The perception of Italian pregnant women and new mothers about their psychological wellbeing, lifestyle, delivery, and neonatal management experience during the COVID-19 pandemic lockdown: a web-based survey

Abstract

Background In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. Methods We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. Results We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. Conclusions The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage “home” physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.

Maternity care during COVID-19: a qualitative evidence synthesis of women’s and maternity care providers’ views and experiences

“…Recent pooled prevalence, based on a rapid review of 46 studies, has cited rates of perinatal depression and anxiety during COVID-19 of 25.6% and 30.5%, respectively, more than double pre-COVID levels [ 9 ]. Moreover, anxiety and depression in new mothers who gave birth during COVID-19 was reported as high as 61.9% [ 10 ], with rates of clinically relevant depression, up to 12 weeks postpartum, of 43% [ 11 ]. The seriousness of the altered systems of care, alongside increased rates of psychological distress was highlighted in a recent Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) report which documented two instances where women died by suicide, as referrals to perinatal mental health services were denied or delayed because of COVID-19 related restrictions [ 12 ].…”

Experiences of Perinatal Mental Health Care among Minority Ethnic Women during the COVID-19 Pandemic in London: A Qualitative Study

“…Despite this, the most highlighted concerns for women during this time have focused on the potential physical health risks of mother and baby contracting coronavirus [ 13 , 14 , 15 , 16 , 17 , 18 ]. There has been increasing evidence of the negative impact of the pandemic on women’s mental health and wellbeing [ 12 , 19 , 20 , 21 , 22 , 23 ]. However, studies have reported a lack of research focused on the experiences of women from minority ethnic backgrounds [ 12 , 21 , 24 , 25 , 26 , 27 , 28 ].…”

“Worn-out but happy”: Postpartum Women's Mental Health and Well-Being During COVID-19 Restrictions in Australia

“…In contrast with that study, we did not find strong relationships between physical activity (whether pre-pregnancy, or postpartum) and mental health. Based on prior research in pregnant and postpartum mums internationally (11,35,36), it was anticipated that social distancing and isolation measures during COVID-19 restrictions would negatively impact the mental health of Australian postpartum mothers. Previous international research during COVID-19 has been mixed reporting depressive symptoms in the general population were worse (11,35), better (37) or the same (13).…”

“…It is well-known that regular participation in physical activity can improve and maintain mental health and well-being (19-21), however, many women fail to maintain sufficient physical activity during and following pregnancy (40). Based on previous research (11,36) and given the closure of gyms and fitness facilities in Australia, it was widely anticipated that physical activity would be low during COVID-19 social distancing measures. Despite women reporting being physically active on the Godin Leisure questionnaire, on average, only 41% of the postpartum women we sampled were meeting Australian physical activity guidelines of 150 min.week −1 during COVID-19 social distancing restrictions.…”