Unmet Prenatal Expectations During the COVID-19 Pandemic

Abstract

Purpose: To explore the experiences of pregnant women who were living in the United States during the COVID-19 pandemic. Study Design and Methods: Using a qualitative design, we used data obtained from women in their second or third trimester of pregnancy who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to December 22, 2020. Results: 361 of 408 pregnant women (88%) who participated in the PEACE study during that timeframe provided narrative comments. Participants had a mean age of 33.2 years (SD = 3.7) with a high percentage of White women (91.4%). At the time of participation, women were between 2.4 and 8.6 months into the COVID-19 pandemic. Just under half were pregnant for the first time ( n = 177). Content analysis of responses revealed an overall sense of “unmet expectations” within two themes involving the role of relationships: 1) losing the experience of going through pregnancy together and 2) loss of social support and expected relationship building . Differences were noted between participants giving birth for the first time and participants with other children at home. Clinical Implications: This study offers insight for nurses and other clinicians taking care of pregnant women during times of public health crises and provides implications for the care of women as the pandemic continues. Nurses can help women plan for future health care changes that may disrupt their support needs as seen during the COVID-19 pandemic. Nurses should also be aware of possible enduring effects of prenatal unmet needs on later outcomes.

Scoping Review of Racial and Ethnic Representation of Participants in Mental Health Research Conducted in the Perinatal Period During the COVID-19 Pandemic

“…(2020) — 7.1 85.7 14.8 — — 3.6 Goyal, Beck, et al. (2021) 8.4 0.8 82 6.1 — — 2.7 Goyal, De La Rosa, et al. (2021) 86.8 — — — — — 13.2 Groulx et al.…”

“…In 17 studies (68%), researchers categorized participants as ethnic minorities, other, mixed race, one or more races, multiracial, or non-White, accounting for 6.2% of the total sample ( Ahlers-Schmidt et al., 2020 ; Anderson et al., 2022 ; Barbosa-Leiker et al., 2021 ; Claridge et al., 2021 ; Farewell et al., 2020 ; Goyal, Beck, et al., 2021 ; Goyal, De La Rosa, et al. 2021 ; Groulx et al., 2021 ; Khoury et al., 2021 ; Kinser et al., 2021 ; Kornfield et al., 2021 ; Lebel et al., 2020 ; C. H. Liu, Erdei, & Mittal, 2021 ; J. Liu et al., 2021 ; McMillan et al., 2021 ; Mollard et al., 2021 ; Perzow et al., 2021 ).…”

“…In two studies, researchers evaluated the experiences of women of color during the pandemic. Goyal, De La Rosa, et al. (2021) assessed symptoms of depression and experiences in women of Asian American descent.…”

“…(2021) assessed symptoms of depression and experiences in women of Asian American descent. Researchers asked participants to self-report their Asian ethnicity resulting in the following 10 ethnicities: Asian Indian, Chinese, Filipino, Hmong, Japanese, Laotian, Korean, Thai, and Vietnamese ( Goyal, De La Rosa, et al., 2021 ). In a prospective, longitudinal cohort design, Wheeler et al.…”

“…The COVID-19 public health crisis intensified the risk of antenatal mental health disorders because of related stressors that included (a) a shift to virtual health care and the inability to bring a partner or support person to in-person visits ( C. H. Liu, Goyal, et al., 2021 ); (b) fear and the unknown effects of the virus on the fetus or newborn ( Basu et al., 2021 ; Burgess et al. 2022 ; Kotlar et al., 2021 ); (c) the increased demand of juggling work from home, loss of child care, and school closures ( Ajayi et al., 2021 ; Basu et al., 2021 ; Lee & Parolin, 2021 ; Mollard et al., 2021 ; Perzow et al., 2021 ); and (d) missed milestone celebrations, such as baby showers and gender reveals ( Goyal, De La Rosa, et al., 2021 ; Goyal, Han, et al., 2021 ). Fear of exposure to COVID-19, partner/support restrictions during the birth, and being separated from the infant after the birth increased the risk of depression and anxiety in women in the postnatal period ( Burgess et al., 2022 ; C. H. Liu et al., 2022 ; Shuman et al., 2022 ).…”