Impact of COVID-19 Institutional Isolation Measures on Postnatal Women in Level 3 COVID Facility in Northern India

Abstract

Aim:The COVID-19 pandemic has influenced many aspects of a woman's life. The aim of the present study was to explore whether hospital isolation and containment policies among women giving birth in COVID-19 Level 3 facility enhanced psycho-emotional distress in the immediate postpartum period. Methodology: The study was designed as an observational study. All women giving birth at Santosh Hospital, a Level 3 COVID facility in Ghaziabad, from June 2020 to October 2020, were studied. Data collection was done by a pretested structured questionnaire which was administered to the participants in isolation ward on the second postpartum day. The women were interrogated regarding the experiences of the COVID isolation ward with special reference to the problems faced during their stay there, the anxiety for the baby, loneliness, and other factors. The women were evaluated using Edinburgh Postnatal Depression Scale (EPDS). Result: The study group comprised 61 women who delivered in our hospital. The mean age of the subjects was 24.2 ± 1.2 years. In the study, majority of the patients were distressed with loneliness (54%) and anxiety for the baby (43%). As the policy of the institution was to hand over the newborn baby immediately to the attendants, the mother was bound to be distressed. Sleeplessness, loss of appetite, and boredom were other problems faced by the COVID-positive patients. The incidence of postnatal depression was 24.5% during COVID-19 pandemic in this institution. In the study, we found that patients with postnatal complications, patients who had symptoms of COVID, whose baby was handed over to the attendants, postpartum stay more than 7 days, and inability to connect to the family had a statistically significant correlation with those who had EPDS score >13. Conclusion:The COVID-19 pandemic has shown that perinatal mental health and well-being needs to be protected during this time.

Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review

“…Additionally, with the restriction of postpartum visitors, many mothers were eager to discharge and reunite with their partner and family [55] , [83] , but others perceived the rushed discharge as negligence and poor quality of care [44] , [54] , [71] . Moreover, a longer postpartum hospital stay during COVID was associated with higher postpartum depression scores [84] .…”

“…In Ciagran et al’s study [31] , 73.2% of mothers did not perceive the pandemic restrictions to have affected their relationship with their baby. A small percentage of mothers (3.6% to 17.7%) were separated from their babies immediately after birth [67] , [70] , [85] which is associated with lower birth satisfaction [67] and higher risk of postnatal depression [84] .…”

Prevalence and Factors of Postpartum Depression During the COVID-19 Pandemic: A Review

“…In terms of the social networks, the inability to connect to the family (Gupta et al, 2021 ), a low number of network members seen in person, and a higher proportion of relatives (Myers & Emmott, 2021 ) were associated with a heightened risk of PPD. Besides, the number of household members were found to be protecting mothers against PPD (Matsushima et al, 2021 ; Miranda et al, 2021 ).…”

“…Apart from that, the increase in non-exclusive breastfeeding, such as increased use of formula milk or practiced complementary and formula breastfeeding had heightened the risk of PPD among postpartum women (Fallon et al, 2021 ; Miranda et al, 2021 ; Zanardo et al, 2021a , 2021b ). Furthermore, women with a previous history of pregnancy or postnatal complications are also more depressed (Gupta et al, 2021 ). Nevertheless, studies also found no significant difference in PPD risk between mothers with or without postnatal complications (An et al, 2021 ; Matsushima et al, 2021 ).…”

“…more than six months of postpartum)(Miranda et al, 2021 ). Lastly, women who have their baby handed over to the attendants and stay in hospital for more than seven days after delivery showed an increased risk of PPD (Gupta et al, 2021 ).…”