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. 2021 Jul;34(4):335-343.
doi: 10.1016/j.wombi.2020.07.002. Epub 2020 Jul 13.

Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy

Claudia Ravaldi  1 , Alyce Wilson  2 , Valdo Ricca  3 , Caroline Homer  4 , Alfredo Vannacci  5
Affiliations

Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy

Claudia Ravaldi et al. Women Birth. 2021 Jul.

Abstract

Background: In March 2020, COVID-19 was declared to be a pandemic. While data suggests that COVID-19 is not associated with significant adverse health outcomes for pregnant women and newborns, the psychological impact on pregnant women is likely to be high.

Aim: The aim was to explore the psychological impact of the COVID-19 pandemic on Italian pregnant women, especially regarding concerns and birth expectations.

Methods: A cross-sectional online survey of pregnant women in Italy was conducted. Responses were analysed for all women and segregated into two groups depending on previous experience of pregnancy loss. Analysis of open text responses examined expectations and concerns before and after the onset of the pandemic.

Findings: Two hundred pregnant women responded to the first wave of the survey. Most (n=157, 78.5%) had other children and 100 (50.0%) had a previous history of perinatal loss. 'Joy' was the most prevalent emotion expressed before COVID-19 (126, 63.0% before vs 34, 17.0% after; p<0.05); fear was the most prevalent after (15, 7.5% before vs 98, 49.0% after; p<0.05). Positive constructs were prevalent before COVID-19, while negative ones were dominant after (p<0.05). Across the country, women were concerned about COVID-19 and a history of psychological disorders was significantly associated with higher concerns (p<0.05). A previous pregnancy loss did not influence women's concerns.

Conclusions: Women's expectations and concerns regarding childbirth changed significantly as a result of the COVID-19 pandemic in Italy. Women with a history of psychological disorders need particular attention as they seem to experience higher levels of concern.

Keywords: Birth; COVID-19; Concerns; Constructs; Emotions; Pregnancy.

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Figures

Fig. 1
Fig. 1
(A, B): Distribution of respondents according to previous pregnancy loss (A, orange) and history of psychological distress (B, orange); larger circles correspond to larger clusters of women. (C, D): Number of confirmed COVID-19 positive cases per 100,000 inhabitants in each Italian region, at the time of the survey (C). Geographical distribution of mean values of concern in each Italian region (D).
Fig. 2
Fig. 2
Level of concern of women according to history of psychological distress.
Fig. 3
Fig. 3
Distributions of primary emotions regarding birth experience, before and after COVID-19 pandemics.
Fig. 4
Fig. 4
Distributions of positive and negative psychological constructs regarding birth experience, before and after COVID-19 pandemics. Black line indicates average number of positive/negative concerns (shaded area 95% CI; p < 0.05 before vs after).
Fig. 5
Fig. 5
Network of words associated with the word ‘fear’, plotted using a fifth order word relations network analysis (Raven’s Eye software), before and after COVID-19 pandemic.
See this image and copyright information in PMC

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