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Küçük Öztürk G, Elmas S. "The Dark Farewell to the Light of Life": A Qualitative Study About Prenatal Loss. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:21-38. [PMID: 36179368 DOI: 10.1177/00302228221131599] [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] [Indexed: 11/17/2022]
Abstract
AIM This study was conducted to determine the experiences of women who encountered loss in the prenatal period. METHOD This study was a qualitative study conducted using the phenomenological method and was conducted according to the guidelines of the COREQ checklist. A total of 11 women who were experienced loss in the early prenatal period were interviewed. The data were analyzed using the content analysis. RESULTS Three main themes and eight sub-themes emerged. The themes were light of life (bubble of happiness, journey), dark farewell (silent scream inside, unfinished tale: motherhood, loneliness, family approach) and obscurity (uncertainty about the future, need for support). Women expressed that the loss process had negative effects on their mental health and that they needed help. CONCLUSION Pregnancy illuminates women's lives, while prenatal loss involves intense and various negative emotions, and women need support in many ways. These results show that women who experienced loss in the prenatal period should be allowed to express their feelings, thoughts and experiences, and the risks in terms of mental health should be reduced by supporting them during the loss and mourning process.
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Affiliation(s)
- Gülhan Küçük Öztürk
- Department of Psychiatric Nursing, Nevşehir Hacı Bektaş Veli UniversitySemra and Vefa Küçük Faculty of Health Sciences, Nevşehir, Turkey
| | - Semra Elmas
- Department of Nursing, School of Health, European University of Lefke, Lefke, Northern Cyprus
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2
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Nowland R, Charles J, Thomson G. Loneliness in Pregnancy and Parenthood: Impacts, Outcomes, and Costs. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:93-98. [PMID: 38559456 PMCID: PMC10964817 DOI: 10.59249/nktk3337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background: Becoming a parent has been highlighted as a period associated with increased risks for loneliness, with around one-third of parents reporting feeling lonely often or always. However, as most understanding of loneliness is based on elderly or student cohorts, further insights into the costs of parental loneliness is needed. Method: We conducted a literature review of impacts of loneliness in pregnancy and parenthood and present a synthesis of the health, social, societal, and economic costs. We draw on evidence about impacts and costs of loneliness in other cohorts to help provide a wider context to understand the impacts and costs and how parental loneliness differs from other populations. Results: Similar to literature with elderly cohorts, parental loneliness has impacts on health and wellbeing, such as depression in new parents and increased general practitioner (GP) visits in pregnancy. But also has intergenerational impacts via its association with poor mental health and social competence and increased respiratory tract infections in the child. Physical health impacts widely associated with loneliness in other cohorts have yet to be examined in parents. Loneliness in parents is likely to result in social withdrawal further isolating parents and wider societal and economic costs relating to absence from employment and informal caring roles. Conclusion: Parental loneliness has the potential for negative and pervasive impacts. As parental loneliness has wide ranging and intergenerational impacts it is important that a multi-sectoral perspective is used when examining its costs.
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Affiliation(s)
- Rebecca Nowland
- School of Nursing and Midwifery, University of Central
Lancashire, Preston, UK
| | - Joanna Charles
- Health and Social Services Group, Welsh Government,
Cardiff, Wales, UK
| | - Gill Thomson
- School of Nursing and Midwifery, University of Central
Lancashire, Preston, UK
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3
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Koire A, Erdei C, Mittal L, Wiegartz P, Liu CH. Virtual(ly) no support: Associations between virtual support group participation and peripartum mental health outcomes during the COVID-19 pandemic. Psychiatry Res 2024; 332:115683. [PMID: 38218050 DOI: 10.1016/j.psychres.2023.115683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE This study examined associations between participation in virtual support groups for peripartum women and mental health outcomes at follow-up approximately 8 months later. METHODS This cross-sectional online survey study assessed 383 women from the Perinatal Experiences and COVID-19 Effects (PEACE) study. Initial participants (T1) were re-contacted (T2) and self-reported mental health symptoms of depression (CES-D), anxiety (GAD-7), and COVID-related grief were assessed at both time points. Participants reported involvement in virtual support groups and their perception of the effectiveness of social media in addressing feelings of loneliness. RESULTS The majority (62%) of respondents participated in a virtual support group, 99% of whom used informal social media-based groups (e.g. Facebook groups). At initial evaluation, virtual group participants reported higher levels of depressive symptoms (p=0.008) and COVID grief (p=0.004), but not higher levels of anxiety. Across the cohort, self-reported depressive, anxiety, and grief symptoms did not change significantly at follow-up in paired analysis, and virtual group participants did not demonstrate improvement in mental health symptoms. CONCLUSIONS Participation in virtual support groups did not seem to improve mental health outcomes for peripartum women, and most women found social media engagement minimally effective at addressing loneliness.
