The antenatal psychological experiences of women during two phases of the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis

Abstract

Initial COVID-19-related social distancing restrictions, imposed in the UK in March 2020, and the subsequent lifting of restrictions in May 2020 caused antenatal disruption and stress which exceeded expected vulnerabilities associated with this lifecourse transition. The current study aimed to explore the antenatal psychological experiences of women during different phases of pandemic-related lockdown restrictions in the UK. Semi-structured interviews were held with 24 women about their antenatal experiences: twelve were interviewed after the initial lockdown restrictions (Timepoint 1; T1), and a separate twelve women were interviewed after the subsequent lifting of those restrictions (Timepoint 2; T2). Interviews were transcribed and a recurrent, cross-sectional thematic analysis was conducted. Two themes were identified for each timepoint, and each theme contained sub-themes. T1 themes were: ‘A Mindful Pregnancy’ and ‘It’s a Grieving Process’, and T2 themes were: ‘Coping with Lockdown Restrictions’ and ‘Robbed of Our Pregnancy’. COVID-19 related social distancing restrictions had an adverse effect on women’s mental health during the antenatal period. Feeling trapped, anxious, and abandoned were common at both timepoints. Actively encouraging conversations about mental wellbeing during routine care and adopting a prevention opposed to cure attitude toward implementing additional support provisions may serve to improve antenatal psychological wellbeing during health crises.

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

“…This also requires recognising the importance of quality, holistic, post-partum care, specifically in the community ( 33 ). To re-establish these priorities, face-to-face care and support should be reinstated ( 24 , 25 , 35 ) and should remain the dominant form of care provision.…”

“…At this time, personalised care was often deprioritised ( 24 , 25 ). Considering these findings, recommendations are made to cease the provision of exclusively virtual or remote care ( 28 ) and the exclusion of wanted birth partners ( 31 ).…”

“…Furthermore, confusing and conflicting messaging amongst government organisations, Royal Colleges, individual NHS Trusts, and other Learned Academies has been a persistent issue of concern ( 28 ). When national public health messaging is necessary, disinformation and/or conflicting information must be stopped as a matter of utmost importance ( 24 , 25 ). Messaging must be consistent from policy to practice, and policymakers and healthcare professionals must be agile enough to interpret and implement change in a uniform way.…”

“…A large, online, national survey was distributed to pregnant and post-partum women during initial mandated lockdown restrictions ( 20 ), during the initial easing of social distancing restrictions ( 21 ), and post-“Freedom Day” [defined as the easing of all legal restrictions on social contact; ( 22 )]. The PRaM Study involved the distribution of a battery of psychometric measures ( 19 , 23 ), with nested qualitative interviews in accordance with the corresponding mandated lockdown restrictions ( 24 , 25 ).…”

“…A lack of support for the schooling of older children was particularly inflammatory to maternal mental health and wellbeing disturbance ( 24 ). Antenatally, respondents were consistent across timepoints in feeling their pregnancy was overshadowed by uncertainties pertaining to the pandemic, which left respondents grieving for the loss of the kind of transition to motherhood that they would have had in the absence of mandated lockdown restrictions ( 25 ).…”