Perinatal Experiences Research Articles

The evolved nest, oxytocin functioning, and prosocial development.

Prosociality, orientation to attuned, empathic relationships, is built from the ground up, through supportive care in early life that fosters healthy neurobiological structures that shape behavior. Numerous social and environmental factors within early life have been identified as critical variables influencing child physiological and psychological outcomes indicating a growing need to synthesize which factors are the most influential. To address this gap, we examined the influence of early life experiences according to the evolved developmental niche or evolved nest and its influence on child neurobiological and sociomoral outcomes, specifically, the oxytocinergic system and prosociality, respectively. To-date, this is the first review to utilize the evolved nest framework as an investigatory lens to probe connections between early life experience and child neurobiological and sociomoral outcomes. The evolved nest is comprised of characteristics over 30 million years old and is organized to meet a child's basic needs as they mature. Converging evidence indicates that humanity's evolved nest meets the needs of a rapidly developing brain, optimizing normal development. The evolved nest for young children includes soothing perinatal experiences, breastfeeding, positive touch, responsive care, multiple allomothers, self-directed play, social embeddedness, and nature immersion. We examined what is known about the effects of each evolved nest component on oxytocinergic functioning, a critical neurobiological building block for pro-sociomorality. We also examined the effects of the evolved nest on prosociality generally. We reviewed empirical studies from human and animal research, meta-analyses and theoretical articles. The review suggests that evolved nest components influence oxytocinergic functioning in parents and children and help form the foundations for prosociality. Future research and policy should consider the importance of the first years of life in programming the neuroendocrine system that undergirds wellbeing and prosociality. Complex, interaction effects among evolved nest components as well as among physiological and sociomoral processes need to be studied. The most sensible framework for examining what builds and enhances prosociality may be the millions-year-old evolved nest.

The effect of the COVID-19 pandemic on substance use patterns and physiological dysregulation in pregnant and postpartum women.

The SARS-CoV-2/COVID-19 pandemic has been associated with increased stress levels and higher alcohol use, including in pregnant and postpartum women. In the general population, alcohol use is associated with dysregulation in the autonomic nervous system (ANS), which is indexed by heart rate variability (HRV). The objectives of this study were to: (1) characterize changes in substance use during the SARS-CoV-2/COVID-19 pandemic via a baseline self-report survey followed by mobile ecological momentary assessment (mEMA) of substance use; and (2) examine the associations between momentary substance use and ambulatory HRV measures in pregnant and postpartum women. Pregnant and postpartum women were identified from the ENRICH-2 prospective cohort study. Participants were administered a baseline structured phone interview that included the Coronavirus Perinatal Experiences (COPE) survey and ascertained the prevalence of substance use. Over a 14-day period, momentary substance use was assessed three times daily, and HRV measurements were captured via wearable electronics. Associations between momentary substance use and HRV measures (root mean square of successive differences [RMSSD] and low frequency/high frequency [LF/HF] ratio) were examined using a mixed effects model that included within-subject (WS) and between-subject (BS) effects and adjusted for pregnancy status and participant age. The sample included 49 pregnant and 22 postpartum women. From a combination of a baseline and 14-day mEMA surveys, 21.2% reported alcohol use, 16.9% reported marijuana use, and 8.5% reported nicotine use. WS effects for momentary alcohol use were associated with the RMSSD (β = -0.14; p = 0.005) and LF/HF ratio (β = 0.14; p = 0.01) when controlling for pregnancy status and maternal age. No significant associations were observed between HRV measures and instances of marijuana or nicotine use. These findings highlight the negative effect of the SARS-CoV-2/COVID-19 pandemic on the psychological health of pregnant and postpartum women associated with substance use, and in turn, ANS dysregulation, which potentially puts some women at risk of developing a substance use disorder.

