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Velo Higueras M, Douglas F, Kennedy C. Exploring women's motivations to freebirth and their experience of maternity care: A systematic qualitative evidence synthesis. Midwifery 2024; 134:104022. [PMID: 38718432 DOI: 10.1016/j.midw.2024.104022] [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: 01/19/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/17/2024]
Abstract
BACKGROUND Freebirth is currently defined as the deliberate decision to give birth without a regulated healthcare professional. Previous reviews have identified factors influencing women's decision to freebirth, yet there is limited evidence on what is the care experience for women who opt to freebirth. AIM To synthesise the qualitative evidence on women's motivations to freebirth and their experience of maternity care when deciding to freebirth. METHODS We conducted a qualitative evidence synthesis using a sensitive search strategy in May 2022 and August 2023. Twenty-two publications between 2008 and 2023 and from ten different high-income countries were included. Thematic synthesis, underpinned by a feminist standpoint, was used to analyse the data. FINDINGS Three main analytical themes were developed in response to each of the review questions. 'A quest for a safer birth' describes the factors influencing women's decision to freebirth. 'Powerful and powerless midwives' describes women's perceptions of their care providers (mostly midwives) and how these perceptions influenced their decision to freebirth. 'Rites of self-protection' describes women's care experiences and self-care practices in the pregnancy leading to freebirth DISCUSSION: Freebirth was rarely women's primary choice but the result of structural and relational barriers to access wanted care. Self-care in the form of freebirth helped women to achieve a positive birth experience and to protect their reproductive self-determination. CONCLUSION A new woman-centred definition of freebirth is proposed as the practice to self-care during birth in contexts where emergency maternity care is readily available.
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Affiliation(s)
- Maria Velo Higueras
- School of Nursing, Midwifery and Paramedic practice, Ishbel Gordon Building, Robert Gordon University, Garthdee Rd, Aberdeen AB10 7QE, United Kingdom.
| | - Flora Douglas
- School of Nursing, Midwifery and Paramedic practice, Ishbel Gordon Building, Robert Gordon University, Garthdee Rd, Aberdeen AB10 7QE, United Kingdom
| | - Catriona Kennedy
- School of Nursing, Midwifery and Paramedic practice, Ishbel Gordon Building, Robert Gordon University, Garthdee Rd, Aberdeen AB10 7QE, United Kingdom
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Holdren S, Crook L, Lyerly A. Birth setting decisions during COVID-19: A comparative qualitative study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227363. [PMID: 38282515 PMCID: PMC10826375 DOI: 10.1177/17455057241227363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The COVID-19 pandemic resulted in an increased number of out-of-hospital births in the United States and other nations. While many studies have sought to understand the experiences of pregnant and birthing people during this time, few have compared experiences across birth locations. OBJECTIVE The purpose of this study is to compare the narratives and decision-making processes of those who gave birth in and out of hospitals during the pandemic. DESIGN We conducted semi-structured narrative interviews with 24 women who gave birth during the COVID-19 pandemic. METHODS Interviews were transcribed and coded, and a thematic narrative analysis was employed. Final themes and exemplary quotes were determined in discussion among the research team. RESULTS Results from narrative analysis revealed three themes that played into participants' birth location decisions: (1) birth efficacy and values, (2) diverse definitions of safety, and (3) childcare and other logistics. In each of these themes, participants who gave birth in birthing centers, at the hospital, and at home describe their individualized approach to achieving a supportive birth environment while mitigating the risk of labor complications and COVID-19 infection. CONCLUSION Our study suggests that for some childbearing people, the pandemic did not change birthing values or decisions but rather brought enhanced clarity to their individual needs during birth and perceived risks, benefits, and limitations of each birthing space. This study further highlights the need for improved structural support for birthing people to access a range of safe and supportive birthing environments.
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Affiliation(s)
- Sarah Holdren
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Laura Crook
- Department of English and Comparative Literature, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anne Lyerly
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Moreno-Louzada L, Menezes-Filho N. The relationship between staying at home during the pandemic and the number of conceptions: A national panel data analysis. PLoS One 2023; 18:e0289604. [PMID: 37566617 PMCID: PMC10420359 DOI: 10.1371/journal.pone.0289604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
hether the COVID-19 pandemic has changed fertility patterns is still an open question, as social isolation for long periods can impact the number of conceptions in many ways. We combine administrative data on all recent births in Brazil with daily data on individual location to estimate the relationship between the share of individuals staying close to their homes in each week and the number of conceptions in that same week, comparing municipalities with different social isolation patterns during the first semester of 2020. We find that conceptions unequivocally decline when social isolation increases. The effect is stronger for women who are between 21 and 25 years old and more educated, as well as for richer, larger, and more urban municipalities. COVID-19 is likely to change fertility across countries depending on the behavior of the population and on the lock-down measures implemented to fight the pandemic.
