Pregnant during the COVID-19 pandemic: an exploration of patients’ lived experiences

Abstract

Background Infectious outbreaks are known to cause fear and panic. Exploration of pregnant individuals’ psychosocial condition using a qualitative lens during an infectious outbreak is limited. In this study we explore pregnant individuals’ lived experiences as well as their psychological and behavioural responses during COVID-19 with the goal of providing useful strategies from the patient’s perspective to enable health care providers to help pregnant patients navigate this and future pandemics. Methods Pregnant individuals between 20-weeks gestation and 3 months postpartum who received maternity care from an urban academic interprofessional teaching unit in Toronto, Canada were invited to participate. Semi-structured 60 min interviews were audio-recorded, transcribed and analyzed using descriptive thematic analysis. Interview questions probed psychological responses to the pandemic, behavioural and lifestyle changes, strategies to mitigate distress while pregnant during COVID-19 and advice for other patients and the healthcare team. Results There were 12 participants, mean age 35 years (range 30–43 years), all 1 to 6 months postpartum. Six main themes emerged: 1) Childbearing-related challenges to everyday life; 2) Increased worry, uncertainty and fear; 3) Pervasive sense of loss; 4) Challenges accessing care; 5) Strategies for coping with pandemic stress; 6) Reflections and advice to other pregnant people and health care professionals. Pregnant individuals described lack of social support due to COVID-19 pandemic restrictions and a profound sense of loss of what they thought their pregnancy and postpartum period should have been. Advice to healthcare providers included providing mental health support, clear and up to date communication as well as more postpartum and breastfeeding support. Conclusions These participants described experiencing psychosocial distress during their pregnancies and postpartum. In a stressful situation such as a global pandemic, health care providers need to play a pivotal role to ensure pregnant individuals feel supported and receive consistent care throughout the pregnancy and postpartum period. The health care provider should ensure that mental health concerns are addressed and provide postpartum and breastfeeding support. Without addressing this need for support, parental mental health, relationships, parent-infant bonding, and infant development may be negatively impacted.

“I had so many life-changing decisions I had to make without support”: a qualitative analysis of women’s pregnant and postpartum experiences during the COVID-19 pandemic

“…A minority of respondents felt pandemic changes had a positive effect on their mental well-being. Infection mitigation plans produced an environment where families could have more time at home, with fewer parents leaving the house for work and children for school or daycare, and fewer social obligations, which is supported by other qualitative findings on postpartum experiences during the COVID-19 pandemic [30]. Some expressed relief in not having to entertain visitors during the postpartum period.…”

“…Others have also reported qualitative data about the impact of COVID-19 on prenatal care using different survey instruments or via semi-structured interviews [29][30][31][32]. Javid et al identified similar structural changes in healthcare and behavioral changes to reduce disease transmission (e.g.…”

“…virtual visits and absence of support people, respectively) that led to emotional responses of increased fear, anxiety, and feeling unsupported. Others reported similar levels of both generalized uncertainty around the pandemic and perinatal care and more specific concerns related to the effects of viral infection on their own health and their children, feelings of missing out on a more traditional pregnancy experience, and challenges from limited family and medical care support [30][31][32].…”

Psychological Distress and Behavioural Changes in Pregnant and Postpartum Individuals During the COVID-19 Pandemic

“…The impact of social support as a protective factor during the pandemic has been reported. 23 The importance of social support and its “buffering effect” was also seen in the SARS data as those that reported more social support were less depressed. 4 Finally, individuals who exercised at least weekly or more were significantly less likely to have depression, anxiety or stress, similar to a previous study.…”

“I feel more protective over my body:” A brief report on pregnant women’s embodied experiences during the COVID-19 pandemic

“…Further, competing media messaging and medical advice has led to increased vaccine hesitancy among pregnant people ( Ayhan et al, 2021 ; Iacobucci, 2021 ). The scant literature on pregnant people’s experiences during the pandemic has revealed that pregnant individuals report heightened anxiety and depression, compared to pre-pandemic cohorts and non-pregnant individuals ( Caparros-Gonzalez & Alderice, 2020 ; Harrison et al, 2021 ; Kolker et al, 2021 ; Schaal et al, 2021 ). However, to date, no research has explored pregnant people’s experiences of their bodies and body image during the pandemic.…”