ABSTRACT

Individuals who gave birth during the COVID-19 pandemic experienced an increased risk for premature births, stillbirths, depression, and lower access to care. Their stories provide valuable information that can inform clinical care, particularly due to loss of in-person support resulting from visitor restrictions in hospitals. Grounded in a theory of narrative problematics, we explored how elicited birth narratives were affected by COVID-19 and how stories can be used as material evidence to inform healthcare systems. We facilitated seven focus group discussions with 65 women from 19 states who had given birth between March and July 2020. Three themes emerged from our qualitative thematic analysis: (1) navigating disrupted access to healthcare; (2) experiencing loss of co-construction of birth experience; and (3) recognizing fissures in the mask-wearing master narrative. Practical implications for improving healthcare include developing spaces for individuals to process birth stories for cathartic benefit due to significant disruption, improving hospital policies about in-person support to avoid loss of co-construction of experience, and centering hospitals and the providers that work within them as audiences for interventions around preventive measures during a disease outbreak.

摘要

在 COVID-19 大流行期间分娩的人早产、死产、抑郁症和获得护理的机会减少的风险增加。他们的故事提供了有价值的信息，可以为临床护理提供信息，特别是由于医院的访客限制导致失去现场支持。基于叙事问题理论，我们探讨了引出的出生叙事如何受到 COVID-19 的影响，以及如何将故事用作物质证据来为医疗保健系统提供信息。我们与来自 19 个州的 65 名在 2020 年 3 月至 2020 年 7 月期间分娩的妇女进行了七次焦点小组讨论。我们的定性主题分析得出了三个主题：(1) 应对中断的医疗服务；(2) 生育经历共建缺失；(3) 识别戴面具的大师叙事中的裂痕。改善医疗保健的实际意义包括为个人开发空间，以便在严重中断的情况下处理出生故事以获得宣泄益处，改进医院关于面对面支持的政策以避免失去共同建设的经验，以及以医院和在其中工作的提供者为中心作为疾病爆发期间围绕预防措施进行干预的受众。