Birth in the time of COVID

30/09/2024

This is the 10th paper we have published from our longitudinal cohort study called Birth in the Time of COVID-19 (BITTOC). This is a large international collaboration though looking at Australian data. We have been following two cohorts of thousands of women who had a baby during 2020 and 2021 during the height of the pandemic and we are doing regular surveys with them for two years following the birth. We have just finishing collecting the 24 month data following up the 2021 cohort.

This latest paper looks at pandemic-related prenatal stress, model of maternity care and postpartum mental health. Our aim was to investigate whether model of care moderates the association between prenatal maternal stress from the COVID-19 pandemic, and postpartum depression and anxiety. The study involved 3048 women who provided detail responses on COVID-19 related objective hardship and and subjective distress during pregnancy and then completed depression and anxiety measures (0-6 weeks; 7-21 weeks and 22-30weeks).

Higher subjective distress was associated with elevated depression and anxiety at all timepoints. Compared with standard fragmented health care models we found, women receiving private midwifery care had a 74% reduction in the odds of elevated anxiety in early postpartum. We hypothesise they may have experienced lower anxiety due to a greater duration of postpartum in-home care, fewer changes to service delivery, and the option of homebirth. Several other studies we have published on this pandemic data have shown the protective effect on women of having continuity of midwifery care, especially private midwifery care. This raises interesting questions about providing models of care to women that may be more protective during disasters (the Queensland flood study also showed similar results). This is important as we know this impacts on women’s mental health and also child development.

Thanks Belinda Lequertier for leading the paper and the amazing BITTOC-19 team for all their support and input. Link below

https://www.sciencedirect.com/science/article/pii/S1871519224002877

16/01/2024

We have just published our paper on Telehealth during the pandemic from the BITTOC study, looking at what women and midwives felt about using Telehealth. We found perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges.

Well done Emma Collins Hill on leading the analysis for this paper and thanks to the amazing team who contributed.

To reduce transmission risk during the COVID-19 pandemic, ‘telehealth’ (health care delivered via telephone/video-conferencing) was implemented into A…

19/09/2023

Another paper is out from our Birth in the Time of COVID-19 study (BITTOC). Well done all, especially Hazel Keedle and Kimberley Tomkzak for your hard work on this.

This study followed seven women throughout their pregnancy and early parenthood. Women created audio or video recordings in real time using the Voqual app and were followed up by in-depth interviews after they gave birth.

These findings highlight the protective impact midwifery continuity of care has on reducing anxiety in women during the pandemic, and that the home environment can either be secure and safe or a place of isolation.

Purpose Internationally, the COVID-19 pandemic impacted maternity services. In Australia, this included changes to antenatal appointments and the reduction of support people during labour and birth. For women pregnant during the pandemic there were increased stressors of infection in the community a...

30/08/2023

Excited to see our next Birth in the Time of COVID-19 paper published on childbirth classes during the pandemic.

Survey responses were received from 3172 women (1343pregnantand1829postnatal) for the ‘Birth In The Time Of Covid-19 (BITTOC)’ survey (August 2020 to February 2021) in Australia. One of the survey questions asked women if they had experienced changes to CBPE class schedules or format during the pandemic, with a follow up open ended text box inviting women to comment on the impact of these changes. The majority of women experienced changes to CBPE, with only 9% stating they experienced no changes to classes. A content analysis was undertaken on the 929 open text responses discussing the impact these changes had on women’s experience of pregnancy, birth and postpartum.

Results
929 women (29%) made 1131 comments regarding changes to CBPE classes during the pandemic. The main finding ‘I felt so unprepared’, highlights how women perceived the cessation or alteration of classes impacted their birth preparation, with many reporting an increased sense of isolation. Some women reported feeling ‘It was good enough’ with adequate provision of online classes, and others feeling ‘I was let down by the system’ due to communication and technological barriers.