Prescribed and Penalized: The Detrimental Impact of Mandated Reporting for Prenatal Utilization of Medication for Opioid Use Disorder

ObjectivesSome states, including Massachusetts, require automatic filing of child abuse and neglect for substance-exposed newborns, including infants exposed in-utero to clinician-prescribed medications to treat opioid use disorder (MOUD). The aim of this article is to explore effects of these mandated reporting policies on pregnant and postpartum people receiving MOUD.MethodsWe used modified grounded research theory, literature findings, and constant comparative methods to extract, analyze and contextualize perinatal experiences with child protection systems (CPS) and explore the impact of the Massachusetts mandated reporting policy on healthcare experiences and OUD treatment decisions. We drew from 26 semi-structured interviews originally conducted within a parent study of perinatal MOUD use in pregnancy and the postpartum period.ResultsThree themes unique to CPS reporting policies and involvement emerged. First, mothers who received MOUD during pregnancy identified mandated reporting for prenatally prescribed medication utilization as unjust and stigmatizing. Second, the stress caused by an impending CPS filing at delivery and the realities of CPS surveillance and involvement after filing were both perceived as harmful to family health and wellbeing. Finally, pregnant and postpartum individuals with OUD felt pressure to make medical decisions in a complex environment in which medical recommendations and the requirements of CPS agencies often compete.Conclusions for PracticeUncoupling of OUD treatment decisions in the perinatal period from mandated CPS reporting at time of delivery is essential. The primary focus for families affected by OUD must shift from surveillance and stigma to evidence-based treatment and access to supportive services and resources.

Association between the person-centered maternity care experience and mental health after delivery in urban and rural Dhading, Nepal: a cross-sectional study

BackgroundPerson-centered maternity care is a component of quality care, which includes effective communication, respect, and dignity. Supportive care has a positive effect on mothers’ perinatal experience. In contrast, negative childbirth experiences can cause psychological problems. However, the impact of person-centered maternity care experience on mothers’ mental health after delivery remains unknown. Therefore, in this study, we examined the association between person-centered maternity care experience at healthcare facilities and maternal mental health after delivery among Nepali women.MethodsWe conducted a cross-sectional study in urban and rural areas in Dhading District, Nepal. Participants were women who gave birth at public healthcare facilities, and their baby’s age was between 1 and 12 months. After purposively selecting the target areas, we recruited the women from July to August 2019 and interviewed them using questionnaires. We conducted multiple regression analyses to analyze the association between delivery care experience and depressive symptoms and the association between delivery care experience and mental well-being.ResultsIn total, 595 women were included in the data analysis. The experience of better person-centered maternity care was associated with lower depressive symptom scores in urban (unstandardized coefficient [B]= − 0.09, p < 0.001) and rural areas (B= − 0.10, p < 0.001). Moreover, the experience of better person-centered maternity care was associated with higher mental well-being scores in both urban (B= 0.30, p < 0.001) and rural areas (B= 0.15, p = 0.017).ConclusionsPerson-centered maternity care was associated with lower depressive symptom scores and higher mental well-being, regardless of the setting in Nepal. Person-centered maternity care during childbirth can potentially improve mental health after delivery. Maternity care should be improved with more attention to person-centered maternity care aspects.

Perinatal care and breastfeeding education during the COVID-19 pandemic: Perspectives from Kenyan mothers and healthcare workers.

The impact of the COVID-19 pandemic on breastfeeding (BF) practices in low- and middle-income countries (LMICs) is not well understood.Modifications in BF guidelines and delivery platforms for breastfeeding education during the COVID-19 pandemic are hypothesised to have affected BF practices. We aimed to understand the experiences with perinatal care, BF educationand practice among Kenyan mothers who delivered infants during the COVID-19 pandemic.We conducted in-depth key informant interviews with 45 mothers who delivered infants between March 2020 and December 2021, and 26 health care workers (HCW) from four health facilities in Naivasha, Kenya.While mothers noted that HCWs provided quality care and BF counselling, individual BF counselling was cited to be less frequent than before the pandemic due to altered conditions in health facilities and COVID-19 safety protocols. Mothers stated that some HCW messages emphasised the immunologic importance of BF. However, knowledge among mothers about the safety of BF in the context of COVID-19 was limited, with few participants reporting specific counselling or educational materials on topics such as COVID-19 transmission through human milk and the safety of nursing during a COVID-19 infection. Mothers described COVID-19-related income loss and lack of support from family and friends as the major challenge to practising exclusive breastfeeding (EBF) as they wished or planned. COVID-19 restrictions limited or prevented mothers' access to familial support at facilities and at home, causing them stress and fatigue. In some cases, mothers reported job loss, time spent seeking new means of employmentand food insecurity as causes for milk insufficiency, which contributed to mixed feeding before 6 months.The COVID-19 pandemic created changes to the perinatal experience for mothers. While messages about the importance of practising EBF were provided, altered HCW education delivery methods, reduced social supportand food insecurity limit EBF practices for mothers in this context.

