Women’s Experiences of Pregnancy, Birth, and the Postpartum Period During the COVID-19 Pandemic: A Cross-Sectional Survey Study

Abstract

BACKGROUND:The 2019 coronavirus disease (COVID-19) is linked with an increased risk of adverse pregnancy outcomes. However, the effects of lockdown measures on pregnant women’s mental health are still largely unknown.AIM:To explore women’s experiences of pregnancy, labor/birth, and the postpartum period during the COVID-19 pandemic.METHOD:An online cross-sectional survey was conducted between July 2020 and May 2021. Two questionnaires were used: one focused on demographic information and women’s experiences of pregnancy and perinatal period, and the Edinburgh Postnatal Depression Scale. Data were analyzed via statistical and content analysis.RESULTS:Two-hundred and 78 women answered the questionnaire. Stress and anxiety were the predominant challenges for many women; 36.3% reported being moderately and 17.3% highly stressed and anxious during pregnancy; 23.9% reported being moderately and 26.8% highly stressed and anxious during labor/birth. On the EPDS, 40.2% of women scored ≥11 points, indicating that they were at high risk for postpartum depression. The level of stress and anxiety during pregnancy and labor/birth was significantly higher in women with depressive symptoms compared with the other women (p< .001 for both comparisons). In addition, the proportion of women with depressive symptoms who were supported by friends during pregnancy was significantly lower compared with the other women (51.8% vs. 68.3%,p= .006). Women with depressive symptoms also reported a significantly lower presence of their partner during birth (95.5% vs. 99.4%,p= .040) and significantly lower perceived support from the midwife during labor and birth (p= .042). Content analysis revealed that sources of social and emotional stress and anxiety included women’s inability to meet with friends and extended families, lack of support, loneliness, the need to protect the baby, and concerns about hygiene.CONCLUSION:Partners, friends, and family members play a significant role in the social support systems of pregnant women, and their support was hindered by the lockdown measures during the COVID-19 pandemic. In our study, the prevalence of women at high risk for postpartum depression was higher when compared with previous literature, suggesting that the pandemic contributed to an increase in stress and anxiety. This should be taken into consideration in planning maternity services after the pandemic.