The effect of the COVID-19 pandemic on UK parent experiences of pregnancy ultrasound scans and parent-fetal bonding: A mixed methods analysis

Abstract

Introduction Companionship in antenatal care is important for facilitating positive parental experiences. During the COVID-19 pandemic, restrictions on partner attendance at fetal ultrasound scans were introduced nationally to minimise transmission of the virus. This study aimed to explore the effect of these restrictions on maternal and paternal experiences of pregnancy scans and evaluate their potential effect on parent-fetal bonding. Methods A UK-wide, anonymous cross-sectional survey was completed by new and expectant parents (n = 714) who had, or were awaiting a pregnancy scan during the COVID-19 pandemic. The CORE-10 and an adapted version of the Prenatal Attachment Inventory were used to evaluate psychological distress and prenatal bonding. Additional survey questions captured parental experiences of scans. Separate statistical and thematic analyses of the data were undertaken. A joint display matrix was used to facilitate integration of quantitative and qualitative claims to generate a comprehensive interpretation of study findings. Findings When fathers did not attend the scan, feelings of excitement and satisfaction were significantly reduced (p<0.001) and feelings of anxiety increased (p<0.001) in both parents. Mothers were concerned about receiving unexpected news alone and fathers felt excluded from the scan. Mean paternal bonding (38.22, SD 10.73) was significantly lower compared to mothers (47.01, SD 7.67) although no difference was demonstrated between those who had attended the scan and those who had not. CORE-10 scores suggested low-to-mild levels of psychological distress, although the mean difference between mothers and fathers was not significant. Key themes described both parents’ sense of loss for their desired pregnancy scan experience and reflected on sonographers’ central role in providing parent-centred care during scans. Conclusion Restrictions on partner attendance at scans during the COVID-19 pandemic had a negative effect on parental experiences of antenatal imaging. Provision of parent-centred care, which is inclusive of partners, is essential for improved parental experiences.

The influence of antenatal imaging on prenatal bonding in uncomplicated pregnancies: a mixed methods analysis

“…In this study, parent-fetal bonding scores were significantly increased following imaging in both parents which is consistent with existing literature [ 6 ]. However, in contrast to other studies [ 25 , 38 – 40 ], bonding scores were not observed to be significantly different between mothers and fathers. Four variables were identified as significant predictors of parent-fetal bonding after imaging: scores were significantly higher in parents who had MRI, who scored their imaging experience and excitement levels higher, and who were not in full-time employment.…”

“…In this study, COVID-19 infection control measures in the ultrasound department requiring fathers to wait in a separate area of the hospital to their partners created stress for both parents. This reflects findings reported in relation to the COVID-19 pandemic when partners were temporarily restricted from attending scans [ 25 ]. As they do not physically experience pregnancy, providing support through companionship is thought to be a key aspect of how expectant fathers conceptualise their role during the prenatal period [ 19 ].…”

“…Higher scores are associated with a more developed bond [ 23 ], and in this 16-item PAI, the maximum possible score was 64. Good reliability of the modified PAI is previously established [ 24 , 25 ]. In this study, Cronbach’s alpha (α) was 0.90, indicating excellent internal consistency.…”

“…Exisiting measures of parental expectations and experiences of antenatal imaging [ 29 ] were not suitable for the current study’s focus on bonding so a measure was specifically developed for use based on prior literature findings and research studies [ 6 , 25 ]. For statistical comparison, expectation and experience factors were matched (Fig.…”