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Background: Rates of perinatal depression and anxiety increased during the COVID-19 pandemic. It remains unclear how the COVID-19 pandemic influenced risk perception and help-seeking behaviours among pregnant and postpartum individuals. Objectives: To explore pregnant and postpartum individuals' decision-making process about when and how to seek support for feelings of depression and/or anxiety during the COVID-19 pandemic. Design: A qualitative descriptive design was used. Methods: The current study is a secondary analysis of qualitative data collected for a larger mixed-methods project that recruited participants who gave birth from 1 May 2020, to 1 December 2021, in Ontario and British Columbia, Canada, using maximum variation and purposive sampling. Seventy-three semi-structured interviews were conducted over Zoom or telephone. This analysis focuses on 56 individuals who discussed their self-identified feelings of prenatal or postpartum depression and/or anxiety. Conventional (inductive) content analysis was employed with iterative stages of open coding, focused coding and cross-checking themes. Results: Most participants recognized their need to seek help for their feelings of depression and/or anxiety through discussions with a mental health professional or someone within their social circle. Nearly all participants accessed informal social support for these feelings, which sometimes entailed social contact in contravention of local COVID-19 public health policies. Many also attempted to access formal mental healthcare, encountering barriers both related and unrelated to the pandemic. Participants described the pandemic as having the dual effect of causing or exacerbating their feelings of depression and/or anxiety while also constraining their ability to access timely professional care. Conclusion: Participants struggled to address their feelings of perinatal depression and anxiety during the COVID-19 pandemic, with many describing a lack of readily available resources and limited access to professional mental healthcare. This study highlights the need for improved provision of instrumental mental health support for pregnant and postpartum populations. Plain language summary: Seeking mental health support for feelings of perinatal depression and/or anxiety during the COVID-19 pandemic: A qualitative descriptive study of decision-making It is not unusual for pregnant and postpartum individuals to experience feelings of depression and/or anxiety. Studies have shown that this became more common during the COVID-19 pandemic. Depression and anxiety can be challenging to recognize and treat in pregnant and postpartum individuals but may lead to long-term negative effects if not addressed. The COVID-19 pandemic brought on public health measures, including social distancing, which created barriers to accessing mental health professionals or social interactions. In this study, we wanted to understand when and how pregnant and postpartum people chose to seek support for their feelings of depression and/or anxiety during the COVID-19 pandemic. We interviewed people who gave birth during the pandemic in either Ontario or British Columbia, Canada and asked them about whether they experienced feelings of perinatal anxiety or depression, and how they chose to seek help for those feelings. Most participants acknowledged their feelings of depression and/or anxiety through discussions with a mental health professional or someone within their social circle, even though many experienced barriers to accessing these supports. Nearly all participants interacted with friends or family outside of their household to cope with their feelings, which sometimes meant acting against local COVID-19 public health policies. Although some participants talked about facilitators for accessing mental health professionals, many who tried also encountered challenges, and a few were unsuccessful. Participants in this study shared that the pandemic sometimes caused or worsened feelings of depression and/or anxiety while also making it harder to access the support they felt was necessary to cope with their feelings. These findings show that there is a need for more frequent conversations about mental health during healthcare appointments and more readily accessible mental health resources for pregnant and postpartum people. [ABSTRACT FROM AUTHOR]

Parents and non-parental adults who interact with children influence child development. This study evaluates the knowledge of child development in two large and diverse samples of adults from Alberta in 2007 and 2013. Telephone interviews were completed by two random samples (1,443 in 2007; 1,451 in 2013). Participants were asked when specific milestones in physical, cognitive, emotional and social domains typically occur (age birth to six years). Data were analysed using univariate and multivariate techniques. Linear logistic regression models were used to examine factors associated with knowledge and differences between the two samples while adjusting for differences and covariates. Adults' knowledge was overall poor (<25% correct responses), but notably higher for physical (48% in 2007, 44% in 2013) than social, cognitive or emotional milestones (=21% in all cases). Knowledge was lower in the 2013 than the 2007 sample (23% in 2007, 21% in 2013), and in particular for mothers after adjusting for location and income (24% in 2007, 22% in 2013). Evidence of low knowledge may have important education and policy implications. Factors such as availability of child development evidence-based information, parental stress and access to quality childcare might play a role in the low levels of knowledge.