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Bjertrup AJ, Væver MS, Miskowiak KW. Prediction of postpartum depression with an online neurocognitive risk screening tool for pregnant women. Eur Neuropsychopharmacol 2023; 73:36-47. [PMID: 37119561 DOI: 10.1016/j.euroneuro.2023.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023]
Abstract
Postpartum depression (PPD) is a severe mental illness affecting 10-15% of mothers. Emerging evidence indicates that negative neurocognitive bias in response to infant distress during pregnancy marks an increased risk of PPD. This proof-of-concept study aimed to investigate the association between negatively biased neurocognitive processing of infant distress during pregnancy and subsequent PPD and to explore the feasibility of an online risk screening tool. In the second or third trimester of pregnancy, 87 participants underwent two online tests of reactivity to and evaluation of infant distress and completed questionnaires regarding psychosocial risk factors. After birth, participants rated their depressive symptoms online and underwent a diagnostic telephone interview concerning PPD. Irrespective of depressive symptoms during pregnancy, negative reactivity to and evaluation of infant distress predicted PPD (reactivity: Exp(B)=1.33, p = 0.04) and depressive symptoms after birth (reactivity: B = 0.04, p = 0.048; evaluation: B = 0.10, p = 0.04). The negative reactivity toward infant distress showed high sensitivity and moderate specificity (89% and 77%, respectively), while the evaluation of infant distressed cries showed lower sensitivity and specificity (67% and 66%, respectively). The relatively small sample size prevented the inclusion of additional risk variables in the regression models. The replication of an association between negative neurocognitive bias during pregnancy with PPD risk is noteworthy and has clinical implications in terms of early prevention. However, the low response rate indicates that this tool is not feasible in its current form. Future larger-scale studies are needed to further investigate candidate risk factors in a brief online screening tool.
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Affiliation(s)
- Anne Juul Bjertrup
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Hovedvejen 17, DK-2000 Frederiksberg, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark
| | - Mette Skovgaard Væver
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Hovedvejen 17, DK-2000 Frederiksberg, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
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Jackson C, Brawner J, Ball M, Crossley K, Dickerson J, Dharni N, Rodriguez DG, Turner E, Sheard L, Smith H. Being pregnant and becoming a parent during the COVID-19 pandemic: a longitudinal qualitative study with women in the Born in Bradford COVID-19 research study. BMC Pregnancy Childbirth 2023; 23:494. [PMID: 37403018 PMCID: PMC10320984 DOI: 10.1186/s12884-023-05774-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 06/10/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Uncertainty around the risk of COVID-19 to pregnant women and their babies prompted precautionary restrictions on their health and care during the pandemic. Maternity services had to adapt to changing Government guidance. Coupled with the imposition of national lockdowns in England and restrictions on daily activities, women's experiences of pregnancy, childbirth and the postpartum period, and their access to services, changed rapidly. This study was designed to understand women's experiences of pregnancy, labour and childbirth and caring for a baby during this time. METHODS This was an inductive longitudinal qualitative study, using in-depth interviews by telephone with women in Bradford, UK, at three timepoints during their maternity journey (18 women at timepoint one, 13 at timepoint two and 14 at timepoint three). Key topics explored were physical and mental wellbeing, experience of healthcare services, relationships with partners and general impact of the pandemic. Data were analysed using the Framework approach. A longitudinal synthesis identified over-arching themes. RESULTS Three longitudinal themes captured what was important to women: (1) women feared being alone at critical points in their maternity journey, (2) the pandemic created new norms for maternity services and women's care, and (3) finding ways to navigate the COVID-19 pandemic in pregnancy and with a baby. CONCLUSIONS Modifications to maternity services impacted significantly on women's experiences. The findings have informed national and local decisions about how best to direct resources to reduce the impact of COVID-19 restrictions and the longer-term psychological impact on women during pregnancy and postnatally.
