COVID Pandemic in the UK Determinants of Mental Health During Pregnancy

The UK has been blamed for the early stages of the 2019 coronavirus disease (COVID-19) pandemic, placing severe restrictions on personal interaction and supportive care during pregnancy, labor, and postpartum. rice field. This adversely affects the perception of women and their families or supporters about their pandemic pregnancy experience.

study: Factors Affecting Mental Health of Pregnant Women Using UK Maternity Services During the COVID-19 Pandemic: Qualitative Interview Survey.. Image Credit: Natalia Deriabina / Shutterstock.com

New research published in preprint research medRxiv* We report the results of a qualitative study on the determinants of a pregnant woman’s mental state during a pandemic within a UK obstetric service.

“”Decreased social support and the inability of partners or supporters to be present while using obstetric services were the greatest concerns reported by women in this study... “

Background

Pregnancy is one of the most important changes in a woman’s life, affecting not only her physical condition but also her mental health. During pregnancy, many factors work together to create an overall experience. This includes difficulties with important people, responsibility to care for babies, life stresses, financial difficulties, and unexpected natural events.

Mental changes that occur during this period include changes in the meaning of identity and life, as well as shame and guilt. Postpartum depression occurs in one in seven mothers, but at present nearly two-thirds experience negative or depressed mood.

The presence of these changes meant that women needed help from nearby people during this period, especially as long-term health and family health of women depended on this coping strategy. increase.

In the United Kingdom, many changes have been made to obstetric services to protect pregnant women who were considered at high risk for COVID-19-related complications. This included replacing many face-to-face services, such as outpatient appointments, with virtual services while forcing a social distance of 2 meters during the appointments made. In addition, most obstetric services do not allow anyone but the patient to attend such appointments, limit visitors during and shortly after delivery, and mainly mothers of newborns to prevent viral infections. Restricted to handle.

Early warnings about the negative effects of such changes, such as the difficulty of establishing breastfeeding and the weakening of the bond between mother and child, were not lacking. In fact, current studies suggest that these are largely correct, with mothers reporting increased depression and loneliness, especially if they have a miscarriage or a high-risk pregnancy.

These effects of the COVID-19 pandemic are associated with inaccessibility to the care needed, resulting in missed or canceled appointments, lack of continuity of care due to frequent changes in providers, and / or postnatal care. Follow-up has become inadequate. The inability to bring husbands, mothers, midwives and other social supporters during these difficult times has been a source of complaints and psychological stress for many women.

The reason for this is being investigated in current research. This paper is one of the few to investigate women’s experiences with prenatal and postnatal mental health, including women with miscarriages at this time.

Investigation result

In interviews with 23 women, the researchers found six common themes. Most of them are married and live with their spouse. Over 60% were Caucasian, with 1 in 15 children and 2 in 4 children, but 3 had no children due to a miscarriage during the pandemic. Eight women were diagnosed with psychiatric disorders such as depression, anxiety, and premenstrual dysphoric disorders.

Some women reported that the restrictions reduced pregnancy-related discomfort because people were unaware of pregnancy and did not always ask about their mother’s health. It also reduces the need to deal with motion sickness, daily activities, fatigue and nausea because you don’t have to go to work or shopping, giving you the flexibility to work when you feel better.

Second, some reported that family ties were improved, which helped them cope better and adapt to change. Access to their immediate support groups was critical to ensuring that women were able to stay safe and get help from the company. At the moment, the parent group was the key to proper coordination, but some issues with virtual conferencing have been reported.

Third, some women reported sadness and grief over not being able to share their pregnancy and new parent-child experiences with others, especially in the first months of their baby’s birth.

The fourth concern was the inability of support partners to attend appointments, especially the anxiety and stress they experienced when they were in the labor ward at birth, especially when they needed important information to decide how to give birth. Illustration. Women reported a sense of loss of support and advocacy when there were no support personnel nearby.

Women who participated in this study also felt that the process excluded their partners from their significant involvement in pregnancy and childbirth. Due to the rapidly changing COVID-19 standards, patients were unable to tell how well their staff were aware of the current regulations.

Hospitals often seemed confused, probably because the staff were ill or the number of cases was high. The impact on the patient was a decrease in awareness of support, increased anxiety about inadequate care, and at the same time a guilty feeling about seeking help when things were clearly tight.

Another cause of dissatisfaction was the inability to experience continuous care with a single doctor or midwife, for example, especially in high-risk pregnancies. Patients were upset by the need to repeatedly discuss pregnancy issues and concerns with each new healthcare provider.

Finally, no-touch policies often caused a sense of separation and communication problems, especially with masks to hide facial expressions. It was mentioned that it was difficult to build and maintain relationships, and that he missed a health problem because reservations were only made over the phone for several months.

Implications

The pandemic has brought about many changes in maternal care, with negative consequences such as increased loneliness and isolation from social and medical support systems due to restricted face-to-face interactions. The current study examined these phenomena from the perspective of affected women.

The results of current studies may have helped remote counseling enhance medical access for some groups, but many women have face-to-face care, especially if they have health problems of concern. Suggests that you like. This is not consistent with all studies, and one paper from Canada, a much more populous power, prefers virtual care to reduce the time, cost, and stress associated with hospital visits. It shows that. Minimize the resulting disruption of family routines.

Failure to connect with healthcare providers at the individual level can hinder the building of trust and leave a loophole in distrust and disability. The inability to provide continuity of care is another hallmark of pandemic-related changes and has been added to the problems already existing in the UK healthcare system. Simultaneous reduction of social and family interactions exacerbated loneliness and isolation.

“”Loss of connection with staff, in addition to restrictions on partners and visitors [the women] Feeling lonely during childbirth and postnatal care.. “

The introduction of a support bubble system was important in alleviating isolation, adverse pregnancy effects, infant care challenges, and depression / anxiety problems. To prevent this buildup of stress, the authors say the system, in which two households support each other, may have been introduced earlier. However, the system was subsequently extended to target all parents with domestic violence survivors and infants.

Workplace flexibility was a plus for pandemic restrictions because it made it easier to manage pregnancy-related symptoms and reduce pregnant women’s holidays. These restrictions also increased support from partners at home, strengthened family ties, and shared future decisions.

“”This suggests that the availability of birth partners or support personnel should be prioritized as much as possible to protect the mental health of women experiencing pregnancy or miscarriage during a pandemic... Support bubbles during pregnancy should be investigated as a priority to properly support mental health, physical symptoms, and high-risk pregnancies... “

*Important Notices

medRxiv Publish preliminary scientific reports that should not be considered definitive as they are not peer-reviewed, guide clinical practice / health-related behaviors, and should not be treated as established information.