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Affiliation(s)
- A Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - C Erdei
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115, USA
| | - L Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - P Wiegartz
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - C H Liu
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115, USA.
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4
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Sayahi M, Nikbina M, Jahangirimehr A, Barati B. Mental health status of pregnant women during COVID-19 in healthcare centers of Iran: A cross-sectional study. PLoS One 2023; 18:e0294850. [PMID: 38015922 PMCID: PMC10683986 DOI: 10.1371/journal.pone.0294850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic impacted every single aspect of life. In addition to being a public health emergency, the COVID-19 outbreak impacted the mental health of individuals, especially pregnant women. This study aimed to examine the mental health status of pregnant women and also the effect of sociodemographic factors on their mental health status during COVID-19 in healthcare centers of Iran. METHODS This cross-sectional, analytical-descriptive study was conducted among pregnant women referring to healthcare centers in Shoushtar, Iran, in 2021. Multistage cluster sampling was used to select participants. Data were collected using the General Health Questionnaire-28 (GHQ-28). Data were analyzed using SPSS software version 22. The Pearson correlation coefficient was used to examine the association between quantitative variables. A generalized linear model (GLM) was applied to estimate the effect of independent variables on the dependent variable (mental health). RESULTS A total of 197 participants with a mean ± SD age of 27.85 ± 6.37 years took part in this study. The total mean score of mental health was estimated at 17.47±8.20. The highest mean ± SD score was, respectively, related to social dysfunction (6.63 ± 2.86), anxiety and insomnia (5.28 ± 3.53), and somatic symptoms (4.17 ± 3.27). Mental health disorder was significantly correlated with participants' age (R = .223, P = .00), number of pregnancy (gravida) (R = .272, P = .00), number of births (para) (R = 0.272, P = .00), and number of abortions (R = .172, P = .015). About 80% of pregnant women did not reveal impaired mental health conditions or psychological distress, while 19.3% showed scores that indicate probable mental health conditions. CONCLUSION Social dysfunction was the most common mental health problem among pregnant women. It is necessary to pay more attention to the mental health status of pregnant women during a pandemic. Interventions such as practical strategies to promote social support and improve pregnant women's mental health during pregnancy are highly important.
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Affiliation(s)
- Masoumeh Sayahi
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Maryam Nikbina
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Azam Jahangirimehr
- Department of Public Health, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Barat Barati
- Department of Radiologic Technology, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
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5
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Baumel A. Digital Tools in the Service of Peer and Social Support for Perinatal Mental Health. Curr Psychiatry Rep 2023; 25:741-746. [PMID: 37782453 DOI: 10.1007/s11920-023-01464-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE OF REVIEW This study is critically evaluating the current status of digital tools for perinatal mental health, specifically focusing on how these tools can enhance peer and social support. RECENT FINDINGS Digital tools could be used to: (1) identify individuals in need and guide them towards appropriate human-supportive care; (2) autonomously train and allocate peers to aid women experiencing perinatal mental health challenges; and (3) amplify support from their natural social network. Despite clear evidence supporting the significance of social support for perinatal mental health, there is a dearth of studies on digital tools aimed at boosting such support, leaving a gap in the evidence. Findings underscore the necessity of developing digital initiatives that explicitly aim to augment social support as an active ingredient of therapeutic change for women's perinatal mental health. To establish clear evidence of digital tools' value in providing digital peer-support, further development and research are indispensable.
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Affiliation(s)
- Amit Baumel
- Department of Community Mental Health, University of Haifa, Abba Khoushy Ave 199, 3498838, Haifa, Israel.
