The Psychological Experience of Obstetric Patients and Health Care Workers after Implementation of Universal SARS-CoV-2 Testing

Abstract

Objective This study was aimed to describe the hospitalization and early postpartum psychological experience for asymptomatic obstetric patients tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) as part of a universal testing program and report the impact of this program on labor and delivery health care workers' job satisfaction and workplace anxiety. Study Design This is a cohort study of asymptomatic pregnant women who underwent SARS-CoV-2 testing between April 13, 2020 and April 26, 2020. Semistructured interviews were conducted via telephone at 1 and 2 weeks posthospitalization to assess maternal mental health. Depression screening was conducted using the patient health questionnaire-2 (PHQ-2). An online survey of labor and delivery health care workers assessed job satisfaction and job-related anxiety before and during the novel coronavirus disease 2019 (COVID-19) pandemic, as well as employees' subjective experience with universal testing. Patient and employee responses were analyzed for recurring themes. Results A total of 318 asymptomatic women underwent SARS-CoV-2 testing during this 2-week period. Six of the eight women (75%) who tested positive reported negative in-hospital experiences secondary to perceived lack of provider and partner support and neonatal separation after birth. Among the 310 women who tested negative, 34.4% of multiparous women reported increased postpartum anxiety compared with their prior deliveries due to concerns about infectious exposure in the hospital and lack of social support. Only 27.6% of women, tested negative, found their test result to be reassuring. Job satisfaction and job-related anxiety among health care workers were negatively affected. Universal testing was viewed favorably by the majority of health care workers despite concerns about delays or alterations in patient care and maternal and neonatal separation. Conclusion Universal testing for SARS-CoV-2 in obstetric units has mixed effects on maternal mental health but is viewed favorably by labor and delivery employees. Ongoing evaluation of new testing protocols is paramount to balance staff and patient safety with quality and equality of care. Key Points

A Scoping Review of Psychosocial Risks to Health Workers during the Covid-19 Pandemic

“…Organising childcare was recommended as a form of support for HCWs [ 106 , 115 ], and work-life balance was reported to decrease the extent of the psychological consequences of the pandemic on HCWs [ 116 , 117 ].…”

The experiences of childbearing women who tested positive to COVID-19 during the pandemic in northern Italy

“…As highlighted by our findings, the most traumatic elements of these women’s experiences were the sudden family separation, self-isolation, the partner not allowed to be present at birth and the use of masks and gloves in the physical interaction with the newborn. A mixed-method cohort study by Bender et al (2020) similarly identifies neglect, isolation and neonatal separation as difficult aspects of COVID-19 positive women’s experiences of birth [ 18 ]. The theme named ‘pandemic relationships’ is the one to which the interviewed women gave most attention when recounting their experiences.…”

Mentality of pregnant women and obstetric healthcare workers about prenatal SARS‐CoV‐2 testing: A regional survey over the first wave of the COVID‐19 pandemic in Japan

“…As shown in Table 2, most pregnant women who tested negative thought that prenatal SARS‐CoV‐2 screening tests could decrease anxieties about the viral infection to themselves, their offspring, and their families. In contrast, Bender et al reported that, in Philadelphia, about 72% of asymptomatic pregnant women who tested negative felt no change in the already existing fear or anxiety 14 . The difference in maternal feelings about prenatal PCR testing between these two areas is probably attributed to the higher prevalence of COVID‐19 in Philadelphia than in Fukui.…”