The impact of the second COVID-19 lockdown on anxiety and depressive symptoms in pregnant women: A case study of pregnant women in northern Italy

Backgroundthe different lockdown phases due to COVID-19 may have negatively impacted pregnant women's mental health. Concerning antenatal stress, most studies focused more on the effect of pandemic onset than on the impact of the following phases and restrictions. Aimthe present study aimed to assess levels of anxiety and depression in a group of Italian pregnant women during the second COVID-19 phase and possible risk factors. MethodWe recruited 156 pregnant women through our Perinatal Psychology Outpatient Clinic. We divided the sample into women recruited before the pandemic (N = 88) through a face-to-face antenatal class and pregnant women recruited during the second lockdown (Covid-19 study group) (November 2020–April 2021) through the same antenatal class via Skype (N = 68). To investigate depressive and anxiety symptoms, we administered the Edinburgh Postnatal Depression Scale (EPDS) and the State and Trait Anxiety Inventory (STAI-Y) scales; women's medical history and obstetric data were collected. Findingswomen belonging to the Covid-19 study group reported higher depressive and anxious levels than the pre-pandemic group. Moreover, during the second lockdown previous psychopathology and being close to childbirth were related to increased depression; a history of abortion was related to higher levels of trait anxiety instead. Conclusionrecurrent restrictive measures due to COVID-19 negatively affected the antenatal mental well-being of pregnant women, particularly worsening depressive and anxious feelings. Pregnant women during the pandemic represented a vulnerable population to be monitored more closely and timely to prevent psychological problems in the postpartum period and their consequences on the child. Keywordsanxiety, depression, pregnancy, COVID-19, mental health, lockdown.

Embryo as Person: As in the Womb, So in the World

Findings in the field of pre- and perinatal psychology reveal that, even as little embryos, we are having experiences, and that these experiences profoundly affect how we live our lives1. Our earliest days establish lifelong tendencies influencing how we connect with ourselves, each other, and our planet.2 This paper examines the intersection of embryo and psyche, how development of one relates to development of the other. Evidence of cellular intelligence, responsiveness, memory, and learning is offered as a foundation for understanding the profound effects of very early experience.3,4 Specific developmental milestones of conception, implantation, and discovery are considered in relation to their psychological effects, underlining the importance of treating the embryo as a sentient, sensitive human being that both models and thrives on love and connection5. It is proposed that supporting new parents from the time of pre-conception in providing a welcoming, safe, loving environment for their baby contributes to a world characterized by these qualities, where we can return to our original potential.

SUPPORTING CONNECTIONS BETWEEN FIRST MOTHERS AND THEIR UNBORNS: AN ANTIDOTE TO DISSOCIATION?

The old saw in child welfare circles— “A baby is the only living thing without a past, only a future”—was always self-serving. Now we know it was always patently false. The new science in infant mental health and prenatal psychology makes it possible to reconsider the matter of various risks in prenatal life. We are then released to wonder what life is like in there, for example, for a child scheduled to be surrendered for adoption. While we don’t yet proclaim to have special avenues into the mental life of prenates—or even systematic means to investigate it—evidence mounts that there IS such life, that it’s responsive to the mother’s mental life, and that such early and interactive mental life is of consequence for the baby’s later development. While there is still much to learn, we can surely say that it’s incomprehensible that the first nine months of the life of a child whose mom does not intend to keep him is anything but innocuous. What if we considered these questions non-rhetorically and non-judgmentally: “How could a woman ever be expected to forget a baby she had carried for nine months? What would it take to ‘move on’ from the experience…” (Glaser, 2021, p. 4). Might we even conclude that we’re disrespecting first mothers to assume that they pay no attention to what is happening, and have no psychological response to it? And if moms do have a response, is it detectable by the babies within? Finally, are early and primitive working models of self and other created in utero? Might these early working models be brought by the adoptee to his relationship with his adoptive mother? If so, to what effect? This paper focuses on one aspect of the mental life of a mother who intends to surrender her child for adoption: the possibility that she may, as a defense, dissociate—a kind of withdrawal from her own experience—and that such withdrawal may be experienced by the baby as maternal absence and rejection. We will try to show what this experience is like for the unborn, what defenses may be erected, and how such early experience may shape later relationships.