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Stott D, Klobodu C, Chiarello LA, Posmontier B, Egohail M, Geller PA, Andrews Horowitz J, Milliron BJ. Nutrition-Related Experiences of Women With Perinatal Depression During the COVID-19 Pandemic: A Qualitative Study. J Patient Exp 2023; 10:23743735231199818. [PMID: 37693189 PMCID: PMC10486215 DOI: 10.1177/23743735231199818] [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] [Indexed: 09/12/2023] Open
Abstract
Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to the COVID-19 pandemic: (1) Adaptations in shopping and cooking behaviors; (2) increases in stress and declines in respite; (3) declines in support and increases in isolation; and (4) low levels of breastfeeding guidance. Our findings confirm the importance of resilience among women with perinatal depression and future research is needed to elucidate the mechanisms connecting resilience and dietary behaviors.
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Affiliation(s)
- Dahlia Stott
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Cynthia Klobodu
- Department of Nutrition and Food Science, College of Natural Sciences, California State University, Chico, Chico, CA, USA
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Bobbie Posmontier
- PhD in Nursing Program, College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Pamela A Geller
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Drexel University, Philadelphia, PA, USA
| | - June Andrews Horowitz
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, Dartmouth, MA, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
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MacLeod A, Aston M, Price S, Stone K, Ollivier R, Benoit B, Sim M, Marcellus L, Jack S, Joy P, Gholampourch M, Iduye D. "There's an Etiquette to Zoom That's Not Really Present In-Person": A Qualitative Study Showing How the Mute Button Shapes Virtual Postpartum Support for New Parents. QUALITATIVE HEALTH RESEARCH 2023; 33:1005-1016. [PMID: 37554077 PMCID: PMC10494476 DOI: 10.1177/10497323231187541] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Virtual spaces that allow parents in the postpartum period to connect, support each other, and exchange information have been increasing in popularity. With the COVID-19 pandemic, many parents had to rely on virtual platforms as a primary means to connect with others and attend to their postpartum health. This study explored virtual postpartum support sessions through the web-based videoconferencing software, Zoom. Guided by feminist poststructuralism and sociomaterialism, we held seven virtual support sessions for parents caring for a baby 0-12 months in age, in Canada, and interviewed 19 participants about their experiences in the sessions. Our methodological approach allowed us to analyze discourses of (1) parenthood, (2) material realities of virtual environments, and (3) support and information on this virtual platform. The purpose of this research was to understand how technology influences postpartum support and learning through online videoconferencing for parents. Our findings document an overarching discourse of Zoom etiquette by which muting was a discursive practice that all participants used. The consistent use of the mute button while not talking structured conversation in virtual postpartum sessions and resulted in three themes: (1) minimizing disruptions; (2) taking turns; and (3) staying on task. The norm of using the mute button changed how parents received and gave support and information. Based on findings and broader literature, we discuss considerations for facilitation of virtual postpartum support sessions.