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Affiliation(s)
- Cath Jackson
- Valid Research Ltd, Sandown House, Sandbeck Way, Wetherby, LS22 7DN, UK.
| | | | - Matthew Ball
- Justice Studio, 10 Portfleet Place, De Beauvoir Road, London, N1 5SZ, UK
| | - Kirsty Crossley
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Nimarta Dharni
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Ella Turner
- Justice Studio, 10 Portfleet Place, De Beauvoir Road, London, N1 5SZ, UK
| | - Laura Sheard
- York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD, York, UK
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Prinds C, Hvidt NC, Schrøder K, Stokholm L, Rubin KH, Nohr EA, Petersen LK, Jørgensen JS, Bliddal M. Prayer and meditation practices in the early COVID-19 pandemic: A nationwide survey among Danish pregnant women. The COVIDPregDK study. Midwifery 2023; 123:103716. [PMID: 37209582 DOI: 10.1016/j.midw.2023.103716] [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: 03/09/2022] [Revised: 04/17/2023] [Accepted: 05/06/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND The emergence of the COVID-19 pandemic and the derived changes in maternity care have created stress and anxiety among pregnant women in different parts of the world. In times of stress and crisis, spirituality, including spiritual and religious practices, may increase. OBJECTIVE To describe if the COVID-19 pandemic influenced pregnant women's considerations and practises of existential meaning-making and to investigate such considerations and practices during the early pandemic in a large nationwide sample. METHODS We used survey data from a nationwide cross-sectional study sent to all registered pregnant women in Denmark during April and May 2020. We used questions from four core items on prayer and meditation practices. RESULTS A total of 30,995 women were invited, of whom 16,380 participated (53%). Among respondents, we found that 44% considered themselves believers, 29% confirmed a specific form of prayer, and 18% confirmed a specific form of meditation. In addition, most respondents (88%) reported that the COVID-19 pandemic had not influenced their responses. CONCLUSION In a nationwide Danish cohort of pregnant women, existential meaning-making considerations and practices were not changed due to the COVID-19 pandemic. Nearly one in two study participants described themselves as believers, and many practised prayer and/or meditation.
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Affiliation(s)
- Christina Prinds
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Hospital Sønderjylland, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark.
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Katja Schrøder
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; User Perspectives and Community-based Interventions, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Lonny Stokholm
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Katrine Hass Rubin
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Ellen A Nohr
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Lone K Petersen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Jan Stener Jørgensen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Mette Bliddal
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
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Meng T, Zhang Y, Lv J, Zhu C, Lan L, Zhang T. Effect of the COVID-19 pandemic on women's fertility intentions and its policy implications for China and the rest of the world: a perspective essay. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2023; 68:87-100. [PMID: 37309161 DOI: 10.1080/19485565.2023.2221842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic and its social, economic, and health implications have generally reduced women's fertility intentions in different countries. In this article, we aimed to review studies of the impact of COVID-19 infection on women's fertility intentions and interventions to provide a theoretical basis and practical benchmark for the development of effective intervention strategies in China, which lifted its zero COVID system in early December 2022.
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Affiliation(s)
- Tiantian Meng
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, P.R. China
| | - Yongmei Zhang
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, P.R. China
| | - Jiayu Lv
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, P.R. China
| | - Chunle Zhu
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, P.R. China
| | - Lan Lan
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, P.R. China
| | - Ting Zhang
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, P.R. China
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Kusumawati N, Erlinawati E, Safitri Y, Nurman M, Erlin F. Exploring Women's Reasons for Choosing Home Birth with the Help of Their Untrained Family Members: A Qualitative Research. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2023; 11:72-84. [PMID: 37114100 PMCID: PMC10126444 DOI: 10.30476/ijcbnm.2023.97491.2186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 04/29/2023]
Abstract
Background Home births with the help of untrained family members continue to be women's preference in Indonesia. However, the practice has received very little attention. The purpose of this study was to explore women's reasons for choosing home births with the help of their untrained family members. Methods This study used an exploratory-descriptive qualitative research approach and was conducted from April 2020 to March 2021 in Riau Province, Indonesia. A total of 22 respondents determined by data saturation was recruited using purposive and snowball samplings. The respondents consisted of 12 women who had at least one planned home birth with the help of their untrained family members, and 10 untrained relatives who had an experience in intentionally assisting their family member's home birth. Data were collected through semi-structured telephone interviews. Nvivo version 11 software was used for data analysis using the Graneheim and Lundman's content analysis. Results 13 categories and 4 themes emerged. The themes were living with fallacious beliefs in unassisted home childbirths, feeling of socially alienated from the surrounding communities, dealing with limited access to healthcare services, and escaping from childbirth-related stressors. Conclusion Home birth with the help of untrained family members takes place because of not only limited access to healthcare services, but also women's personal beliefs, values, and needs. Designing culturally sensitive health education, ensuring culturally competent healthcare workers and services, overcoming healthcare access barriers, and improving the community's pregnancy and childbirth literacies are fundamental in reducing unassisted home births and promoting facility childbirths.
