Associations between postpartum depression and assistance with household tasks and childcare during the COVID-19 pandemic: evidence from American mothers

Sleep and Mood Among Women With Histories of Depression When They Used a Responsive Infant Bassinet During the COVID-19 Pandemic

OBJECTIVE

To describe the experiences of women with histories of depression who used a responsive infant bassinet during the first 6 months after birth during the COVID-19 pandemic.

DESIGN

Secondary qualitative descriptive study with analytic expansion.

SETTING

United States.

PARTICIPANTS

Women (N = 139) who gave birth up to 6 months previously and had histories of depression.

METHODS

We used Kyngäs's method of inductive content analysis to analyze 109 open-ended responses that were collected between August 2020 to November 2021 as part of a previously conducted longitudinal study of women who used a responsive bassinet.

RESULTS

Most participants indicated that the responsive bassinet improved their infants' sleep, which, in turn, subjectively improved their sleep and mood. External stressors and challenges presented barriers to good sleep for the participants and their infants, and participants described how these challenges contributed to their symptoms related to mood. When participants reported that they used the responsive bassinet, they shared that their infants were swaddled in the supine sleep position. Participants who did not use the bassinet commonly reported unsafe sleep practices. We identified seven themes from the data: Improved Maternal Sleep Quality, Barriers to Good Maternal Sleep, Mood and Sleep Go Hand and Hand, External Stressors Impair Mood, Improved Infant Sleep Quality, Barriers to Good Infant Sleep, and Safe Sleep Positioning.

CONCLUSION

These findings can be used to inform clinicians on how a responsive bassinet may offer women at high risk for postpartum depression improved sleep and instrumental support. Future researchers should use validated measures to objectively evaluate rates of postpartum depression and sleep quality in high-risk women when using a responsive bassinet.

Childcare disruptions and maternal health during the COVID-19 pandemic

During the COVID-19 pandemic, nearly all US states enacted stay-at-home orders, upending usual childcare arrangements and providing a unique opportunity to study the association between childcare disruptions and maternal health. Using data from the 2021-2022 National Survey of Children's Health, we estimated the association between childcare disruptions due to the COVID-19 pandemic and self-reported mental and physical health among female parents of young children (ages 0-5 years). Further, we assessed racial, ethnic, and socioeconomic disparities in (1) the prevalence of childcare disruptions due to the COVID-19 pandemic and (2) the association between childcare disruptions and mental or physical health. Female parents who experienced childcare disruptions due to the COVID-19 pandemic were less likely to report excellent or very good mental (-7.4 percentage points) or physical (-2.5 percentage points) health. Further, childcare disruptions were more common among parents with greater socioeconomic privilege (ie, higher education, higher income), but may have been more detrimental to health among parents with less socioeconomic privilege (eg, lower education, lower income, and single parents). As state and federal policymakers take action to address the maternal health crisis in the United States, our findings suggest that measures to improve childcare stability may also promote maternal health and health equity.

Understanding the Psychological Risks to Maternal Mental Health, Maternal-Infant Bonding, and Infant Development During the COVID-19 Pandemic

This short review summarizes two recent U.S.-based studies in which researchers evaluated the impact of the COVID-19 pandemic on postpartum outcomes. The first study examined the neurodevelopmental status of infants born to women infected with SARS-CoV-2, and the second examined psychological risks to maternal-infant bonding. Results indicated that pandemic-related stressors likely contributed to diminished maternal-infant health outcomes. It is imperative that nurses stay informed on the latest science exploring the impact the pandemic has had on the health and well-being of pregnant persons and infants.

"This is not what I imagined motherhood would look like": pregnancy, postpartum, and parenting during COVID-19 - a qualitative analysis of the first year since birth

BACKGROUND

Childbearing is one of the most emotional and transformative events in a woman's life. This study aims to explore the impact COVID-19 had on childbirth, postpartum, and the first year since giving birth.

METHODS

This was a qualitative study using data previously collected for a larger study of women who had given birth during the COVID-19 pandemic in the United States. The findings presented here are from an analysis of a subset of open-ended questions. Sixty-six participants completed questions about how COVID-19 affected childbearing and postpartum experiences. Data was analyzed using inductive thematic analysis.

