Experiences of A Population of Recovered Iranian Pregnant Women from COVID-19: A Qualitative Study

Document Type : Original Article

Authors

1 Department of Midwifery and Reproductive Health, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

2 Department of Mother and Child Health, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran

3 Students Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Mother and Child Health, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Background: It seems pandemics may have a notable potential adverse effect on the pregnant women. The important biological COVID-19 aspect of the pregnancy has been led to the neglect of its psychological aspect of the pregnant women, especially COVID-19 affected. The present qualitative study aims to explore the experiences of Iranian pregnant women who were recovered from the COVID-19 pandemics.
Materials and Methods: This qualitative study designed based on a semi-structured interview with 9 pregnant women who had developed COVID-19 during pregnancy and had recovered.
Results: Data analysis revealed five themes including: anxiety and helplessness, stigma, confront disease, apprehension in the heart of desire, and seeking calmness. Rrecovered pregnant women from COVID-19 spoke of their mixed feelings; being happy with their survival and that of their fetus, despite getting the disease, along with anxiety and fear of the future, which had resulted in the continuation of pregnancy in the limbo of ambiguity and expectation. Recovered pregnant women during unknown pandemics, despite being saved from disease, continue to tolerate concerns about their unborn child.
Conclusion: Recovered pregnant women during unknown pandemics, despite being saved from disease, continue to tolerate concerns about their fetus. Therefore, they require comprehensive and complete management approaches that require familiarity with the psychological challenges of this group of patients.