Introduction Vulnerable pregnant women (e.g. women with low socio-economic status or recent immigrants) are less likely to receive adequate prenatal care or to attend perinatal education classes. CenteringPregnancy (CP) is a model of group prenatal care which combines assessment, education and support. This study aimed to assess patient experience among vulnerable women in group prenatal care compared to individual care. Methods Women participating in CP at a community-based health centre in urban Alberta were eligible to participate. A convenience sample of women who received individual care at a low-risk maternity clinic served as comparison. Women were asked a series of questions on their prenatal care experience. Demographic and patient responses were compared using Chi square, fisher's exact and t tests. Results Forty-five women accessing CP and 92 women accessing individual care participated. Women in CP were younger, more likely to be single and having their first baby than women in individual care. Women in CP were significantly more likely to report having received enough information on exercise during pregnancy (92 vs. 66%, p = 0.002), breastfeeding (95 vs. 70%, p = 0.002) and baby care (95 vs. 67%, p = 0.001). Women in CP were more likely to report that they felt their prenatal care providers were interested in how the pregnancy was affecting their life (100 vs. 93%, p [less than or equal to] 0.001). Discussion Group prenatal care provides a positive experience and improved information exchange among vulnerable populations. Programs interested in engaging, educating and empowering vulnerable pregnant women may benefit from implementation of group care., Author(s): Erin Hetherington [sup.1] , Suzanne Tough [sup.1] [sup.2] , Deborah McNeil [sup.1] [sup.3] [sup.4] , Hamideh Bayrampour [sup.5] , Amy Metcalfe [sup.1] [sup.6] Author Affiliations: (Aff1) 0000 0004 1936 [...]

Background: Large-scale longitudinal studies with biological samples are needed to examine the associations between prenatal cannabis use and birth and developmental outcomes. Objectives: The aim of this study was to understand the feasibility and acceptability of collecting umbilical cord tissue for the purpose of cannabis use testing in a community sample. Design: This is a mixed methods research study consisted of a prospective cohort study and a qualitative descriptive study. Methods: This study was conducted in Vancouver, British Columbia between January 2021 and August 2022. Participants were recruited during pregnancy, and the umbilical cord tissues were collected at birth and tested for the presence of cannabinoids. After the completion of the study, participants completed an online open-ended questionnaire about their overall experience. Data were analyzed using descriptive and thematic analyses. Results: Among the 85 eligible individuals, 57 people (67%) consented to the study. The cord tissue was collected for 39 participants (68.4%). The collection rates for participants with vaginal, elective, and emergency cesarean delivery were 73.0%, 71.4%, and 53.8%, respectively, and for those with spontaneous and induced labor were 81.5% and 50%, respectively. Four (7.0%) and seven participants (12.3%) reported prenatal cannabis use in direct and probing self-report questions, respectively. The agreement between any self-report and cord tissue test was moderate (kappa 0.53, 95% confidence interval 0.06–0.99). Qualitative findings were classified into five themes. Conclusion: The collection of cord tissue was perceived acceptable by most participants. Implementation of collection protocols for complex labors, a central hospital unit to liaise direct communications and active participants' involvement might increase the feasibility of future studies. [ABSTRACT FROM AUTHOR]

Objectives Introducing new programming into an existing setting may be challenging. Understanding how staff and clinicians who are not directly involved in program delivery view the program can help support program implementation. This study aimed to understand how peripheral staff and clinicians perceived a newly implemented Centering Pregnancy group prenatal care program in a community-based health center and its impact on clinic operations. Methods Semi-structured interviews were conducted with a purposive sample of 12 staff members at a community-based health center. The interview guide covered topics such as perceptions of Centering Pregnancy and how the program impacted their work. An interpretive description approach was used to analyze the interview data. A coding framework was developed iteratively and all interview data were analyzed independently by multiple researchers. Results Staff had overall positive perceptions of Centering Pregnancy, but the level of understanding about the program varied widely. Most respondents viewed the Centering Pregnancy program as separate from other programs offered by the clinic, which created both opportunities and challenges. Opportunities included increased cross-referrals between established services and Centering Pregnancy. Challenges included a lack of communication about responsibilities of staff in relation to Centering Pregnancy patients. Impact on staff and overall clinic operations was perceived to be minimal to moderate, and most tensions related to roles and expectations were resolved. Conclusions for Practice Clear communication regarding fit within clinic structures and processes and expectations of staff in relation to the program was critical to the integration of Centering Pregnancy program into an established health center., Author(s): Ania Kania-Richmond [sup.1] , Erin Hetherington [sup.2] , Deborah McNeil [sup.3] [sup.4] , Hamideh Bayrampour [sup.5] , Suzanne Tough [sup.2] [sup.6] , Amy Metcalfe [sup.1] [sup.2] [sup.7] Author Affiliations: [...]

