BACKGROUND: The 2019 coronavirus disease (COVID-19) is linked with an increased risk of adverse pregnancy outcomes. However, the effects of lockdown measures on pregnant women’s mental health are still largely unknown.

AIM: To explore women’s experiences of pregnancy, labor/birth, and the postpartum period during the COVID-19 pandemic.

METHOD: An online cross-sectional survey was conducted between July 2020 and May 2021. Two questionnaires were used: one focused on demographic information and women’s experiences of pregnancy and perinatal period, and the Edinburgh Postnatal Depression Scale. Data were analyzed via statistical and content analysis.

RESULTS: Two-hundred and 78 women answered the questionnaire. Stress and anxiety were the predominant challenges for many women; 36.3% reported being moderately and 17.3% highly stressed and anxious during pregnancy; 23.9% reported being moderately and 26.8% highly stressed and anxious during labor/birth. On the EPDS, 40.2% of women scored ≥11 points, indicating that they were at high risk for postpartum depression. The level of stress and anxiety during pregnancy and labor/birth was significantly higher in women with depressive symptoms compared with the other women (p < .001 for both comparisons). In addition, the proportion of women with depressive symptoms who were supported by friends during pregnancy was significantly lower compared with the other women (51.8% vs. 68.3%, p = .006). Women with depressive symptoms also reported a significantly lower presence of their partner during birth (95.5% vs. 99.4%, p = .040) and significantly lower perceived support from the midwife during labor and birth (p = .042). Content analysis revealed that sources of social and emotional stress and anxiety included women’s inability to meet with friends and extended families, lack of support, loneliness, the need to protect the baby, and concerns about hygiene.

CONCLUSION: Partners, friends, and family members play a significant role in the social support systems of pregnant women, and their support was hindered by the lockdown measures during the COVID-19 pandemic. In our study, the prevalence of women at high risk for postpartum depression was higher when compared with previous literature, suggesting that the pandemic contributed to an increase in stress and anxiety. This should be taken into consideration in planning maternity services after the pandemic.

INTRODUCTION: Major placenta previa with advanced maternal age (AMA) is a significant risk factor for obstetric hemorrhage and associated maternal and neonatal complications.

OBJECTIVE: The objective was to study major placenta previa in advanced age among nulliparous with cesarean section.

METHODS: This prospective cross-sectional study analyzes 78 pregnant women of advanced age with major placenta previa under a cesarean section. Data were collected using interview questionnaires between January 2019 and June 2020.

RESULTS: The mean gestational age at delivery was 35.7 ± 3 years. Antepartum hemorrhage, premature membrane rupture, and placenta accreta occurred in 15.4%, 35.9%, and 15.4% of cases, respectively. About 12.8% of women were at risk of post-traumatic stress disorder symptoms. Fetal distress, postpartum hemorrhage (PPH), and cesarean hysterectomy occurred in 37.2%, 46.2%, and 15.4% of patients. Mean Apgar scores in the first and fifth minutes were 7.0 ± 0.90 and 8.0 ± 0.82, respectively. The mean birth weight was 2.7 ± 0.14823. Of neonates, 37.2% were premature, 37.2% required resuscitation, less than half (44.9%) were admitted to the neonatal intensive care unit, and 37.2% had respiratory distress syndrome. Moreover, there is a statistically significant relationship between placenta accreta and cesarean hysterectomies and the occurrence of PPH. Also, a highly significant association was observed between the use of antenatal steroids, fetal distress, Apgar score <3 at 1 minute, and neonatal respiratory distress syndrome.

CONCLUSION: Major placenta previa with AMA significantly influences pregnancy outcomes and is considered an obstetric emergency. Therefore, early detection of major placenta previa and proper management during clinical care is essential.

BACKGROUND: In addition to improving maternal and neonatal mortality and morbidity, the World Health Organization now additionally requests that maternity care providers provide high-quality respectful care to childbearing women. Within this study, providing respectful care surrounds helping women make decisions about whether or not to have their labor induced, which encompasses providing good care provider interaction (CPI) within a considerate and empathetic interface. With this in mind, we wanted to explore what prior studies report about women’s experiences of CPI when deciding whether or not to have their labor induced.