RESULTS

Thematic analysis of the data identified five major themes and several subthemes, including: (1) amplification of new mother typical emotions (positive emotions and negative emotions), (2) financial impact on mothers and their families, (3) persistent impact of COVID-19, (4) new mom paradigm crash (first time mothers and experienced mothers faced different issues such as lack of education and support, adding a layer to the day-to-day, and negotiating time with others) and (5) validating the importance of maternal health. On the whole, participants were overwhelmed, isolated, and did not have enough physical and emotional support. There was a lack of supportive maternal healthcare both in the short-term and long-term, with an emphasis on poor postpartum support.

CONCLUSIONS

This study supports previous findings that women who gave birth and entered motherhood during the COVID-19 pandemic were impacted in many ways. These findings contribute to the understanding of women's experiences not just in the immediate postpartum period, but in their daily lives one year after childbirth. The results highlight that our nation's traditional maternal healthcare model may be insufficient, especially when facing a national crisis. Strain placed on the healthcare system by COVID-19 impacted both the physical and mental health of mothers who were often left with inadequate care, education, and support. Our findings point to the need for more supportive maternal health both during childbirth and postpartum.

The impact of postpartum social support on postpartum mental health outcomes during the COVID-19 pandemic

Social support is an influential component of postpartum recovery, adjustment, and bonding, which was disrupted by social distancing recommendations related to the COVID-19 pandemic. This study reports on changes in the availability of social support for postpartum women during the pandemic, investigates how those changes may have contributed to postpartum mental health, and probes how specific types of social support buffered against poor postpartum mental health and maternal-infant bonding impairment. Participants were 833 pregnant patients receiving prenatal care in an urban USA setting and using an electronic patient portal to access self-report surveys at two time points, during pregnancy (April-July 2020) and at ~12 weeks postpartum (August 2020-March 2021). Measures included an assessment of COVID-19 pandemic-related change in social support, sources of social support, ratings of emotional and practical support, and postpartum outcomes including depression, anxiety, and maternal-infant bonding. Overall self-reported social support decreased during the pandemic. Decreased social support was associated with an increased risk of postpartum depression, postpartum anxiety, and impaired parent-infant bonding. Among women reporting low practical support, emotional support appeared to protect against clinically significant depressive symptoms and impaired bonding with the infant. Decreases in social support are associated with a risk for poor postpartum mental health outcomes and impaired maternal-infant bonding. Evaluation and promotion of social support are recommended for healthy adjustment and functioning of postpartum women and families.

Women's experience of perinatal support in a high migrant Australian population during the COVID-19 pandemic: a mixed methods study

BACKGROUND

As a COVID-19 risk mitigation measure, Australia closed its international borders for two years with significant socioeconomic disruption including impacting approximately 30% of the Australian population who are migrants. Migrant populations during the peripartum often rely on overseas relatives visiting for social support. High quality social support is known to lead to improved health outcomes with disruption to support a recognised health risk.

AIM

To explore women's experience of peripartum social support during the COVID-19 pandemic in a high migrant population. To quantify type and frequency of support to identify characteristics of vulnerable perinatal populations for future pandemic preparedness.

METHODS

A mixed methods study with semi-structured interviews and a quantitative survey was conducted from October 2020 to April 2021. A thematic approach was used for analysis.

RESULTS

There were 24 participants interviewed both antenatally and postnatally (22 antenatal; 18 postnatal). Fourteen women were migrants and 10 Australian born. Main themes included; 'Significant disruption and loss of peripartum support during the COVID-19 pandemic and ongoing impact for migrant women'; 'Husbands/partners filling the support gap' and 'Holding on by a virtual thread'. Half of the participants felt unsupported antenatally. For Australian born women, this dissipated postnatally, but migrants continued to feel unsupported. Migrant women discussed partners stepped into traditional roles and duties of absent mothers and mothers-in-law who were only available virtually.