Background Suboptimal weight gain during pregnancy is a potentially modifiable risk factor. We aimed to investigate the association between suboptimal gestational weight gain and severe adverse birth outcomes by pre-pregnancy body mass index (BMI) categories, including obesity class I to III. Methods and findings We conducted a population-based study of pregnant women with singleton hospital births in Washington State, US, between 2004 and 2013. Optimal, low, and excess weight gain in each BMI category was calculated based on weight gain by gestational age as recommended by the American College of Obstetricians and Gynecologists and the Institute of Medicine. Primary composite outcomes were (1) maternal death and/or severe maternal morbidity (SMM) and (2) perinatal death and/or severe neonatal morbidity. Logistic regression was used to obtain adjusted odds ratios (AORs) and 95% confidence intervals. Overall, 722,839 women with information on pre-pregnancy BMI were included. Of these, 3.1% of women were underweight, 48.1% had normal pre-pregnancy BMI, 25.8% were overweight, and 23.0% were obese. Only 31.5% of women achieved optimal gestational weight gain. Women who had low weight gain were more likely to be African American and have Medicaid health insurance, while women with excess weight gain were more likely to be non-Hispanic white and younger than women with optimal weight gain in each pre-pregnancy BMI category. Compared with women who had optimal weight gain, those with low gestational weight gain had a higher rate of maternal death, 7.97 versus 2.63 per 100,000 (p = 0.027). In addition, low weight gain was associated with the composite adverse maternal outcome (death/SMM) in women with normal pre-pregnancy BMI and in overweight women (AOR 1.12, 95% CI 1.04-1.21, p = 0.004, and AOR 1.17, 95% CI 1.04-1.32, p = 0.009, respectively) compared to women in the same pre-pregnancy BMI category who had optimal weight gain. Similarly, excess gestational weight gain was associated with increased rates of death/SMM among women with normal pre-pregnancy BMI (AOR 1.20, 95% CI 1.12-1.28, p < 0.001) and obese women (AOR 1.12, 95% CI 1.01-1.23, p = 0.019). Low gestational weight gain was associated with perinatal death and severe neonatal morbidity regardless of pre-pregnancy BMI, including obesity classes I, II, and III, while excess weight gain was associated with severe neonatal morbidity only in women who were underweight or had normal BMI prior to pregnancy. Study limitations include the ascertainment of pre-pregnancy BMI using self-report, and lack of data availability for the most recent years. Conclusions In this study, we found that most women do not achieve optimal weight gain during pregnancy. Low weight gain was associated with increased risk of severe adverse birth outcomes, and in particular with maternal death and perinatal death. Excess gestational weight gain was associated with severe adverse birth outcomes, except for women who were overweight prior to pregnancy. Weight gain recommendations for this group may need to be reassessed. It is important to counsel women during pregnancy about specific risks associated with both low and excess weight gain., Author(s): U. Vivian Ukah 1,*, Hamideh Bayrampour 2, Yasser Sabr 3, Neda Razaz 4, Wee-Shian Chan 5, Kenneth I. Lim 6, Sarka Lisonkova 6,7 Introduction Weight gained during pregnancy is [...]

Abstract Background Advanced maternal age (AMA) is associated with several adverse pregnancy outcomes, hence these pregnancies are considered to be “high risk.” A review of the empirical literature suggests that it is not clear how women of AMA evaluate their pregnancy risk. This study aimed to address this gap by exploring the risk perception of pregnant women of AMA. Methods A qualitative descriptive study was undertaken to obtain a rich and detailed source of explanatory data regarding perceived pregnancy risk of 15 women of AMA. The sample was recruited from a variety of settings in Winnipeg, Canada. In-depth interviews were conducted with nulliparous women aged 35 years or older, in their third trimester, and with singleton pregnancies. Interviews were recorded and transcribed verbatim, and content analysis was used to identify themes and categories. Results Four main themes emerged: definition of pregnancy risk, factors influencing risk perception, risk alleviation strategies, and risk communication with health professionals. Conclusions Several factors may influence women's perception of pregnancy risk including medical risk, psychological elements, characteristics of the risk, stage of pregnancy, and health care provider’s opinion. Understanding these influential factors may help health professionals who care for pregnant women of AMA to gain insight into their perspectives on pregnancy risk and improve the effectiveness of risk communication strategies with this group.

Parents and non-parental adults who interact with children influence child development. This study evaluates the knowledge of child development in two large and diverse samples of adults from Alberta in 2007 and 2013. Telephone interviews were completed by two random samples (1,443 in 2007; 1,451 in 2013). Participants were asked when specific milestones in physical, cognitive, emotional and social domains typically occur (age birth to six years). Data were analysed using univariate and multivariate techniques. Linear logistic regression models were used to examine factors associated with knowledge and differences between the two samples while adjusting for differences and covariates. Adults’ knowledge was overall poor (<25% correct responses), but notably higher for physical (48% in 2007, 44% in 2013) than social, cognitive or emotional milestones (≤21% in all cases). Knowledge was lower in the 2013 than the 2007 sample (23% in 2007, 21% in 2013), and in particular for mothers after adjusting for location and income (24% in 2007, 22% in 2013). Evidence of low knowledge may have important education and policy implications. Factors such as availability of child development evidence-based information, parental stress and access to quality childcare might play a role in the low levels of knowledge. [ABSTRACT FROM AUTHOR]