Conclusions
Results highlight the importance of ensuring continued provision of hybrid/online childbirth education models to enable versatility during times of crisis. Gaps in service provision, communication and resources for childbirth and parenting education need addressing.

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15/04/2023

Another one of our papers published. Prenatal maternal stress was not associated with birthweight or gestational age at birth during COVID‐19 restrictions in Australia: The BITTOC longitudinal cohort study. Thanks to all the women who participated.

Background Various forms of prenatal maternal stress (PNMS) have been reported to increase risk for preterm birth and low birthweight. However, the associations between specific components of stress...

13/04/2023

We have published in the Conversation today on COVID-19 vaccines for pregnant women stemming from our paper just published in BMJ Open.

Pregnant this winter? Here's how to prepare for COVID and get vaccinated

Concerns about taking any medication when pregnant are common and understandable. But the risks of getting COVID while pregnant and unvaccinated are high.

13/04/2023

Our next paper from the Birth in The Time of COVID-19 study is now published . This study includes 2140 women responding to the survey (838 pregnant; 1302 recently post partum)on COVID-19 vaccine uptake

Results Amongst pregnant women, 586 (69.9%) were vaccinated, 166 (19.8%) indicated intention and 86 (10.3%) were hesitant. In postnatal women, this was 1060 (81.4%), 143 (11.0%) and 99 (7.6%), respectively. Only 52 (6.2%) of pregnant women stated never wanting a COVID-19 vaccine. Vaccine hesitancy increased over time, and for pregnant women was associated with: living in a state other than New South Wales (NSW) (Adjusted Relative Risk (ARR) 2.77, 95%CI: 1.68-4.56 for vaccine intention and ARR=3.31, 95%CI: 1.52-7.20 for vaccine hesitancy), younger age

Objective To examine the prevalence of COVID-19 vaccination, and factors associated with vaccination intention and hesitancy in pregnant and postnatal women in Australia. Design and setting A national online survey was conducted over 6 months between 31 August 2021 and 1 March 2022 and responses to....

11/07/2022

Our paper now published on prenatal stress and postpartum maternal anxiety during the COVID-19 pandemic. Well done to Amber-Lee Di Paolo on her first ever publication 👏🏽👏🏽👏🏽👏🏽. This is from the BITTOC study. Thanks to all the amazing women who took part and made this study happen 🙏🏽💗💗

While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research …

01/07/2022

Our paper led by Bronwyn Brew on the 'double jeopardy' of the bushfires and COVID on pregnancy and birth has just been published! Do bushfires and COVID increase perinatal risk?Yes, in a way, but more research is needed

From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were…

29/06/2022

Excited to share with you our third paper from the Birth in the Time of COVID study (BITTOC). This paper was led by an amazing Canadian Intern who worked with us called Amber-Lee Di Paolo.

Resilience is key and we need to find ways to support women and families to build and maintain this resilience in difficult times

-Greater objective hardship and subjective distress in the face of the COVID-19 pandemic predicted higher 2-month postpartum anxiety
-For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety.
-For women with a negative cognitive appraisal, greater prenatal subjective distress due to the pandemic predicted higher postpartum anxiety. Conversely, for women with a neutral/positive cognitive appraisal, there was no association.

While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research …

17/05/2022

Excited to present our vaccine data from the Birth in the Time of COVID-19 today ⁦‪at PSANZ‬⁩ and catching up with ⁦‪Mia‬⁩ all the way from Canada ⁦‪‬⁩ and Leanne Luck. Great discussions and debate being had ⁦

08/05/2022

Thanks to all the amazing women and midwives who have been involved in the BITTOC study over the past two years. The main surveys are now closed and we will be following women and babies up until 2 years of age. The women who have kindly agreed to follow up surveys will be receiving these at 2, 6, 12 and 24 months after the birth. If we can get some more research funds we might even follow up further. We have so many papers in development now and will also be presenting 5 papers at the national PSANZ conference in Adelaide next week. Without you this study could not have happened! Thanks!