A scoping review of maternal health among resettled refugee women in the United States.

Globally, refugee women continue to face higher maternity-related risks from preventable complications during pregnancy and childbirth, partly due to high health care costs, unfamiliarity with the healthcare system, language barriers, and discrimination. Nevertheless, there is still a paucity of literature that evaluates the available evidence in the US. This scoping review delineated the body of literature on maternal health among refugee women resettled in the US in order to identify knowledge gaps in the literature and highlight future research priorities and directions for maternal health promotion. Electronic databases were searched in PubMed, CINAHL, PsycINFO, and EMBASE from inception through July 2021. We included all peer-reviewed study designs; qualitative, quantitative, and mixed method if they reported on refugee women's perinatal health experiences and outcomes in the US. A total of 2,288 records were identified, with 29 articles meeting the inclusion criteria. Refugee women tend to initiate prenatal care late and have fewer prenatal care visits compared to women born in the US. Some of them were reluctant to get obstetric interventions such as labor induction and cesarean delivery. Despite numerous risk factors, refugee women had generally better maternal health outcomes. Studies have also highlighted the importance of health care providers' cultural competency and sensitivity, as well as the potential role of community health workers as a bridge between refugee women and health care providers. The scoping review emphasizes the need for early prenatal care initiation and more frequent prenatal care visits among refugee women. Furthermore, more needs to be done to mitigate resistance to obstetric interventions and mistrust. The mechanism by which healthy migrant effects occur could be better understood, allowing protective factors to be maintained throughout the resettlement and acculturation process. The scoping review identifies critical gaps in the literature, such as the underrepresentation of different ethnic groups of refugee women in refugee maternal studies in the US. Since this invisibility may indicate unspoken and unaddressed needs, more attention should be paid to underrepresented and understudied groups of refugee women in order to achieve health equity for all.

The disability-related education and training experiences of perinatal care providers in Ontario

Women with disabilities are at increased risk of perinatal health complications and experience barriers to perinatal care, including unmet physical and communication needs and providers with limited disability knowledge. This study aimed to understand the disability-related education and training experiences of perinatal care providers in Ontario.

The socio-demographic profile associated with perinatal depression during the COVID-19 era

BackgroundCoronavirus disease 2019 (COVID-19) has caused an increase in perinatal depression. The aim of this research was to identify which sociodemographic variables are related to the increase in perinatal depression due to the pandemic. In addition to estimating to what extent they predict perinatal depression, differentiating the prenatal and postnatal periods.MethodsThe sample consisted of 3,356 subjects, 1,402 in the prenatal period and 1,954 in the postnatal period. The Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology. A subset of 14 questions was included to collect demographic data. Items from the Spanish version of the Coronavirus Perinatal Experiences Survey were also included.ResultsExperiencing the change of environment due to COVID-19 as negative and having a history of mental health predict perinatal depression, otherwise having higher education decreases the risk. In the prenatal stage having symptoms compatible with COVID-19 is a predictor of perinatal depression and having more than 3 years living together with the partner and being a housewife decreases the risk. In the postnatal stage being unemployed is a predictor of prenatal depression and being a first-time mother decreases the risk.ConclusionsThis study highlights the relevance of sociodemographic status. It is essential to be aware of the risk factors of perinatal depression, to make adequate prevention, and to create health policies to alleviate the consequences of the pandemic.

Exploring Tandem Breastfeeding Motivations Via Self-Determination Theory: An Interpretative Phenomenological Study.

