Top

BMC Pregnancy and Childbirth

Published in:

Open Access 01-12-2021 | Care | Research article

Postpartum women’s psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis

Authors: Leanne Jackson, Leonardo De Pascalis, Joanne A. Harrold, Victoria Fallon, Sergio A. Silverio

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

COVID-19 has placed additional stressors on mothers during an already vulnerable lifecourse transition. Initial social distancing restrictions (Timepoint 1; T1) and initial changes to those social distancing restrictions (Timepoint 2; T2) have disrupted postpartum access to practical and emotional support. This qualitative study explores the postpartum psychological experiences of UK women during different phases of the COVID-19 pandemic and associated ‘lockdowns’.

Methods

Semi-structured interviews were conducted with 12 women, approximately 30 days after initial social distancing guidelines were imposed in the UK (22 April 2020). A separate 12 women were interviewed approximately 30 days after the initial easing of social distancing restrictions (10 June 2020). Data were transcribed verbatim, uploaded into NVivo for management and analysis, which followed a recurrent cross-sectional approach to thematic analysis.

Results

Two main themes were identified for T1: ‘Motherhood is Much Like Lockdown’ and ‘A Self-Contained Family Unit’. Each main T1 theme contained two sub-themes. Two main themes were also identified for T2: ‘Incongruously Held Views of COVID-19’ and ‘Mothering Amidst the Pandemic’. Each main T2 theme contained three sub-themes. Comparisons between data gathered at each timepoint identified increased emotional distress over time. Current findings call for the improvement of postpartum care by improving accessibility to social support, and prioritising the re-opening of schools, and face-to-face healthcare appointments and visitation.

Conclusion

Social distancing restrictions associated with COVID-19 have had a cumulative, negative effect on postpartum mental health. Recommendations such as: Allowing mothers to ‘bubble’ with a primary support provider even at their healthcare appointments; allowing one support partner to attend all necessary healthcare appointments; and providing tailored informational resources, may help to support postpartum emotional wellbeing during this, and similar health crises in the future.

Available only for authorised users

Royal College of Obstetricians and Gynaecologists & Royal College of Midwives. Coronavirus (COVID-19) infection in pregnancy: Information for healthcare professionals (12th Vers.). 2020. https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health/

The British Medical Journal. COVID-19 guideline watch: Covid-19 and pregnancy. BMJ. 2020;369(8244):1–2. https://doi.org/10.1136/bmj.m1672.CrossRef

World Health Organisation. COVID-19 public health emergency of international concern (PHEIC) global research and innovation forum. 2020. https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum

Ioannidis JPA, Axfors C, Contopoulos-Ioannidis DG. Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters. Environ Res. 2020;188(109890):1–10. https://doi.org/10.1016/j.envres.2020.109890.CrossRef

National Health Service. Who is at higher risk from coronavirus (clinically extremely vulnerable). 2021. https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/who-is-at-high-risk-from-coronavirus-clinically-extremely-vulnerable/

UK Government & Public Health England. Stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection. 2021. https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection

Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020;2(2):1–9. https://doi.org/10.1016/j.ajogmf.2020.100107.CrossRef

Jardine J, Relph S, Magee LA, von Dadelszen P, Morris E, Ross-Davie M, et al. Maternity services in the UK during the COVID-19 pandemic: a national survey of modifications to standard care. BJOG. 2020;128(5):880–9. https://doi.org/10.1111/1471-0528.16547.

Babetin K. The birth of a mother: a psychological transformation. J Prenat Perinat Psychol Health. 2020;34(5):410–28.

10.

Prinds C, Mogensen O, Hvidt NC, Bliddal M. First child’s impact on parental relationship: an existential perspective. BMC Pregnancy Childb. 2018;18(157):1–7. https://doi.org/10.1186/s12884-018-1802-5.CrossRef

11.

Makama M, Awoke MA, Skouteris H, Moran LJ, Lim S. Barriers and facilitators to a healthy lifestyle in postpartum women: a systematic review of qualitative and quantitative studies in postpartum women and healthcare professionals. Obes Rev. 2021;22(4):1–11. https://doi.org/10.1111/obr.13167.CrossRef

12.

Papworth R, Harris A, Durcan G, Wilton J, Sinclair C. Maternal mental health during the pandemic: a rapid evidence review of Covid-19’s impact. 2021. https://maternalmentalhealthalliance.org/mmhpandemic/

13.