METHOD: A narrative systematic review of qualitative literature was conducted.

RESULTS: Nine articles published between 2010 and May 2022 met the inclusion criteria, from which four themes were identified: (a) involvement in the decision-making process; (b) risk awareness; (c) sources and format of the information; and (d) trust in the care provider. The synthesis of data showed that many women feel uninvolved in decision-making processes surrounding their induction of labor (IOL) and perceive that they were provided with minimal choice. While most women have high levels of trust in their care provider, risks surrounding continuing the pregnancy often remain undiscussed. Additionally, women sometimes feel rushed into making a decision, with a lack of information provided in the right format regarding potential risks that might be involved.

CONCLUSIONS AND RECOMMENDATIONS: In full recognition that maternity care professionals are motivated to communicate effectively with women, it is important that the risks of having IOL are fully discussed. The information provided needs to be tailored in both content and format according to individualized needs. Women require to explore their options and be afforded time to ask questions prior to deciding whether or not to have their labor induced.

BACKGROUND: Pregnancy-related anxiety is a distinct psychological construct during pregnancy, requiring adequate coping behavior.

METHOD: A cross-sectional survey was performed among 420 pregnant Dutch-speaking women in Belgium to establish the prevalence rate of pregnancy-related anxiety and to explore its associated coping styles and strategies. Pregnancy-related anxiety was measured with the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R2) and coping was measured with the Brief Coping Orientation to Problems Experienced.

FINDINGS: Based on PRAQ-R2 score ≥90th percentile, the pregnancy-related anxiety prevalence rate was 13.3%. Women with heightened scores significantly more often had a (family) history of psychological problems (p = .027, p = .013), were significantly more often nulliparous women (p < .000), had a fear of birth (p = .041), felt ill-prepared for birth and parenthood (p < .000), and significantly more often reported to have received insufficient emotional (p = .002) and practical support (p < .000) during pregnancy. The coping style “avoidance” showed a significant positive association with pregnancy-related anxiety (p < .000), while “positive thinking” showed a significant negative association (p = .054). The coping strategies “self-blame,” “substance use,” and “self-distraction” showed a significant positive association with pregnancy-related anxiety (p < .001, p = .011, p = .003).

CONCLUSION: Flemish women show overall maladaptive styles and strategies in coping with pregnancy-related anxiety, of which self-blame seems to be a newfound strategy, requiring attention. Health care practitioners might benefit when being aware of the predisposing factors of pregnancy-related anxiety and women’s (mal)adaptive coping styles and strategies to better understand and adequately support these women.

BACKGROUND: Obstetric anal sphincter injury (OASI) is a complication of childbirth. Some women will develop symptoms, which may appear in the short or long term. In most clinical practice guidelines, follow-up is only recommended in women with anal incontinence (AI). In our hospital, follow-up is offered to all women who suffer an OASI: Anorectal manometry (ARM) and endoanal ultrasound (EAUS) are scheduled for all patients. The aim of this study was to determine if a symptom-based or systematic follow-up was better for these patients. To do so, we compared the results of investigations (EAUS and ARM) between asymptomatic and symptomatic women.

METHODS: A retrospective analysis of prospectively collected data from 259 women who suffered an OASI in a single tertiary hospital in Barcelona (Spain) between May 2008 and May 2018.

RESULTS: Seventy-seven percent of women attended the first follow-up visit at the perineal clinic, and 40.5% of women completed the 12-month follow-up. At initial evaluation, 60% of the patients had a Wexner score of 0. Seventy-two percent of women had an abnormal result on one or both investigations (EAUS and ARM).

CONCLUSIONS: Attendance and adherence to our follow-up protocol are low. Although the incidence of AI symptoms is low at early follow-up in women after OASI, they show a high rate of functional dysfunctions on manometry. If follow-up is offered only to symptomatic patients, it could lead to an underestimation of their true condition.

BACKGROUND: Pelvic floor exercise is beneficial to every antenatal and postnatal woman as it helps to strengthen the pelvic floor muscle and prevent pelvic floor complications. Although the knowledge, practice, and benefits of pelvic floor muscle exercises (PFMEs) are fairly known among health care professionals, there seems to be a deficit in knowledge and practice of PFMEs among antenatal and postnatal women in the study location.