Tandem breastfeeding is defined as a situation in which a mother continues breastfeeding her child through a subsequent pregnancy, including after the new baby is born. In some countries where motherhood may be delayed and the time between births may be reduced, support for the promotion of tandem breastfeeding is necessary to help mothers continue to breastfeed their eldest child and avoid early weaning. There is no existing research about mothers' motivations to breastfeed in tandem. To explore the motivations of women to initiate and maintain tandem breastfeeding, based on their lived experience, framed within the self-determination theory. A prospective, cross-sectional, interpretive, phenomenological study was carried out through in-depth interviews with 15 mothers in Madrid, who had practiced tandem breastfeeding for more than 6 months, and whose weaning of their eldest child had occurred within the previous year. Convenience and snowball sampling were used. The data were analyzed using an established interpretive phenomenological analysis process. Among the motivations for initiating tandem breastfeeding, the following themes were identified: "avoid wasting the effort invested," "desire such life experience," and "exercise the freedom to decide." The motivations for maintaining tandem breastfeeding were classified as "pass on parenting values" and "benefits of teamwork." The participants based their motivation to tandem breastfeed to follow their freely chosen motherhood model. They discovered the advantages of its implementation, forming a team of themselves and their children, and healing their traumatic perinatal experiences.

Maternal health equity in Georgia: a Delphi consensus approach to definition and research priorities

BackgroundPregnancy-related mortality in the United States is the greatest among all high-income countries, and Georgia has one of the highest maternal mortality rates—almost twice the national rate. Furthermore, inequities exist in rates of pregnancy-related deaths. In Georgia, non-Hispanic Black women are nearly 3 times more likely to die from pregnancy-related complications than non-Hispanic White women. Unlike health equity, a clear definition of maternal health equity is lacking, overall and in Georgia specifically, but is needed to reach consensus and align stakeholders for action. Therefore, we used a modified Delphi method to define maternal health equity in Georgia and to determine research priorities based on gaps in understanding of maternal health in Georgia.MethodsThirteen expert members of the Georgia Maternal Health Research for Action Steering Committee (GMHRA-SC) participated in an iterative, consensus-driven, modified Delphi study comprised of 3 rounds of anonymous surveys. In round 1 (web-based survey), experts generated open-ended concepts of maternal health equity and listed research priorities. In rounds 2 (web-based meeting) and 3 (web-based survey), the definition and research priorities suggested during round 1 were categorized into concepts for ranking based on relevance, importance, and feasibility. Final concepts were subjected to a conventional content analysis to identify general themes.ResultsThe consensus definition of maternal health equity created after undergoing the Delphi method is: maternal health equity is the ultimate goal and ongoing process of ensuring optimal perinatal experiences and outcomes for everyone as the result of practices and policies free of interpersonal or structural bias that tackle current and historical injustices, including social, structural, and political determinants of health impacting the perinatal period and life course. This definition highlights addressing the current and historical injustices manifested in the social determinants of health, and the structural and political structures that impact the perinatal experience.ConclusionThe maternal health equity definition and identified research priorities will guide the GMHRA-SC and the broader maternal health community for research, practice, and advocacy in Georgia.

Links between perceived social support, sense of parental efficacy and postpartum paternal depression

ObjectiveAlthough fathers are strongly encouraged to get involved in parenthood since pregnancy, there is still little research on the perinatal experience of fatherhood. In order to better understand and appreciate the experience of fathers during the first months after their child's birth, in this study we investigated the links between perceived social support, sense of parental efficacy and postpartum depression. Similar to studies on mothers, several risk factors may increase the fathers’ vulnerability to the development of postpartum depression symptoms. The objective of this study was to determine whether higher levels of perceived social support and sense of parental efficacy are predictive of lower levels of postpartum depression symptoms in a sample of fathers living in France. Material and methodThe study population is made up of 376 fathers aged 18 to 59 years old, living in France, and having had a child in the past 6 months. Fathers answered to measures of depression symptoms (Edinburgh Postnatal Depression Scale), perceived social support (Social Provisions Scale), and sense of parental efficacy (Parenting Expectations Survey). ResultsIn accordance with our hypotheses, fathers who reported the lowest perceptions of their parental efficacy and the lowest levels of perceived social support are those who reported the highest levels of postpartum depression symptoms. Low levels of perceived social support and of sense of parental efficacy predicted higher postpartum depression symptoms in fathers. Multiple linear regression analyses also showed that the oldest fathers in our sample (30 years and more) had the highest depression scores, as well as lower levels of perceived social support and sense of parental efficacy than younger fathers. Primiparous fathers had higher postpartum depression scores and lower parental efficacy scores than multiparous fathers. ConclusionThe considerable involvement of fathers in the study and the large size of our sample are strengths of our study that substantiate the interest of fathers in issues related to their parenthood, well-being and mental health. Our results encourage caregivers to give them more attention and well-tailored support to better respond to their specific needs during the transition to parenthood. Couple and individualized care for each parent should be proposed throughout the perinatal period in order to promote parental social support and sense of parental efficacy, particularly for first-time fathers, and to prevent postpartum disorders.