Matvienko-Sikar K, Meedya S, Ravaldi C. Perinatal mental health during the COVID-19 pandemic. Women Birth. 2020;33(4):309–10. https://doi.org/10.1016/j.wombi.2020.04.006.CrossRefPubMedPubMedCentral

14.

Karavadra B, Stockl A, Prosser-Snelling E, Simpson P, Morris E. Women’s perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom. BMC Pregnancy Childb. 2020;20(600):1–8. https://doi.org/10.1186/s12884-020-03283-2.CrossRef

15.

Fallon V, Davies SM, Silverio SA, Jackson J, De Pascalis L, Harrold J. Psychosocial experiences of postnatal women during the COVID-19 pandemic: a UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety. J Psychiatr Res. 2021;136:157–66. https://doi.org/10.1016/j.jpsychires.2021.01.048.CrossRefPubMed

16.

Han E, Tan MMJ, Turk E, Sridhar D, Leung GM, Shibuya K, et al. Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe. Lancet. 2020;396(10261):1525–34. https://doi.org/10.1016/S0140-6736(20)32007-9.CrossRefPubMedPubMedCentral

17.

Office for National Statistics. Structure and descriptions of unit groups. Revisions to the latest UK Standard Occupational Classification (SOC) and how these affect its classification of similarly-skilled jobs into groups. 2020. https://www.ons.gov.uk/methodology/classificationsandstandards/standardoccupationalclassificationsoc/soc2020/soc2020volume1structureanddescriptionsofunitgroups

18.

UK Government. What qualification levels mean. 2021. https://www.gov.uk/what-different-qualification-levels-mean/list-of-qualification-levels

19.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa.CrossRef

20.

Terry G, Hayfield N, Clarke V, Braun V, Thematic analysis. In: Willig C, Rogers WS, editors. The SAGE Handbook of Qualitative Research in Psychology: SAGE Publications; 2017. p. 17–37.CrossRef

21.

Silverio SA, Rayment-Jones H, Gubijev A, Fallon V, Coxon K, Bick D, et al. Longitudinal approaches to qualitative analysis: guidance for practical application paper presented at the qualitative research symposium, Bath; 2020. https://www.researchgate.net/publication/338902373_Longitudinal_Approaches_to_Qualitative_Analysis_Guidance_for_Practical_Application

22.

Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, et al. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health. 2010;25(10):1229–45. https://doi.org/10.1080/08870440903194015.CrossRefPubMed

23.

Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18(1):59–82. https://doi.org/10.1177/1525822X05279903.CrossRef

24.

Grossoehme D, Lipstein E. Analyzing longitudinal qualitative data: the application of trajectory and recurrent cross-sectional approaches. BMC Res Notes. 2016;9(136):1–5. https://doi.org/10.1186/s13104-016-1954-1.CrossRef

25.

Office of National Statistics. Coronavirus and the social impacts on Great Britain. 2021. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandwellbeing/bulletins/coronavirusandthesocialimpactsongreatbritain/previousReleases

26.

Cheng Z, Mendolia S, Paloyo AR, Savage DA, Tani M. Working parents, financial insecurity, and childcare: mental health in the time of COVID-19 in the UK. Rev Econ Househ. 2021;19(1):123–44. https://doi.org/10.1007/s11150-020-09538-3.CrossRef

27.

Chandola T, Kumari M, Booker CL, Benzeval M. The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK. Psychol Med. 2020:1–10. https://doi.org/10.1017/S0033291720005048.

28.

Department for Education. Restricting attendance during the national lockdown: Schools. Guidance for all schools in England. 2021. https://www.gov.uk/coronavirus/education-and-childcare

29.

Silverio SA, De Backer K, Easter A, Von Dadelszen P, Magee LA, Sandall J. Women’s experiences of maternity service reconfiguration during the COVID-19 pandemic: A qualitative investigation. Midwifery. 2021;102:1-9. https://doi.org/10.1016/j.midw.2021.103116.

30.

UK Government. Paternity pay and leave. 2021. https://www.gov.uk/paternity-pay-leave

31.

Gutterman NB, Bellamy JL, Banman A. Promoting father involvement in early home visiting services for vulnerable families: findings from a pilot study of “dads matter”. Child Abuse Negl. 2018;76:261–72. https://doi.org/10.1016/j.chiabu.2017.10.017.CrossRef

32.

Davidson EL, Ollerton RL. Partner behaviours improving breastfeeding outcomes: an integrative review. Women Birth. 2020;33(1):15–23. https://doi.org/10.1016/j.wombi.2019.05.010.CrossRef

33.