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Affiliation(s)
| | | | | | | | - Rachel Ollivier
- Dalhousie University, Halifax, NS, Canada
- Queen’s University, Kingston, ON, Canada
| | | | | | | | - Susan Jack
- McMaster University, Hamilton, ON, Canada
| | - Phillip Joy
- Mount Saint Vincent University, Halifax, NS, Canada
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8
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Adlington K, Vasquez C, Pearce E, Wilson CA, Nowland R, Taylor BL, Spring S, Johnson S. 'Just snap out of it' - the experience of loneliness in women with perinatal depression: a Meta-synthesis of qualitative studies. BMC Psychiatry 2023; 23:110. [PMID: 36849948 PMCID: PMC9970854 DOI: 10.1186/s12888-023-04532-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Pregnancy and the arrival of a new baby is a time of great transition and upheaval. Women often experience social isolation and loneliness at this time and may develop depression, particularly in the postnatal period. Qualitative studies have reported that loneliness is also a feature of perinatal depression. However, until now there has been no attempt to synthesise research exploring the links between loneliness and perinatal depression. This study's aim was to explore existing qualitative evidence to answer two research questions: What are the experiences of loneliness for women with perinatal depression? What helps and what makes loneliness worse for women with perinatal depression? METHODS A qualitative meta-synthesis retrieved primary qualitative studies relevant to the research questions. Four electronic databases were systematically searched (Ovid MEDLINE®; PsycINFO; Embase; Web of Science). Papers were screened according to pre-defined inclusion criteria and assigned a quality score. Thematic analysis was used to identify major overarching themes in the literature. RESULTS Twenty-seven relevant qualitative studies were included. Themes relating to the interaction between perinatal depression and loneliness included self-isolation and hiding symptoms due to stigma of perinatal depression and fear of judgement as a 'bad mother'; a sudden sense of emotional disconnection after birth; and a mismatch between expected and actual support provided by partner, family and community. There was also a double burden of loneliness for women from disadvantaged communities, due to increased stigma and decreased social support. Validation and understanding from healthcare professionals, peer support from other mothers with experience of perinatal depression, and practical and emotional family support were all important factors that could ameliorate loneliness. CONCLUSIONS Loneliness appears to play a central role in the experience of perinatal depression based on the frequency with which it emerged in women's accounts. The findings provide a foundation for the development of further theories about the role of loneliness in perinatal depression and evidence in which future psychological and social intervention design processes can be rooted. Addressing stigma and offering culturally appropriate professional and peer support are potential targets for interventions that could help women with perinatal depression, particularly in disadvantaged communities, feel less lonely. TRIAL REGISTRATION Prospero registration: https://www.crd.york.ac.uk/prospero/display_record.php? RecordID = 251,936.
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Affiliation(s)
- Katherine Adlington
- Division of Psychiatry, University College London, London, UK. .,Section of Women's Mental Health, King's College London, London, UK. .,East London NHS Foundation Trust, London, UK.
| | | | - Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Rebecca Nowland
- School of Health and Midwifery, University of Central Lancashire, Preston, UK
| | | | | | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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Birken M, Chipp B, Shah P, Olive RR, Nyikavaranda P, Hardy J, Chhapia A, Barber N, Lee S, Pearce E, Lloyd-Evans B, Perkins R, McDaid D, Stefanidou T, Shafran R, Pitman A, Johnson S. Exploring the experiences of loneliness in adults with mental health problems: A participatory qualitative interview study. PLoS One 2023; 18:e0280946. [PMID: 36881570 PMCID: PMC9990944 DOI: 10.1371/journal.pone.0280946] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 01/11/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Loneliness is associated with many mental health conditions, as both a potential causal and an exacerbating factor. Richer evidence about how people with mental health problems experience loneliness, and about what makes it more or less severe, is needed to underpin research on strategies to help address loneliness. METHODS Our aim was to explore experiences of loneliness, as well as what helps address it, among a diverse sample of adults living with mental health problems in the UK. We recruited purposively via online networks and community organisations, with most interviews conducted during the COVID-19 pandemic. Qualitative semi-structured interviews were conducted with 59 consenting participants face-to-face, by video call or telephone. Researchers with relevant lived experience were involved at all stages, including design, data collection, analysis and writing up of results. FINDINGS Analysis led to identification of four overarching themes: 1. What the word "lonely" meant to participants, 2. Connections between loneliness and mental health, 3. Contributory factors to continuing loneliness, 4. Ways of reducing loneliness. Central aspects of loneliness were lack of meaningful connections with others and lack of a sense of belonging to valued groups and communities. Some drivers of loneliness, such as losses and transitions, were universal, but specific links were also made between living with mental health problems and being lonely. These included direct effects of mental health symptoms, the need to withdraw to cope with mental health problems, and impacts of stigma and poverty. CONCLUSIONS The multiplicity of contributors to loneliness that we identified, and of potential strategies for reducing it, suggest that a variety of approaches are relevant to reducing loneliness among people with mental health problems, including peer support and supported self-help, psychological and social interventions, and strategies to facilitate change at community and societal levels. The views and experiences of adults living with mental health problems are a rich source for understanding why loneliness is frequent in this context and what may address it. Co-produced approaches to developing and testing approaches to loneliness interventions can draw on this experiential knowledge.
