetal bonding: A mixed methods analysis. PLoS One 2023; 18:e0286578. [PMID: 37267279 DOI: 10.1371/journal.pone.0286578] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Companionship in antenatal care is important for facilitating positive parental experiences. During the COVID-19 pandemic, restrictions on partner attendance at fetal ultrasound scans were introduced nationally to minimise transmission of the virus. This study aimed to explore the effect of these restrictions on maternal and paternal experiences of pregnancy scans and evaluate their potential effect on parent-fetal bonding. METHODS A UK-wide, anonymous cross-sectional survey was completed by new and expectant parents (n = 714) who had, or were awaiting a pregnancy scan during the COVID-19 pandemic. The CORE-10 and an adapted version of the Prenatal Attachment Inventory were used to evaluate psychological distress and prenatal bonding. Additional survey questions captured parental experiences of scans. Separate statistical and thematic analyses of the data were undertaken. A joint display matrix was used to facilitate integration of quantitative and qualitative claims to generate a comprehensive interpretation of study findings. FINDINGS When fathers did not attend the scan, feelings of excitement and satisfaction were significantly reduced (p<0.001) and feelings of anxiety increased (p<0.001) in both parents. Mothers were concerned about receiving unexpected news alone and fathers felt excluded from the scan. Mean paternal bonding (38.22, SD 10.73) was significantly lower compared to mothers (47.01, SD 7.67) although no difference was demonstrated between those who had attended the scan and those who had not. CORE-10 scores suggested low-to-mild levels of psychological distress, although the mean difference between mothers and fathers was not significant. Key themes described both parents' sense of loss for their desired pregnancy scan experience and reflected on sonographers' central role in providing parent-centred care during scans. CONCLUSION Restrictions on partner attendance at scans during the COVID-19 pandemic had a negative effect on parental experiences of antenatal imaging. Provision of parent-centred care, which is inclusive of partners, is essential for improved parental experiences.
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Affiliation(s)
- Emily Skelton
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Alison Smith
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Gill Harrison
- Society and College of Radiographers, London, United Kingdom
| | - Mary Rutherford
- Perinatal Imaging and Health, King's College London, London, United Kingdom
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Christina Malamateniou
- Division of Radiography and Midwifery, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
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The impact of the COVID-19 pandemic on clinical guidance and risk assessments, and the importance of effective leadership to support UK obstetric sonographers. J Med Imaging Radiat Sci 2022; 53:S107-S115. [PMID: 36289027 PMCID: PMC9595413 DOI: 10.1016/j.jmir.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/05/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The COVID-19 pandemic had a profound impact on the provision of obstetric ultrasound services, leading to the publication of new guidance and requirement for individual departmental risk assessments in the UK. The impact of these changes on clinical practice for UK obstetric sonographers is not currently well reported in published literature. METHODS Obstetric sonographers working in the UK (n = 138) used the Qualtrics XMTM platform to complete an anonymous, online questionnaire about their experiences during the pandemic. Participants responded to closed-type questions about national guidance, risk assessment and their perception of support, and provided additional detail about their experiences in these areas through free-text response options. RESULTS Over 90% of respondents were aware of or had read guidance issued by professional organisations, although challenges for its implementation in departments were identified. These were commonly related to the clinical working environment and included limitations on physical space (76.3%), time constraints (67.5%) and ventilation (61.3%). Sonographers felt most supported by their ultrasound colleagues (83.5%) and line managers (41.2%). They felt least supported by senior management and leadership personnel (60.8%), other antenatal colleagues (51.5%) and professional organisations (41.2%). CONCLUSION Obstetric sonographers will need support from the wider service team and professional organisations to facilitate post-pandemic recovery of the workforce. Formal clinical supervision programmes may be beneficial in facilitating a more holistic approach to peer-support, although there is currently limited evidence of their use in sonographic practice.
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Chang Y, Li KMC, Chien L, Lee EY, Hong SA, Coca KP. Associations between breastfeeding intention, breastfeeding practices and post-natal depression during the COVID-19 pandemic: A multi-country cross-sectional study. MATERNAL & CHILD NUTRITION 2022; 19:e13450. [PMID: 36349949 PMCID: PMC9749603 DOI: 10.1111/mcn.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
Associations between breastfeeding intention, duration and post-natal depression (PND) have been shown in pre-COVID-19 studies. However, studies during COVID-19 have not examined the associations between breastfeeding intention, breastfeeding practices, and PND in an international sample of post-natal women, taking into consideration COVID-19 related factors. This is the first study to address this gap as both PND and breastfeeding may be affected by COVID-19, and have important long-term effects on women's and infant's health. A cross-sectional internet-based survey was conducted with 3253 post-natal women from five countries: Brazil, South Korea, Taiwan, Thailand, and the United Kingdom from July to November 2021. The results showed that women who intended to breastfeed during pregnancy had lower odds of having PND than women who did not intend to. Women who had no breastfeeding intention but actually breastfed had greater odds (AOR 1.75) of having PND than women who intended to breastfeed and actually breastfed. While there was no statistical significance in expressed breast milk feeding in multivariable logistic regression models, women who had shorter duration of breastfeeding directly on breast than they planned had greater odds (AOR 1.58) of having PND than those who breastfed longer than they planned even after adjusting for covariates including COVID-19-related variables. These findings suggested the importance of working with women on their breastfeeding intention. Tailored support is required to ensure women's breastfeeding needs are met and at the same time care for maternal mental health during and beyond the pandemic.