Keywords


  1. Soltani F, Maleki A, Shobeiri F, Shamsaei F, Ahmadi F, Roshanaei G. The limbo of motherhood: Women's experiences of major challenges to cope with the first pregnancy. Midwifery. 2017; 55: 38-44.
  2. Slade A, Cohen LJ, Sadler LS, Miller M. The psychology and psychopathology of pregnancy: reorganization and transformation. Zeanah CH, editor. In: Handbook of infant mental health. New York: Guilford Press; 2009; 22-39.
  3. Duranku┼č F, Aksu E. Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. J Matern Fetal Neonatal Med. 2020; 35(2): 205-211.
  4. Saccone G, Florio A, Aiello F, Venturella R, De Angelis MC, Locci M, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol. 2020; 223(2): 293-295.
  5. Gardner P, Moallef P. Psychological impact on SARS survivors: critical review of the English language literature. Can Psychol. 2015; 56(1): 123-135.
  6. Diamond RM, Brown KS, Miranda J. Impact of COVID-19 on the perinatal period through a biopsychosocial systemic framework. Contemp Fam Ther. 2020; 42(3): 205-216.
  7. Ravaldi C, Wilson A, Ricca V, Homer C, Vannacci A. Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy. Women Birth. 2020; 34(4): 335-343.
  8. Brooks SK, Weston D, Greenberg N. Psychological impact of infectious disease outbreaks on pregnant women: rapid evidence review. Public Health. 2020; 189: 26-36.
  9. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: a systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020; 99(7): 823-829.
  10. Freitas-Jesus JV, Rodrigues L, Surita FG. The experience of women infected by the COVID-19 during pregnancy in Brazil: a qualitative study protocol. Reprod Health. 2020; 17: 108.
  11. Aghababaei S, Bashirian S, Soltanian A, Refaei M, Omidi T, Ghelichkhani S, et al. Perceived risk and protective behaviors regarding COVID-19 among Iranian pregnant women. Middle East Fertil Soc J. 2020; 25(1): 29.
  12. Buekens P, Alger J, Breart G, Cafferata ML, Harville E, Tomasso G. A call for action for COVID-19 surveillance and research during pregnancy. Lancet Glob Health. 2020; 8(7): e877-e878.
  13. Gildner TE, Thayer ZM. Birth plan alterations among American women in response to COVID-19. Health Expect. 2020; 23(4): 969-971.
  14. Davenport MH, Meyer S, Meah VL, Strynadka MC, Khurana R. Moms are not OK: COVID-19 and maternal mental health. Front Glob Womens Health. 2020; 1: 1.
  15. Qiao Y, Wang J, Li J, Wang J. Effects of depressive and anxiety symptoms during pregnancy on pregnant, obstetric and neonatal outcomes: a follow-up study. J Obstet Gynaecol. 2012; 32(3): 237-240.
  16. Field T, Diego M, Hernandez-Reif M, Figueiredo B, Deeds O, Ascencio A, et al. Comorbid depression and anxiety effects on pregnancy and neonatal outcome. Infant Behav Dev. 2010; 33(1): 23-29.
  17. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020; 26: e923549.
  18. Glaser BG, Strauss AL. The discovery of grounded theory: strategies for qualitative research. Aldine Transaction: New Brunswick; 1999.
  19. Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004; 22 (2): 63-75.
  20. Taghizadeh Z, Cheraghi MA, Kazemnejad A, Pooralajal J, Aghababaei S. Difference in perception of pregnancy risk in two maternal age groups. J Clin Diagn Res. 2017; 11(5): QC09- QC12.
  21. Oshvandi K, Jadidi A, Dehvan F, Shobeiri F, Cheraghi F, Sangestani G, et al. Relationship between pregnancy-induced hypertension with neonatal and maternal complications. Int J Pediatr. 2018; 6(11): 8587-8594.
  22. World Health Organization. Maternal mental health and child health and development in low and middle income countries. Available from: https://www.who.int/Publications/i/item/9789241597142 (30 Mar 2020).
  23. Ahorsu DK, Imani V, Lin CY, Timpka T, Broström A, Updegraff JA, et al. Associations between fear of COVID-19, mental health, and preventive behaviors across pregnant women and husbands: an actor-partner interdependence modelling. Int J Ment Health Addict. 2020; 20(1): 68-82.
  24. Castro P, Matos AP, Werner H, Lopes FP, Tonni G, EA Júnior Júnior. Covid-19 and pregnancy: an overview. Rev Bras Ginecol Obstet. 2020; 42(7): 420-426.
  25. Fakari FR, Simbar M. Coronavirus pandemic and worries during pregnancy; a letter to editor. Arch Acad Emerg Med. 2020; 8(1): e21.
  26. Downe S, Finlayson K, Oladapo OT, Bonet M, Gülmezoglu AM. What matters to women during childbirth: a systematic qualitative review. PLoS One. 2018; 13(4): e0194906.
  27. Lynch MM, Mitchell EW, Williams JL, Brumbaugh K, Jones-Bell M, Pinkney DE, et al. Pregnant and recently pregnant women's perceptions about influenza a pandemic (H1N1) 2009: implications for public health and provider communication. Matern Child Health J. 2012; 6(8): 1657-1664.
  28. Lohm D, Flowers P, Stephenson N, Waller E, Davis MD. Biography, pandemic time and risk: Pregnant women reflecting on their experiences of the 2009 influenza pandemic. Health (London). 2014; 18(5):493-508.
  29. Rogers RW. Cognitive and psychological processes in fear appeals and attitude change: a revised theory of protection motivation. Cacioppo J, Petty R, editors. In: Social psychophysiology: a sourcebook. New York: Guilford Press; 1983; 153-177.
  30. Lee CH, Huang N, Chang HJ, Hsu YJ, Wang MC, Chou YJ. The immediate effects of the severe acute respiratory syndrome (SARS) epidemic on childbirth in Taiwan. BMC Public Health. 2005; 5: 30.
  31. Ng J, Sham A, Leng Tang P, Fung S. SARS: pregnant women’s fears and perceptions. Br J Midwifery. 2004; 12(11): 698-703.
  32. Hamzehgardeshi Z, Omidvar S, Amoli AA, Firouzbakht M. Pregnancy-related anxiety and its associated factors during COVID-19 pandemic in Iranian pregnant women: a web-based cross-sectional study. BMC Pregnancy Childbirth. 2021; 15: 208.
  33. Karavadra B, Stockl A, Prosser-Snelling E, Simpson P, Morris E. Women's perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom. BMC Pregnancy Childbirth. 2020; 20: 20: 600.
  34. Sakaguchi S, Weitzner B, Carey N, Bozzo P, Mirdamadi K, Samuel N. Pregnant women's perception of risk with use of the H1N1 vaccine. J Obstet Gynaecol Can. 2011; 33(5): 460-467.
  35. Sasaki TK, Yoshida A, Kotake K. Attitudes about the 2009 H1N1 influenza pandemic among pregnant Japanese women and the use of the Japanese municipality as a source of information. Southeast Asian J Trop Med Public Health. 2013; 44(3): 388-399.
  36. Linde AR, Siqueira CE. Women's lives in times of Zika: mosquito-controlled lives? Cad Saude Publica. 2018; 34(5): e00178917.
  37. Filgueiras Meireles JF, Neves CM, Morgado FFDR, Caputo Ferreira ME. Zika virus and pregnant women: a psychological approach. Psychol Health. 2017; 32(7): 798-809.