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Affiliation(s)
- Nila Kusumawati
- Department of Nursing, Faculty of Health Sciences, Universitas Pahlawan Tuanku Tambusai, Riau Province, Indonesia
| | - Erlinawati Erlinawati
- Department of Midwifery, Faculty of Health Sciences, Universitas Pahlawan Tuanku Tambusai, Riau Province, Indonesia
| | - Yenny Safitri
- Department of Nursing, Faculty of Health Sciences, Universitas Pahlawan Tuanku Tambusai, Riau Province, Indonesia
| | - Muhammad Nurman
- Department of Nursing, Faculty of Health Sciences, Universitas Pahlawan Tuanku Tambusai, Riau Province, Indonesia
| | - Fitry Erlin
- Department of Nursing, STIKes Payung Negeri, Pekanbaru, Riau Province, Indonesia
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Lalor JG, Sheaf G, Mulligan A, Ohaja M, Clive A, Murphy-Tighe S, Ng ED, Shorey S. Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review. Women Birth 2023; 36:e203-e212. [PMID: 35973917 PMCID: PMC9364727 DOI: 10.1016/j.wombi.2022.08.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, pregnant women were identified as a high-risk and vulnerable group. To reduce risk of transmission, maternity healthcare services were modified to limit exposure but maintain services for pregnant women. However, the change in hospital practice may have compromised quality maternal care standards. Therefore, this review aims to explore parental experiences and views with maternity care received from healthcare institutions during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. Six electronic databases (Medline, CINAHL, Embase, PsycInfo, Web of Science, and Maternity and Infant Care) were searched for qualitative, observational, and mixed method studies from the year 2019 to February 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Quantitative findings were converted to narrative findings. Data was synthesised thematically using a convergent synthesis design. RESULTS Fifty-eight articles were included. Four themes were generated: (1) Distress associated with COVID-19 regulations (perception of hospital restrictions, confusion with ever changing policies), (2) adaptability with maternity services (prenatal: changes in birth plans, prenatal: altered antenatal appointments, education, and care, intrapartum: medicalization of birth, postpartum: varied views on care received and Breastfeeding woes, postpartum: skin-to-skin contact and mother infant bonding) (3) importance of support persons, and (4) future direction for maternity services. CONCLUSIONS Parental experiences highlighted how maternity care during the COVID-19 pandemic did not adhere to WHO standards of quality maternity care. This calls for healthcare institutions to continuously appraise the implementation of restrictive practices that deviate from evidence-based frameworks underpinning quality care.
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Affiliation(s)
- Joan Gabrielle Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin 2, Ireland
| | - Andrea Mulligan
- School of Law, Trinity College Dublin, House 39, New Square, Dublin 2, Ireland
| | - Magdalena Ohaja
- School of Nursing and Midwifery, National University of Ireland Galway, Ireland
| | - Ashamole Clive
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | | | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore.
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Mari F, Capasso M, Caso D. Exploring the psychosocial impact of the Covid-19 pandemic on women's perinatal experiences and wellbeing: A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100805. [PMID: 36502624 PMCID: PMC9712141 DOI: 10.1016/j.srhc.2022.100805] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE While many studies have investigated the clinical impact of the Covid-19 pandemic on pregnant women's mental health, little attention has been paid to the exploration of women's experiences during the perinatal period from a psychosocial perspective in the Italian context. Thus, the present study aimed to explore the psychosocial changes associated with the pandemic in the perinatal context. METHODS Twenty-one Italian women who gave birth between March and November 2020 took part in this research by participating in semi-structured interviews, exploring their childbirth experiences. Our data were analysed using a Grounded Theory approach. RESULTS Our findings revealed the enhanced importance of social support as a protective factor against uncertainties, which strongly characterised all phases of the perinatal period during the pandemic. Such uncertainties were mainly linked to the discontinuity in intrapartum care, as well as to concerns of being infected with Covid-19 combined with other pregnancy-specific worries. The main sources of social support were represented by loved ones - most of all partners - along with health care staff and peer networks. CONCLUSIONS Our results suggest the importance of implementing evidence-based policies and interventions to improve women's wellbeing in the perinatal period during the pandemic, as well as of guaranteeing intrapartum care continuity and the presence of social support.