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Affiliation(s)
- Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK
| | - Kan M. C. Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK,Guy's and St. Thomas' NHS Foundation TrustEvelina London Children's HospitalLondonUK
| | - Li‐Yin Chien
- Institute of Community Health Care, National Yang Ming Chiao Tung UniversityYang‐Ming CampusTaipeiTaiwan
| | - Eun Y. Lee
- Department of NursingCatholic Kkottongnae UniversityCheongjuRepublic of Korea
| | - Seo A. Hong
- ASEAN Institute for Health DevelopmentMahidol UniversityNakhon PathomThailand,Institute for Health and SocietyHanyang UniversitySeoulRepublic of Korea
| | - Kelly P. Coca
- Department of Women's Health Nursing, Escola Paulista de EnfermagemUniversidade Federal de São PauloSão PauloBrazil
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Brigante L, Morelli A, Jokinen M, Plachcinski R, Rowe R. Impact of the COVID-19 pandemic on midwifery-led service provision in the United Kingdom in 2020-21: findings of three national surveys. Midwifery 2022; 112:103390. [PMID: 35709677 PMCID: PMC9155188 DOI: 10.1016/j.midw.2022.103390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 12/03/2022]
Abstract
Background The COVID-19 pandemic required all healthcare systems to adapt quickly. There is some evidence about the impact of the pandemic on United Kingdom maternity services overall, but little is known about the impact on midwifery-led services, including midwifery units and home birth services. Objective To describe changes to midwifery-led service provision in the United Kingdom and the Channel Islands during the COVID-19 pandemic. Design Three national surveys were circulated using the United Kingdom Midwifery Study System (UKMidSS) and the Royal College of Midwives (RCM) Heads and Directors of Midwifery Network. The UKMidSS surveys took place in wave 1 (April to June 2020) and in wave 2 (February to March 2021). The RCM survey was conducted in April 2020. Findings The response rate to the UKMidSS surveys was 84% in wave 1 and 70% in wave 2, while 48% of Heads and Directors of Midwifery responded to the RCM survey. Around 60% of midwifery units reported being open as usual in wave 1, with the remainder affected by closures. Fewer unit closures (15%) were reported in the wave 2 survey. Around 40% of services reported some reduction in home birth services in wave 1, compared with 15% in wave 2. The apparent impact of the pandemic varied widely across the four nations of the United Kingdom and within the English regions. Conclusions The pandemic led to increased centralisation of maternity care and the disruption of midwifery-led services, especially in the first wave. Further research should focus on the reasons behind closures, the regional variation and the impact on maternity care experience and outcomes.
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Affiliation(s)
- Lia Brigante
- Royal College of Midwives, London, United Kingdom
| | - Alessandra Morelli
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | | | | | - Rachel Rowe
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom.
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Handelzalts JE, Levy S, Ayers S, Krissi H, Peled Y. Two are better than one? The impact of lay birth companions on childbirth experiences and PTSD. Arch Womens Ment Health 2022; 25:797-805. [PMID: 35697941 PMCID: PMC9191546 DOI: 10.1007/s00737-022-01243-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/05/2022] [Indexed: 11/29/2022]
Abstract
Although continuous support during childbirth is recommended by the World Health Organization (WHO) and has well-established benefits, the practice is still not routinely implemented in all maternity settings. We studied the possible effect of an additional lay companion (other than the partner) on childbirth experience and postpartum post-traumatic stress disorder (PTSD). Two hundred and forty-six women, who gave birth in maternity wards of a large tertiary health center in Israel, responded to questionnaires in person at 1-4 days (Demographic questions and the childbirth experience questionnaire) and on-line at 8-10 weeks postpartum (City Birth Trauma Scale). Obstetric data were taken from the medical files. Women who were accompanied by their partners and an additional companion were lower in birth-related PTSD symptoms (M = 1.17, SD = 2.61) than women accompanied by only their partner (M = 1.53, SD = 2.79) (F(2, 240) = 4.0, p < 0.05). Women who had a single companion (M = 1.44, SD = 2.61) showed more birth-related PTSD symptoms than women who had two or more companions (M = 1.17, SD = 2.52) (F(1, 241) = 6.4, p < 0.05). In addition, women who had a single companion were higher in general PTSD symptoms (M = 3.91, SD = 4.73) than women who had two or more companions (M = 2.31, SD = 4.29) (F(1, 241) = 4.2, p < 0.05). No differences were found in childbirth experiences of women with single or multiple companions. Allowing more than one lay companion (other than the partner) may be a simple cost-effective way of providing beneficial support in all birth settings, promoting respectful maternity care and reducing childbirth-related PTSD levels and by that future psychopathology sequela.
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Affiliation(s)
- Jonathan E Handelzalts
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, 68114, Tel-Aviv, Israel.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Sigal Levy
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, 68114, Tel-Aviv, Israel
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | | | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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