A longitudinal qualitative study of women’s experiences of postnatal care following hypertensive disorders of pregnancy

ProblemThere has been little focus on women’s views of care and recovery following pregnancy complicated by hypertensive disorders of pregnancy [HDP] despite long-term implications for maternal health. BackgroundIncreasingly in clinical research, areas of interest include the extent to which women are involved in postnatal care planning, perceived value of routine postnatal contacts, lifestyle behaviour advice, and extent to which ongoing concerns about HDP could be discussed with healthcare professionals. AimThis study explored women’s experiences of birth-recovery up to 12 months following HDP. MethodsA longitudinal qualitative study using semi-structured interviews at four and 12 months postpartum. Twenty-four women who each had a form of HDP, were recruited using a maximum variation, purposive sampling strategy from four National Health Service maternity units in London, 21 of whom were interviewed at both time points. Data were collected and analysed by timepoint following a recurrent, cross-sectional cohort approach using template analysis methodology. FindingsFour main themes and ten sub-themes were identified. Main themes included: assumptions about blood pressure; perinatal experiences; postnatal care pathways; and managing complex health conditions. DiscussionPostnatal care needs to be tailored to women’s individual needs following HDP, with ongoing review by relevant clinicians during and beyond the first six weeks. Many women with HDP have ongoing information needs about hypertensive status, treatment and prognoses, and future birth planning. ConclusionPolicy makers, health providers and funders cannot continue to ignore the need to ensure postnatal services meet the needs of women who have experienced medically complex pregnancies.

Short periods of perinatal acoustic experience alter the developmental trajectory of auditory cortex

Compared to hearing subjects, psychophysical studies have revealed specific superior visual abilities following hearing loss early in development. The neural substrate for these superior abilities resides in auditory cortex that have been reorganized through crossmodal plasticity. Furthermore, the cartography of auditory cortex is altered following the loss of auditory input early in life. This study examined how perinatal exposure to brief periods of acoustic stimulation alters the developmental trajectory of auditory cortex. Movement detection, localization in the visual periphery, and face discrimination learning are superior in congenitally deaf cats. To examine the role of acoustic experience in mediating these enhanced functions, hearing animals were chemically deafened at increasing ages postnatal. Animals had 1–16 weeks of acoustic exposure prior to deafness onset. Overall, &amp;gt;9 weeks of acoustic experience resulted in no enhanced visual abilities. With &amp;gt;4 weeks of acoustic exposure, enhanced motion detection was not evident. As acoustic experience increased during development, the overall size of auditory cortex, and the size of individual auditory areas also expanded. These results demonstrate that increasingly longer periods of perinatal acoustic experience result in reduced enhanced visual abilities and an increased size of auditory cortex.

Women's Birth Beliefs During Pregnancy and Postpartum in the Netherlands: A Quantitative Cross-Sectional Study.

Women and care providers increasingly regard childbirth as a medical process, resulting in high use of medical interventions, which could negatively affect a woman's childbirth experience. Women's birth beliefs may be key to understanding the decisions they make and the acceptance of medical interventions in childbirth. In this study we explore women's beliefs about birth as a natural and medical process and the factors that are associated with women's birth beliefs. Data were obtained from a cross-sectional survey of women living in the Netherlands asking them about their experiences during pregnancy and childbirth, including their beliefs about birth as a natural and medical process. A total of 3494 women were included in this study. Mean scores of natural birth beliefs ranged between 3.73 and 4.01 points, and medical birth belief scores ranged between 2.92 and 3.12 points. There were significant but very small changes between prenatal and postnatal birth beliefs. Regression analyses showed that (previous) childbirth experiences were the most consistent predictor of women's birth beliefs. Women's high scores on natural birth beliefs and lower scores on medical birth beliefs correspond with the philosophy of Dutch perinatal care that considers pregnancy and childbirth to be natural processes. Perinatal care providers must be aware of women's birth beliefs and recognize that they as professionals influence women's birth beliefs. They make an important contribution to women's perinatal experiences, which affects both women's natural and medical birth beliefs.

