Research Posters
Introduction/Objective
Labor support for pregnant clients is correlated strongly with better childbirth outcomes. U.S. hospital visitor restrictions due to COVID-19 reduced the number of labor support individuals permitted. Our study examined pregnant patients’ perceptions of their birth experiences during COVID-19 visitor restrictions.
Methods
Interviews were conducted at a hospital in Washington, DC, in spring 2021. Participants were older than 18 years, gave birth at 37-weeks’ gestation or later, and spoke English and/or Spanish. Participants without a birth prior to COVID-19 or who experienced a fetal–newborn death with their current fetus were excluded. Recruitment continued until data saturation was achieved through an iterative analysis. Interviews with 24 female-identifying participants explored women’s prenatal and labor–birth experiences, perceptions of visitor restrictions, and decision-making processes. Protocols were approved by the Institutional Review Board. Thematic analysis, as outlined by Clarke and Braun, was conducted on a subset of interviews. Discrepancies were discussed for codebook refinement, and codes were applied to all interviews.
Results
Three themes were revealed: pregnancy–birth experience stresses, support system significance, and response to visitor policies. Identified stressors included loneliness, fear of COVID-19 exposure, and partner disengagement. The fear of dying alone and the obligation to uphold an image of strength were perspectives shared by some Black women. The second theme highlighted the need for personally connected and knowledgeable support people. One patient noted that midwives provide excellent support. Participants were pleased with nursing staff support. There was general agreement about the necessity of visitor restrictions. However, frustrations included unclear communication, forced selection of a support individual, and navigating childcare at home. Several participants appreciated an uncrowded birth room. Visitor restrictions lifted perceived familial obligations. Women generally accepted telehealth prenatal visits.
Discussion/Conclusion
Visitor restrictions may have empowered nurses to more actively support women during birth and fostered a calmer atmosphere. The forced selection of one support person failed to acknowledge cultural–racial differences, the importance of matriarch-centered birth, and equity issues related to childcare. Virtual prenatal visits highlighted telehealth benefits related to travel and childcare. Results will guide obstetric nurses in clinical practice and inform future research related to birth support and hospital visitation.