CONCLUSION

This study identified disrupted social support for migrant women during the pandemic, providing further evidence that the pandemic has disproportionately impacted migrant populations. However, the benefits identified in this study included high use of virtual support, which could be leveraged for improving clinical care in the present and in future pandemics. The COVID-19 pandemic impacted most women's peripartum social support with migrant families having ongoing disruption. Gains in the pandemic included greater gender equity for domestic work as husbands/partners increased their contribution to domestic work and childcare.

ABM Clinical Protocol #37: Physiological Infant Care-Managing Nighttime Breastfeeding in Young Infants

A central goal of the Academy of Breastfeeding Medicine (ABM) is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The ABM empowers health professionals to provide safe, inclusive, patient-centered, and evidence-based care. Pregnant and lactating people identify with a broad spectrum of genders, pronouns, and terms for feeding and parenting. There are two reasons ABM's use of gender-inclusive language may be transitional or inconsistent across protocols. First, gender-inclusive language is nuanced and evolving across languages, cultures, and countries. Second, foundational research has not adequately described the experiences of gender-diverse individuals. Therefore, ABM advocates for, and will strive to use language that is as inclusive and accurate as possible within this framework. For more explanation, please read ABM Position Statements on Infant Feeding and Lactation-Related Language and Gender (https://doi.org/10.1089/bfm.2021.29188.abm) and Breastfeeding As a Basic Human Right (https://doi.org/10.1089/bfm.2022.29216.abm).

Association between depressive symptoms in the postpartum period and COVID-19: A meta-analysis

BACKGROUND

With the pandemic of COVID, the public are faced with tremendous threatens both physically and mentally. Postpartum depression (PPD) is one of the most serious complications of childbearing, bringing severe impact on a woman's mental state and mood after birth. Research has shown that maternal mental state is closely correlated with PPD, those undergo the emergency or significant life changes during the postpartum period are more likely to suffer from PPD. In this study, we conducted the meta-analysis to estimate the association between PPD and COVID-19 pandemic.

METHODS

PubMed, Web of Science, PsycINFO, ScienceDirect, CNKI, China Science and Technology Journal Database, and WANFANG Database were searched for potentially relevant articles published before April 2022. Review Manager 5.2 was used to perform a meta-analysis and subgroup analysis to compute the pooled odds ratio.

RESULTS

A total of 26 studies were included in this review. The overall pooled prevalence of PPD in the review was 24 % (95 % CI: 0.19-0.29), with China's at 22 % (95 % CI 0.16-0.28) and other countries at 25 % (95 % CI 0.18-0.32) during the COVID-19 pandemic. Moreover, compared to those who did not experience COVID-19, those who experienced it had an increased risk of PPD[OR:1.83(95 % CI 1.70-1.97)].

CONCLUSIONS

According to this analysis, there was a significantly higher prevalence and odds of PPD in those who suffered from the COVID-19 pandemic. Additionally, we also found that China had a lower prevalence of postpartum depression than other countries during the COVID-19 pandemic. Our study may provide the instruction for the care of new mother under the situation of COVID-19 prevalence.

Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use?

Rates of mood disorders and substance use increased during the COVID-19 pandemic for postpartum women. The present study's aims were to: (1) examine the prevalence of major depressive disorder (MDD) in postpartum women during the COVID-19 pandemic, and (2) evaluate whether social support can buffer the associations between MDD, psychosocial factors (perceived stress, generalized anxiety, and intimate partner violence) and substance use (alcohol and drug use). A nationwide survey included 593 postpartum mothers (within 12 months from birth). Participants were assessed for a provisional diagnosis of MDD, and provided responses on validated instruments measuring stress, intimate partner violence, suicidal ideation, generalized anxiety, social support, and substance use. A hierarchical logistic regression model assessed the association of psychosocial factors and substance use with MDD. The final model shows that social support attenuates the association of MDD with perceived stress, alcohol use, and drug use, but does not buffer the relationship of MDD with anxiety or intimate partner violence. Social support was shown to significantly attenuate the effects of stress, alcohol use, and drug use on MDD, suggesting that the presence of a strong, supportive social network should be an area of increased focus for public health and healthcare professionals when caring for postpartum women.