Paternal Perinatal Experiences during the COVID-19 Pandemic: A Framework Analysis of the Reddit Forum Predaddit.

During the COVID-19 pandemic, new parents were disproportionately affected by public health restrictions changing service accessibility and increasing stressors. However, minimal research has examined pandemic-related stressors and experiences of perinatal fathers in naturalistic anonymous settings. An important and novel way parents seek connection and information is through online forums, which increased during COVID-19. The current study qualitatively analyzed the experiences of perinatal fathers from September to December 2020 through the Framework Analytic Approach to identify unmet support needs during COVID-19 using the online forum predaddit on reddit. Five main themes in the thematic framework included forum use, COVID-19, psychosocial distress, family functioning, and child health and development, each with related subthemes. Findings highlight the utility of predaddit as a source of information for, and interactions of, fathers to inform mental health services. Overall, fathers used the forum to engage with other fathers during a time of social isolation and for support during the transition to parenthood. This manuscript highlights the unmet support needs of fathers during the perinatal period and the importance of including fathers in perinatal care, implementing routine perinatal mood screening for both parents, and developing programs to support fathers during this transition to promote family wellbeing.

“It was just one moment that I felt like I was being judged”: Pregnant and postpartum black Women's experiences of personal and group-based racism during the COVID-19 pandemic

BackgroundRacial inequities in maternal and child health outcomes persist: Black women and birthing people experience higher rates of adverse outcomes than their white counterparts. Similar inequities are seen in coronavirus disease (COVID-19) mortality rates. In response, we sought to explore the intersections of racism and the COVID-19 pandemic impact on the daily lives and perinatal care experiences of Black birthing people. MethodsWe used an intrinsic case study approach grounded in an intersectional lens to collect stories from Black pregnant and postpartum people residing in Fresno County (July–September 2020). All interviews were conducted on Zoom without video and were audio recorded and transcribed. Thematic analysis was used to group codes into larger themes. ResultsOf the 34 participants included in this analysis, 76.5% identified as Black only, and 23.5% identified as multiracial including Black. Their mean age was 27.2 years [SD, 5.8]. Nearly half (47%) reported being married or living with their partner; all were eligible for Medi-Cal insurance. Interview times ranged from 23 to 96 min. Five themes emerged: (1) Tensions about Heightened Exposure of Black Lives Matter Movement during the pandemic; (2) Fear for Black Son's Safety; (3) Lack of Communication from Health Care Professionals; (4) Disrespect from Health Care Professionals; and (5) Misunderstood or Judged by Health Care Professionals. Participants stressed that the Black Lives Matter Movement is necessary and highlighted that society views their Black sons as a threat. They also reported experiencing unfair treatment and harassment while seeking perinatal care. ConclusionsBlack women and birthing people shared that exposure to racism has heightened during the COVID-19 pandemic, increasing their levels of stress and anxiety. Understanding how racism impacts Black birthing people's lives and care experiences is critical to reforming the police force and revising enhanced prenatal care models to better address their needs.

Nurses' and midwives' perceptions and strategies to cope with perinatal death situations: A systematic literature review.

The aim of this paper is to describe the strategies used by nurses and midwives to cope with experiences of dealing with perinatal death and maintain their satisfaction at work. Systematic literature review, in accordance with the PRISMA Declaration. (2000-2021) Web of Science, PubMed, Scopus, CINALH and Dialnet, for articles in English and Spanish from the period between January 2000 and March 2021. The outcome of the review was the perceptions of nurses and midwives who have cared for people in a situation of perinatal loss. Thirteen studies were identified that evaluated the attitudes, experiences and needs of these healthcare professionals. The combined size of all samples was 2196 participants. The negative effects on these professionals' satisfaction with their situation at work could be mitigated by covering their needs for knowledge, experience, and emotional and technical skills to deal with such events. As potential protective factors against dissatisfaction in nurses and midwives during perinatal death experiences, we identified older age and experience in perinatal care and coping strategies based on communicating one's feelings to peers, empathetic listening to the families cared for, training and institutional support. No Patient or Public Contribution.