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Affiliation(s)
- Federica Mari
- Department of Humanities, University of Naples Federico II, Italy
| | - Miriam Capasso
- Department of Humanities, University of Naples Federico II, Italy.
| | - Daniela Caso
- Department of Humanities, University of Naples Federico II, Italy
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Pařízek A, Janků P, Kameníková M, Pařízková P, Javornická D, Benešová D, Rogalewicz V, Laštůvka Z, Barták M. Laboring Alone: Perinatal Outcomes during Childbirth without a Birth Partner or Other Companion during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2614. [PMID: 36767981 PMCID: PMC9916022 DOI: 10.3390/ijerph20032614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
During the first wave of the COVID-19 pandemic in the spring of 2020, the government of the Czech Republic issued a nationwide ban on visitors to maternity wards. We studied whether the absence of a close person during labor due to this ban impacted perinatal indicators. This study was performed using an administrative observational questionnaire focused on absolute frequencies of events sent to maternity facilities across the Czech Republic. Completed answers were received from 33 facilities covering 4805 births during the study period in 2019 and 4514 births in 2020. The differences in individual parameters were tested using Pearson's chi-squared homogeneity test. There were no significant differences between the two periods in spontaneous pre-term births (p = 0.522) or in the number of cesarean sections (p = 0.536). No significant changes were seen in either local or systemic analgesia. Data showed a significantly shorter (p = 0.026) first stage of labor in 2020 compared to 2019, while there was no significant difference (p = 0.673) in the second stage of labor. There was no statistically significant difference found for newborn perinatal adaptation. There were also no significant differences in intrapartum maternal injuries. Overall, we found no significant differences in basic perinatal indicators during the first wave of COVID-19 in 2020 compared to 2019. Although the absence of a close person may cause stress for the laboring women, it does not impair objective clinical outcomes.
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Affiliation(s)
- Antonín Pařízek
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Petr Janků
- Department of Gynecology and Obstetrics, University Hospital Brno, 602 00 Brno, Czech Republic
| | - Miloslava Kameníková
- Department of Gynecology and Obstetrics, University Hospital Brno, 602 00 Brno, Czech Republic
| | - Petra Pařízková
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Daniela Javornická
- Department of Midwifery, Faculty of Health Sciences, Palacky University Olomouc, 779 00 Olomouc, Czech Republic
| | - Dana Benešová
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Vladimír Rogalewicz
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, 272 01 Kladno, Czech Republic
| | - Zdeněk Laštůvka
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic
| | - Miroslav Barták
- Department of Social Work, Faculty of Social and Economics Studies, J. E. Purkyně University, 400 96 Ústí nad Labem, Czech Republic
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MacDorman MF, Barnard-Mayers R, Declercq E. United States community births increased by 20% from 2019 to 2020. Birth 2022; 49:559-568. [PMID: 35218065 DOI: 10.1111/birt.12627] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anecdotal and emerging evidence suggested that the 2020 COVID-19 pandemic may have influenced women's attitudes toward community birth. Our purpose was to examine trends in community births from 2019 to 2020, and the risk profile of these births. METHODS Recently released 2020 birth certificate data were compared with prior years' data to analyze trends in community births by socio-demographic and medical characteristics. RESULTS In 2020, there were 71 870 community births in the United States, including 45 646 home births and 21 884 birth center births. Community births increased by 19.5% from 2019 to 2020. Planned home births increased by 23.3%, while birth center births increased by 13.2%. Increases occurred in every US state, and for all racial and ethnic groups, particularly non-Hispanic Black mothers (29.7%), although not all increases were statistically significant. In 2020, 1 of every 50 births in the United States was a community birth (2.0%). Women with planned home and birth center births were less likely than women with hospital births to have several characteristics associated with poor pregnancy outcomes, including teen births, smoking during pregnancy, obesity, and preterm, low birthweight, and multiple births. More than two-thirds of planned home births were self-paid, compared with one-third of birth center and just 3% of hospital births. CONCLUSIONS It is to the great credit of United States midwives working in home and birth center settings that they were able to substantially expand their services during a worldwide pandemic without compromising standards in triaging women to optimal settings for safe birth.
