Exploring parents' confidence and experiences of going home with their newborn baby during the COVID-19 pandemic

Aim: To explore parents’ confidence and experiences of going home with their newborn baby, during the COVID-19 pandemic
Design: A cross-sectional exploratory survey
Method: Recruitment was via a survey url available through social media, during July to August 2020. Sample size calculation n=354 (95%, CI =5). Survey included the Maternal Confidence Scale1 (MCS) and open-ended questions about parents’ experiences.

Results: Participants were predominantly mothers (n=369/371, 99.4%), aged 25-34 (n=252, 67.8%), fit and healthy (n=314, 85%), white British (n=351, 94,5%) on maternity leave (n=252, 67.9%) and for half this was their first baby (186, 50.1%).
The lowest reported MCS was 29 (n=1), highest score 70 (n=4), mean score 59 (SD 6.5). On the confidence subscales: knowledge scores were the lowest ranging from 11 (n=1) to 30 (n=21) (mean 24.7, SD 3.4); task scores were the highest ranging from 6 (n=3) to 15 (n=272) (mean 14.4, SD 1.3); feelings scores ranged from 9 (n=2) to 25 (n=20) (mean 19.9, SD 3.3).
Qualitative themes included: mixed emotions (fear vs excitement); psychological impact of ‘no partner’ restrictions and lack of support (professional and social); Lack of COVID-19 information; home as a place of safety vs isolation; birth expectations and experience mismatch; concerns for the baby’s future.
Discussion
The findings support other pandemic studies2,3. Parents’ described experiences ranging from joy to signs of post-traumatic stress disorder, associated with lack of support, visitor restrictions4,5 and unmet birth expectations6. Low MCS knowledge scores may correspond with perceived lack of information and professional support during the pandemic. The long-term impact of COVID-19 on their infant’s physical and social development was a concern for some.
Conclusions.
• Maternal mental health is a post-pandemic priority7-9
• Link between birth expectations, birth satisfaction and possible link to post-natal PTSD6
• Importance of assessing maternal mental health and identifying prevention strategies, including support systems

(currently 299, MAX 300 words)
References
1. Parker SJ, Zahr LK, Cole JG, & Brecht ML. (1992) Outcome after developmental intervention in the neonatal intensive care unit for mothers of preterm infants with low socioeconomic status. J Pediatr. 120(5): 780–785. https://doi.org/10.1016/S0022-3476(05)80248- 3
2. Davenport MH, Meyer S, Meah VL, Strynadka MC and Khurana R (2020) Moms Are Not OK: COVID-19 and Maternal Mental Health. Front. Glob. Womens Health 1:1. doi: 10.3389/fgwh.2020.00001
3. Dib, S., Rougeaux, E., Vázquez‐Vázquez, A., Wells, J.C. and Fewtrell, M., 2020. Maternal mental health and coping during the COVID‐19 lockdown in the UK: Data from the COVID‐19 New Mum Study. International Journal of Gynecology & Obstetrics, 151(3), pp.407-414.
4. Richens Y, Wilkinson M and Connor D, Guidance for the provision of antenatal services during the COVID-19 pandemic. British Journal of Midwifery, 2020; 28 (5), pp.324-327.
5. Royal College of Obstetricians and Gynecologists, Royal College of Midwives, Coronavirus (COVID-19) infection and pregnancy RCOG and RCM; 2020 https://www.rcog.org.uk/coronavirus-pregnancy
6. Webb, R., Ayers, S., Bogaerts, A., Jeličić, L., Pawlicka, P., Van Haeken, S., Uddin, N., Xuereb, R. B., Kolesnikova, N., & COST action CA18211:DEVoTION team (2021). When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences. BMC pregnancy and childbirth, 21(1), 475. https://doi.org/10.1186/s12884-021-03898-z
7. Bailey L, Gaskin K (2021) Spotlight on maternal mental health: a pre-pandemic and post-pandemic priority, Evidence Based Nursing, 10.1136/ebnurs-2021-103378
8. Howard LM, Khalifeh H. Perinatal mental health: a review of progress and challenges. World Psychiatry. 2020 Oct;19(3):313-327. doi: 10.1002/wps.20769.
9. National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance (CG192) 2014 (updated 2020) https://www.nice.org.uk/guidance/cg192