OBJECTIVES: This study assessed the knowledge and practice of PFMEs among women attending antenatal and postnatal clinics in a secondary health center, in Southeast, Nigeria.

METHODS: Using a descriptive cross-sectional design, a convenience sampling technique was used to select 143 pregnant and postpartum women at a secondary health center. A researcher-designed questionnaire was used to collect information on their demographics, knowledge, and the practice of pelvic floor exercises. Data were analyzed using descriptive and inferential statistics in Statistical Package for the Social Sciences version 25 at 5% alpha level.

RESULTS: The findings showed that a small proportion (28.5%) had good knowledge; however, 54 (54.7%) practiced PFMEs. There was a significant relationship between knowledge and practice of pelvic floor exercises (p < .001).

CONCLUSION: Limited knowledge and practice of PFMEs exist among the study population; therefore, good clinical practice guidelines should be developed to train and guide health providers on the best way to utilize antenatal classes to inform and train the antenatal and postnatal women properly on PFMEs.

Introduction: Bipolar disorder (BD) is a severe affective mood disorder with medication management as the backbone of treatment; however, medication use during pregnancy and lactation impacts a patient’s decision and ability to breastfeed. Disparate recommendations from healthcare providers may further undermine a patient’s ability to achieve their lactation goals.

Methods: This case reviews the role of the lactation consultant in facilitating interprofessional collaboration to help meet the breastfeeding goals of the patient with BD.

Results: Interdisciplinary collaboration with several providers through pregnancy, postpartum, and the community setting helped this mother achieve her goal to breastfeed her infant for 5 months.

Conclusion: The IBCLC is perfectly positioned to represent the patient’s interests and facilitate interprofessional collaboration to achieve breastfeeding goals.

Introduction: The American Academy of Pediatrics and the United States Centers for Disease Control and Prevention recommend that women living with HIV (WLHIV) avoid breastfeeding or feeding their infant their own milk to eliminate the risk of HIV transmission via breast milk. Thus, lactation support for WLHIV to breastfeed has been poorly understood in high-income countries. However, the National Institutes of Health has released new perinatal HIV clinical guidelines supporting exclusive breastfeeding under specific conditions.

Case Presentation: This case reviews lactation team support of a WLHIV desiring to breastfeed her infant.

Management and Outcome: Cooperation and collaboration with several providers and departments through pregnancy, hospitalization, and postdelivery to provide counseling, helped this mother exclusively breastfeed her newborn for three months without vertical transmission of HIV.

Discussion: Although challenging, International Board Certified Lactation Consultants are uniquely positioned to support WLHIV to experience their desired breastfeeding outcome for her and her infant.

Objective: Breastfeeding is essential to save the lives of young children; however, housing insecurity has been connected to a lower likelihood of commencing or continuing to breastfeed because of the numerous barriers it creates for breastfeeding mothers. Housing insecurity and household conditions are one of the social determinants that influence the initiation, duration, and exclusivity of breastfeeding. To analyze the housing-related vulnerability of breastfeeding mothers, this review examines the impact of housing and living conditions on the breastfeeding practices of mothers and presents housing-related factors that negatively affect the maternal decision to breastfeed.

Methods: This scoping review was undertaken using four major databases, including JSTOR, EBSCO, PubMed, and OVID Medline. Evidence-based articles were searched without placing any restrictions on the year of publication or geographic location. A total of 18 articles published until 2022 were included in the scoping review.

Results: This review suggests that multiple factors associated with housing impacts the maternal intent and duration of breastfeeding. The housing factors that directly and indirectly affect breastfeeding practices include the type of housing, stress related to housing, housing conditions, unfair allocation of housing, social support in households and neighborhoods, safe space to breastfeed, and homelessness after the catastrophe.

Conclusions: Demographic characteristics of breastfeeding mothers must be examined, and mothers facing housing insecurity must be offered need-based support, guidance, and breastfeeding counseling. Creating and improving screening techniques that recognize the complexity of housing instability is necessary, particularly for communities most at risk for nonexclusive breastfeeding. The systemic barriers to breastfeeding related to housing can be reduced by collaborating with patient partners, communities, interdisciplinary healthcare providers, policymakers, and government and nongovernmental organizations.