Pregnant women’s experiences of social distancing behavioural guidelines during the Covid-19 pandemic ‘lockdown’ in the UK, a qualitative interview study

Abstract

Background Covid-19 triggered the rapid roll-out of mass social distancing behavioural measures for infection control. Pregnant women were categorised as ‘at risk’ requiring extra vigilance with behavioural guidelines. Their understanding and ability to adhere to recommendations was unknown. Objectives To complete a behavioural analysis of the determinants of recommended social distancing behaviour in pregnant women, according to the ‘capability, opportunity, motivation and behaviour’ (‘COM-B’) model to inform the development of recommendations/materials to support pregnant women in understanding and adhering to behavioural guidelines. Design Qualitative interview study with pregnant women in the Bristol area (UK). Methods Semi-structured telephone/videoconference interviews were conducted following a topic guide informed by the COM-B model, transcribed verbatim and subjected to framework analysis. Infographic materials were iteratively produced with stakeholder consultation, to support pregnant women. Results Thirty-one women participated (selected for demographic range). Women reported adhering to social distancing recommendations and intended to continue. COM-B analysis identified gaps in understanding around risk, vulnerability, and the extent of required social distancing, as well as facilitators of social distancing behaviour (e.g. social support, motivation to stay safe, home environment/resources). Additional themes around detrimental mental health effects and changes to maternity healthcare from the social distancing measures were identified. Infographic resources (plus midwife report) addressing women’s key concerns were produced and disseminated. Conclusions The COM-B model provided useful details of determinants of pregnant women’s adherence to social distancing behaviours. The confusion of what being ‘at risk’ meant and varying interpretation of what was expected indicates a need for greater clarity around categories and guidance. The loss of maternity care and negative mental health effects of social distancing suggest a growing area of unmet health needs to be addressed in future.

Midwives’ and maternity support workers’ perceptions of the impact of the first year of the COVID-19 pandemic on respectful maternity care in a diverse region of the UK: a qualitative study

“…Participants echoed the voices of pregnant women that during the pandemic, they needed more time and support from their midwives. 31 This was difficult due to staffing pressures, already present prior to the pandemic, 5 which worsened due to additional tasks and a reduced workforce. 1 Although the literature shows that most frontline staff prioritised service users’ needs above their own health anxiety during the pandemic, 7 an over-worked and distressed workforce is less able to provide high-quality healthcare, creating a downwards spiral.…”

Pregnancy during COVID-19: social contact patterns and vaccine coverage of pregnant women from CoMix in 19 European countries

“…During the pandemic, pregnant women had been demonstrated to meet their social support needs mostly through virtual means, with only approximately one in five meeting with someone in-person [ 25 , 26 ]. Our understanding of how digital communication technology to attenuate people’s sense of isolation and loneliness remains, however, limited [ 27 ]. Our study revealed more contacts in non-essential social settings among pregnant women, suggesting a minimal level of social contacts that women reporting as being pregnant may consider as vital.…”

Pregnancy during COVID-19: social contact patterns and vaccine coverage of pregnant women from CoMix in 19 European countries

“…Prenatal stress may pave the way to postnatal symptoms of depression and anxiety for the mother, and worse behavioural, emotional, cognitive, and physical outcomes for the children 18 . Social and physical distancing likely threaten to aggravate the feelings of concern and isolation that will produce these negative health consequences 19 . In this study, pregnant women maintained a similar level of contacts in “non-essential” social settings – such as other people’s home, a place of entertainment or sports – regardless of NPIs, suggesting a minimum level of social contacts that they may consider as vital.…”

“…CoMix is an online longitudinal, multi-country social contact survey that follows individuals in 19 European countries over the course of the COVID-19 pandemic. The survey asks people aged 18 or above about their awareness, perceptions, social contacts, and health condition over the course of the COVID-19 pandemic.…”