Nearly half of UK parents report negative COVID-19 pandemic-related childbirth experiences
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An online survey of parents in the United Kingdom who experienced a childbirth during the COVID-19 pandemic revealed that nearly half had mostly negative experiences, according to a study published in BMC Pregnancy and Childbirth.
“Feelings of loneliness, uncertainty and anxiety is something that was consistently voiced by the women within our study,” Ezra Aydin, PhD, a postdoctoral research fellow at Columbia University Irving Medical Center in New York City and a visiting researcher at the University of Cambridge Trinity College in England, told Healio. “Changes in the rules and guidance surrounding birthing preferences and birth partners, not only nationally but between [National Health Service (NHS)] trusts, created confusion and anxiety amongst families. This lack of clear guidance left many families feeling a loss of choice and control over their own birthing experiences.”
Findings reported earlier this year from Europe also reflected negative birthing experiences during the pandemic, with almost half of respondents who had undergone labor feeling that COVID-19 had negatively affected maternal and newborn care.
Recruiting participants
As part of the U.K. COVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP) study, Aydin and colleagues distributed an online survey through social media and research and health groups between July 15, 2020, and March 29, 2021. Expectant parents past their first trimester and those with infants aged younger than 6 months were eligible to report on their recent birth experiences.
Characteristics of birth experience
In total, 477 parents responded to the CoCoPIP survey. Of these, 315 (66.1%) had a vaginal delivery, 155 (32.6%) had a cesarean delivery and six (1.3%) had an unspecified delivery method. Among those who had a cesarean delivery, 77 (49.7%) had planned it.
The researchers said the rate of elected cesarean deliveries represented a “significant increase relative to pre-pandemic levels,” which were 7% lower between 2019 and 2020.
Although 37.4% of participants reported no changes to their birthing plan and 37.4% reported changes that were unrelated to COVID-19, 25% reported COVID-19-related changes such as limited birthing options and support.
Almost half (44.8%) of all participants did not know whether someone could be at the birth, and 2.3% reported that their birthing partner could not attend due to pandemic restrictions.
Sentiments on birth experience
Feelings on communication varied among the participants, the researchers wrote.
“We found that clear communication and support really helped families, elevating their anxiety around giving birth during this uncertain time,” Aydin said. “Where guidance was constantly changing, some hospitals resorted to social media platforms to help keep families up-to-date with their guidance, creating a space for parents to be able to ask questions and voice concerns. This feeling of being supported and informed during their journey helped parents have a more positive birthing experience during this uncertain time.”
Overall, 46.9% of participants reported mainly negative birthing experiences, compared with 33.2% who had mainly positive responses and 19.9% who had neutral responses.
Significance
The findings highlighted that communication and support should be prioritized during childbirth.
“Our findings reinforce the importance of the role of choice and control in women’s childbirth experiences, as well as need for clear communication from their health care providers,” Aydin said. “Ensuring consistent guidance and support for women during childbirth will help mitigate negative childbirth experiences of women — capturing and addressing the unique health care needs of each pregnant woman.”
Moving forward, Aydin anticipated that the ongoing CoCoPIP study “will shed light on the longitudinal impact of COVID-19 guidance and restrictions on the long-term development of the child.”
References:
- Aydin E, et al. BMC Pregnancy Childbirth. 2022;doi:10.1186/s12884-022-04637-8.
- Lazzerini M, et al. Lancet Reg Health Eur. 2022; doi:10.1016/j.lanepe.2021.100268.
Perspective
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The experiences described in the Aydin study — specifically, increased feelings of anxiety and negative emotions — were certainly mirrored here in the U.S., especially at the beginning and height of the pandemic. Thankfully, these experiences have improved over time due to a combination of, one, better scientific understanding of the disease itself on pregnancy and the developing fetus; two, accessibility to vaccinations, which have proven safe and effective in pregnancy; three, the trend toward less severe COVID-19 variants (ie, the delta variant causing more significant clinical morbidities and mortality vs. the omicron variant causing less severe disease); and four, improved communication from providers to help support women throughout their childbirth experience, including advocacy for continued partner presence, as well as newborn care for COVID-19 positive mothers.
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