Authors: Cassandra Hendrix and Alexis George
January 14, 2020
How has COVID-19 impacted perinatal care in the US? And how is this impacting mothers’ psychological health?
Our goal was to characterize how perinatal care in the US has changed due to COVID-19. To do this, we compiled data from 14 different sites across the US, resulting in a dataset of over 7,000 pregnant and postpartum women. The states colored on this map indicate the number of participants we recruited from each state in the US.
We started by examining whether the quality of care that postpartum individuals received changed due to COVID-19. Based on the subjective report of the women in our study, 61% indicated their pre and postnatal care worsened because of COVID-19; that equates to about 1,000 women in our sample.
So…did the quality of perinatal care change because of COVID-19? The answer is yes!
But what were the specific changes that women experienced? We decided to quantify these experiences in a more objective way. To do that, we asked people whether they experienced specific disruptions to their perinatal care. The specific disruptions we asked about can be grouped into disruptions to one’s birth plan (in gold below), or disruptions to the postnatal care that people usually receive after giving birth (in blue).
Summary of Findings:
• Quality of perinatal care worsened because of COVID-19
• Individuals who gave birth during COVID had more birth plan & postnatal care changes compared to women who gave birth prior to COVID, with the most common disruptions being:
• Support people (e.g., partner, family members) were not allowed at delivery
• Changed from a spontaneous vaginal birth to a planned c-section or induction
• Provider was not available for baby's birth
• Friends and family were not able to visit after the birth
• Did not receive antenatal/lactation support after discharge
• Postnatal visits switched from in-person to virtual
Despite these changes and despite women feeling like their care generally worsened because of COVID-19, there is a silver lining here. 72% of postpartum people report that they still feel very well supported by their pre and postnatal care providers. This suggests that doctors are working hard to support their patients, and that their postpartum patients notice and appreciate those efforts.
A lot of the disruptions we looked at were not associated with increased psychological distress in postpartum individuals, and the care disruptions that were linked to psychological wellness can be modified in practice. For instance, doctors can try to avoid separating mothers from their infants whenever possible, and when necessary can use video calls so the mother can at least see their baby. Providers can also make more efforts to follow up on postpartum depression, especially during a time when postpartum people are particularly isolated from family and friends.