Leahy-Warren P, Creedon M, O’Mahony A, Mulcahy H. Normalising breastfeeding within a formula feeding culture: an Irish qualitative study. Women Birth. 2017;30(2):103–10. https://doi.org/10.1016/j.wombi.2016.10.002.CrossRef

34.

Latorre G, Martinelli D, Guida P, Masi E, De Benedictis R, Maggio L. Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers. Int Breastfeed J. 2021;16(1):1–7. https://doi.org/10.1186/s13006-021-00382-4.CrossRef

35.

O’Reilly A. “Trying to function in the unfunctionable”: mothers and COVID-19. MIRCI. 2020;11(1):7–24. https://doi.org/10.1111/gwao.12613.CrossRef

36.

Marchetti D, Fontansei L, Mazza C, Di Giandomenico S, Roma P, Verrocchio MC. Parenting-related exhaustion during the Italian COVID-19 lockdown. J Pediatr Psychol. 2020;45(10):1114–23. https://doi.org/10.1093/jpepsy/jsaa093.CrossRefPubMed

37.

Hiraoka D, Tomoda A. Relationship between parenting stress and school closures due to the COVID-19 pandemic. Psychiatry Clin Neurosci. 2020;74(9):497–8. https://doi.org/10.1111/pcn.13088.CrossRefPubMed

38.

Mikolajczak M, Gross JJ, Roskam I. Parental burnout: what is it, and why does it matter? Clin Psychol Sci. 2019;7(6):1319–29. https://doi.org/10.1177/2167702619858430.CrossRef

39.

Booth K, Sundstrom B, De Maria AL, Dempsey A. A qualitative analysis of postpartum contraceptive choice. J Com Healthc. 2018;11(3):215–22. https://doi.org/10.1080/17538068.2018.1477445.CrossRef

40.

Al-Sabbagh M, Al-Ani A, Mafrachi B, Siyam A, Isleem U, Massad I, et al. Predictors of adherence with home quarantine during COVID −19 crisis: the case of health belief model. Psychol Health Med. 2021:1–14. https://doi.org/10.1080/13548506.2021.1871770.

41.

Johansson C, Finnbogadóttir H. First-time mothers’ satisfaction with their birth experience – a cross-sectional study. Midwifery. 2019;79(102540):1–8. https://doi.org/10.1016/j.midw.2019.102540.CrossRef

42.

Watson K, White C, Hall H, Hewitt A. Women’s experiences of birth trauma: a scoping review. Women Birth. 2020;34(5):1–8. https://doi.org/10.1016/j.wombi.2020.09.016.CrossRef

43.

Surkan PJ, Dong L, Ji Y, Hong X, Ji H, Kimmel M, et al. Paternal involvement and support and risk of preterm birth: findings from the Boston birth cohort. J Psychosom Obstet Gynaecol. 2019;40(1):48–56. https://doi.org/10.1080/0167482X.2017.1398725.CrossRefPubMed

44.

Royal College of Obstetricians and Gynaecologists. Guidance for provision of midwife-led settings and home birth in the evolving coronavirus (COVID-19) pandemic: Information for healthcare professionals. (2nd Vers.). 2020.

45.

McLeish J, Harvey M, Redshaw M, Henderson J, Malouf R, Alderdice F. First-time mothers’ expectations and experiences of postnatal care in England. Qual Health Res. 2020;30(12):1876–87. https://doi.org/10.1177/1049732320944141.CrossRefPubMedPubMedCentral

Title: Postpartum women’s psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis
Authors: Leanne Jackson
Leonardo De Pascalis
Joanne A. Harrold
Victoria Fallon
Sergio A. Silverio
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Care
COVID-19
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-04071-2

2024 ASCO Annual Meeting

Springer Medicine

Postpartum women’s psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

The CErebro Placental RAtio as indicator for delivery following perception of reduced fetal movements, protocol for an international cluster randomised clinical trial; the CEPRA study

Does the additional use of clomiphene citrate or letrozole for in vitro fertilization deserve more attention?

Socio-demographic characteristics and outcomes of pregnant women who delivered prior to and after the termination of the one-child policy in China: a comparative study

Intrauterine fetal death followed by shoulder dystocia and birth by modified posterior axillary sling method: a case report

Exploring women’s experiences of participation in shared decision-making during childbirth: a qualitative study at a reference hospital in Spain

Proposing a machine-learning based method to predict stillbirth before and during delivery and ranking the features: nationwide retrospective cross-sectional study