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Affiliation(s)
- Marian F MacDorman
- Maryland Population Research Center, University of Maryland, College Park, Maryland, USA
| | | | - Eugene Declercq
- Boston University School of Public Health, Boston, Massachusetts, USA
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Thorn-Cole H, De Labrusse C, Abderhalden-Zellweger A, Kaech C, Hammer R. Impact of the COVID-19 pandemic on maternity services in Europe: a mixed methods systematic review protocol. JBI Evid Synth 2022; 20:2303-2311. [PMID: 35989639 PMCID: PMC9593326 DOI: 10.11124/jbies-22-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This review will synthesize and integrate the best available evidence on the changes caused by the COVID-19 pandemic in access to and the provision of maternity services in Europe. The review will also consider health care professionals' experiences in providing maternity care during the COVID-19 pandemic in Europe. INTRODUCTION Governments and maternity services have introduced various protective sanitary and organizational measures to reduce the spread of COVID-19 and protect the global population, including health care professionals. Since March 2020, the number of publications on this topic has soared, yet little is known about the effect of the pandemic and the accompanying measures on access to and the provision of maternity care in Europe. INCLUSION CRITERIA The review will consider quantitative, qualitative, and mixed methods studies on the impact of COVID-19 on European maternity services. For the quantitative component, the review will consider studies evaluating maternity services outcomes across all types of maternity care settings. For the qualitative component, the review will consider studies exploring maternity health care providers' experiences and perceptions of the impact of the pandemic on care provided to women and their babies. METHODS Six bibliographic databases will be searched for published and unpublished studies since March 2020. Study selection, critical appraisal, data extraction, and data synthesis will follow JBI's segregated mixed methods approach. The quantitative component will be adapted to follow the JBI requirements for systematic reviews of etiology and risk. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021283878.
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Affiliation(s)
- Harriet Thorn-Cole
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Sweet L, Muller A, Kearney L, Martis R, Hartney N, Davey K, Daellenbach R, Hall H, Atchan M. Predictors and impact of women's breastfeeding self-efficacy and postnatal care in the context of a pandemic in Australia and Aotearoa New Zealand. Midwifery 2022; 114:103462. [PMID: 36001943 DOI: 10.1016/j.midw.2022.103462] [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: 02/07/2022] [Revised: 07/05/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate predictors of breastfeeding self-efficacy, postnatal care experiences, and there subsequent impact on breastfeeding outcomes in Australia and Aotearoa New Zealand in the context of the COVID-19 pandemic. DESIGN A cross-sectional online survey collected data between August and October 2020 with recruitment via social media. Quantitative data were analyzed using descriptive analyses, and linear and logistic regression analysis related to the Breastfeeding Self-Efficacy Scale-Short Form findings. Open text responses were analyzed using content analysis. FINDINGS There were 1001 complete responses. Visitor restrictions impacted the woman's early parenting experience in both positive and negative ways. One third of participants stated their postnatal needs were not met with 82 stating that they had no postnatal care at all. During the first six weeks postnatal, 48.1% felt not very or not at all confident caring for their baby. Despite 94.3% of participants initiating breastfeeding, only 70% were exclusively breastfeeding at six weeks. The mean self-efficacy score was 49.98 suggesting the need for additional help, with first time mothers having a statistically significant lower score. DISCUSSION/CONCLUSION Sub-optimal postnatal care and support negatively influence breastfeeding self-efficacy. Women desired additional help during the COVID-19 pandemic inclusive of support and education to meet their postnatal needs and exclusively breastfeed. IMPLICATIONS FOR PRACTICE Women require appropriate and timely postnatal care and support to promote confidence in caring for baby and achieve their breastfeeding goals. Preferably this care should be provided face-to-face.
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Affiliation(s)
- Linda Sweet
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood 3125, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia.
| | - Amanda Muller
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Social Work, University of Queensland, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa New Zealand
| | - Nicki Hartney
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood 3125, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand
| | - Helen Hall
- School of Health, Federation University, Australia
| | - Marjorie Atchan
- School of Nursing, Midwifery & Public Health, University of Canberra, Australia
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