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Affiliation(s)
- Mary Birken
- Division of Psychiatry, University College London, London, United Kingdom
- * E-mail:
| | - Beverley Chipp
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Prisha Shah
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Patrick Nyikavaranda
- NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Jackie Hardy
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Anjie Chhapia
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Nick Barber
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Stephen Lee
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Eiluned Pearce
- Division of Psychiatry, University College London, London, United Kingdom
| | | | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, United Kingdom
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | | | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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10
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Hoang TMH, Wong A. Exploring the Application of Intersectionality as a Path toward Equity in Perinatal Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:685. [PMID: 36613005 PMCID: PMC9819722 DOI: 10.3390/ijerph20010685] [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: 09/30/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To conduct a scoping review to determine how past studies have applied the theory of intersectionality, a critical feminist research paradigm, to understand the physical health and mental health outcomes of perinatal people as a step toward addressing maternal health disparities and injustice. The study includes a review of existing research on maternal physical and mental health outcomes, presents the strengths and limitations of existing studies, and provides recommendations on best practices in applying intersectionality in research to address systemic issues and improve outcomes for the perinatal population. METHODS We conducted an extensive literature search across four search engines, yielding 28 publications using the intersectionality framework that focused on the outcomes of perinatal people, with a total sample of 9,856,042 participants. We examined how these studies applied intersectionality and evaluated them based on three areas: conceptualization, research method, and interpretation/findings. RESULTS Our findings indicate that maternal health researchers have provided good descriptions of the interaction of systemic inequalities and have used analysis that allows for the examination of interlocking and mutually reinforcing social positions or systems. We find that improvement is needed in the areas of conceptualization, reflexivity, and understanding of power structure. Recommendations are provided in the form of a checklist to guide future research toward an impactful approach to addressing perinatal health disparities. RELEVANCE Our scoping review has implications for improving applied health research to address perinatal health disparities, mortality, and morbidity. Recommendations are given along with references to other tools, and a guidance checklist is provided to support scholars in creating an impactful approach to applying intersectionality in the goal of addressing maternal health disparities.
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Affiliation(s)
- Tuyet-Mai H. Hoang
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Ainslee Wong
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
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11
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McKinlay AR, Fancourt D, Burton A. Factors affecting the mental health of pregnant women using UK maternity services during the COVID-19 pandemic: a qualitative interview study. BMC Pregnancy Childbirth 2022; 22:313. [PMID: 35413807 PMCID: PMC9005019 DOI: 10.1186/s12884-022-04602-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/22/2022] [Indexed: 01/16/2023] Open
Abstract
Background People using maternity services in the United Kingdom (UK) have faced significant changes brought on by the COVID-19 pandemic and social distancing regulations. We focused on the experiences of pregnant women using UK maternity services during the pandemic and the impact of social distancing rules on their mental health and wellbeing. Methods We conducted 23 qualitative semi-structured interviews from June 2020 to August 2021, with women from across the UK who experienced a pregnancy during the pandemic. Nineteen participants in the study carried their pregnancy to term and four had experienced a miscarriage during the pandemic. Interviews took place remotely over video or telephone call, discussing topics such as mental health during pregnancy and use of UK maternity services. We used reflexive thematic analysis to analyse interview transcripts. Results We generated six higher order themes: [1] Some pregnancy discomforts alleviated by social distancing measures, [2] The importance of relationships that support coping and adjustment, [3] Missed pregnancy and parenthood experiences, [4] The mental health consequences of birth partner and visitor restrictions, [5] Maternity services under pressure, and [6] Lack of connection with staff. Many participants felt a sense of loss over a pregnancy experience that differed so remarkably to what they had expected because of the pandemic. Supportive relationships were important to help cope with pregnancy and pandemic-related changes; but feelings of isolation were compounded for some participants because opportunities to build social connections through face-to-face parent groups were unavailable. Participants also described feeling alone due to restrictions on their partners being present when accessing UK maternity services. Conclusions Our findings highlight some of the changes that may have affected pregnant women’s mental health during the COVID-19 pandemic. Reduced social support and being unable to have a partner or support person present during maternity service use were the greatest concerns reported by participants in this study. Absence of birth partners removed a protective buffer in times of uncertainty and distress. This suggests that the availability of a birth partner or support person must be prioritised wherever possible in times of pandemics to protect the mental health of people experiencing pregnancy and miscarriage. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04602-5.
