Giving birth during the COVID‐19 pandemic, perspectives from a sample of the United States birthing persons during the first wave: March‐June 2020

Abstract

Background:The COVID-19 pandemic forced hospitals in the United States to adjust policy and procedure in order to provide safe care and prevent the spread of disease. At the beginning of the pandemic, media and case reports described pressure for medical interventions, visitor restrictions, separation from newborns, and an increase in patient demand for community birth (home and birth center). The purpose of this study was to describe birth experiences during the COVID-19 pandemic centering the birthing person's perspective. Methods: A survey was e-mailed to users of the Ovia Pregnancy app reaching a national convenience sample who gave birth between March 1, 2020, and June 11, 2020. Survey topics included birth location, the Mothers on Respect index, and openended questions capturing patient perspectives on the pandemic's effect on their birth experiences. Differences were assessed based on state-level COVID rate and by race. Content analysis was performed to analyze open-ended responses. Results: Respondents from highly impacted COVID-19 states more frequently changed or considered changing their birth location. Racial differences were also found with Black respondents reporting significantly more preterm births and lower respect scores when compared to White respondents. Six themes emerged from the content analysis: Institutional Policies, Changes in Care, Hospital Staff Interactions, Sub-par Care, Issues of Support, and Mental Health. Discussion: The health care community must continue to adapt policies and procedures to best support birthing patients during the COVID-19 pandemic. The community must also continue to address the reality that Black patients receive less respectful care compared with White patients.

Birth Satisfaction During the Early Months of the COVID-19 Pandemic in the United States

“…Women of color had lower birth satisfaction in our study, similarly to Breman et al (2021) and Janevic et al (2021) who found that Black and Latina women had reduced birth satisfaction during the COVID-19 pandemic. These findings are consistent with Hamm et al (2019) that previously reported racial disparities in birth satisfaction.…”

“…The COVID-19 pandemic has affected women's birth experiences ( Breman et al, 2021 ; Burgess et al, 2021 ). Women giving birth during the pandemic have shown a high likelihood of experiencing a traumatic birth, perinatal mental health disruption, and poor maternal–infant bonding ( Hessami et al, 2020 ; Mayopoulos et al, 2021 ).…”

“…Variables that were dissatisfiers both in and outside of a pandemic included epidurals, prolonged active labor, oxytocin, and cesarean birth (Inversetti et al). Breman et al (2021) reported patient dissatisfaction with restrictive hospital policies, changes in care, and miscommunication from health care providers to childbearing women among women giving birth in the United States early in the pandemic (March to June 2020). For women giving birth during the peak of the pandemic in New York City, COVID-19 positivity, and being a Black or Latina women were associated with lower birth satisfaction ( Janevic et al, 2021 ).…”

Unmet Prenatal Expectations During the COVID-19 Pandemic

“…The COVID-19 pandemic is a public health crisis that has dramatically affected the pregnancy experience ( Breman et al, 2021 ; Burgess et al, 2021 ). To accommodate social distancing mandates, prenatal care guidelines were developed ( American College of Obstetricians and Gynecologists, 2020 ; Centers for Disease Control and Prevention, 2020 ).…”

Delays in Infant Hearing Detection and Intervention During the COVID‐19 Pandemic: Commentary

“…2,3 Additionally, survey data suggest that there has been an increase in out-of-hospital births during the pandemic. [4][5][6] We assume that infants born outside the hospital setting are more likely to experience delays in or fail to complete newborn hearing screening. 7 The next step in EHDI is to confirm hearing loss by 3 months of age, typically with auditory brainstem response (ABR) testing.…”