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Affiliation(s)
- A R McKinlay
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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12
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Walker LO, Murry N. Maternal Stressors and Coping Strategies During the Extended Postpartum Period: A Retrospective Analysis with Contemporary Implications. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:104-114. [PMID: 35136882 PMCID: PMC8812510 DOI: 10.1089/whr.2021.0134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 12/18/2022]
Abstract
Background: Despite recent emphasis on the "fourth trimester" and beyond, most knowledge of stressors affecting women is focused on the first 6 postpartum weeks. Our aim was to identify postpartum-specific stressors and coping over the extended postpartum period. Methods: We analyzed data from two surveys for a combined sample of 346 postpartum women. Principal components analysis of survey items on sources of stress was used to identify categories of postpartum-specific stressors. Content analysis was used to categorize text data on coping strategies. Results: Seven stressors were identified: Overload, Working mother concerns, Isolated motherhood, Limited supportive resources, Exhaustion, Parenting demands, and Changes in body and sexuality. Overload was the most frequent stressor (F = 49.32, p < 0.001) and was significantly higher at 9-12 months than at 5-8 months or at 13 months or more (F = 6.42, p = 0.002). Fulltime employment and having more than one child were associated with elevated scores on several stressors. Content analysis yielded seven coping strategies, such as Take time alone or with others, Manage emotions and thoughts, and Maintain a manageable workload. Five of the seven stressors were associated with at least one of the top five coping strategies; none was associated with Overload or Limited supportive resources. Conclusions: Women's predominant source of stress was from overload and was highest at 9 to 12 months postpartum. Community resources and public health policy and programming are needed to prepare and support women during the challenging first postpartum year.
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Affiliation(s)
- Lorraine O Walker
- The University of Texas at Austin, School of Nursing, Austin, Texas, USA
| | - Nicole Murry
- The University of Texas at Austin, School of Nursing, Austin, Texas, USA
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Taylor BL, Nath S, Sokolova AY, Lewis G, Howard LM, Johnson S, Sweeney A. The relationship between social support in pregnancy and postnatal depression. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1435-1444. [PMID: 35451605 PMCID: PMC9246777 DOI: 10.1007/s00127-022-02269-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 03/08/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE Lack of social support is considered a potential risk factor for postnatal depression but limited longitudinal evidence is available. Pregnancy, when women have increased contact with healthcare services, may be an opportune time to intervene and help strengthen women's social networks to prevent feelings of depression postnatally, particularly for those at greatest risk. Our study examined the longitudinal relationship between social support in pregnancy and postnatal depression, and whether this is moderated by age or relationship status. METHODS We analysed data collected from 525 women from a diverse inner-city maternity population in England who were interviewed in pregnancy and again three months postnatally. Women provided sociodemographic information and completed self-report measures of depression (Edinburgh Postnatal Depression Scale) and social support (Social Provisions Scale). RESULTS Less social support in pregnancy was associated with postnatal depression, after adjusting for sociodemographic confounders and antenatal depression (Coef. = - 0.05; 95% CI - 0.10 to - 0.01; p = 0.02). There was weak evidence of a moderating effect of relationship status. Subgroup analysis showed a stronger relationship between social support in pregnancy and postnatal depression for women who were not living with a partner (Coef. = - 0.11; 95% CI - 0.21 to - 0.01; p = 0.03) than for those who were (Coef. = - 0.03; 95% CI - 0.09 to 0.02; p = 0.28). Sensitivity analysis using multiple imputations to account for missing data confirmed the main results. CONCLUSIONS Interventions that target social support in pregnancy have the potential to reduce depression postnatally. Future research should explore in greater detail which women would benefit most from which type of social support.
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Affiliation(s)
- Billie Lever Taylor
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Selina Nath
- grid.83440.3b0000000121901201Present Address: Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UK ,grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - Antoaneta Y. Sokolova
- grid.83440.3b0000000121901201Lived Experience Advisory Group, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Gemma Lewis
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Louise M. Howard
- grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - Sonia Johnson
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Angela Sweeney
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, UK.
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