Caffieri, Alessia (2024) The perinatal experience during the COVID-19 pandemic: mixed-method research on maternal psychological health. [Tesi di dottorato]

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The project, taking the perspective of perinatal clinical psychology (which integrates psychodynamic and infant research approaches), aims to explore the psychological health of pregnant and postpartum women during the COVID-19 pandemic through mixed methods. The dissertation presents four original studies. The first study is a systematic review that aims to synthesize Italian studies on the psychological health of pregnant and postpartum women during the first acute year of the COVID-19 virus spread in Italy. It includes 11 primary articles. The findings and the gaps found in scientific literature by this first study oriented the other steps of the project. The second study aims to in-depth explore maternal experience during the COVID-19 pandemic, through the qualitative approach of Longitudinal Interpretative Phenomenological Analysis (LIPA). Participants were 8 women, interviewed twice: during pregnancy (“second wave” of COVID-19 spread in Italy) and after one year, during postpartum (“third wave” of the COVID-19 spread in Italy). The study shines light on maternal representations during the pandemic, including the mothers’ experience of anti-contagion praxes applied by perinatal healthcare services, and the risks of gender biases and discriminations. The third study is a cross-sectional study that aims to explore the psychological health of pregnant and postpartum women at the formal end of the COVID-19 public health emergency in Italy. It, involving 200 women, shows that, despite the end of the health emergency, COVID-19-related fears continued to influence perinatal psychological distress via the full mediation effect of COVID-19-related post-traumatic impact and loneliness. The fourth study is an umbrella review and meta-analytic synthesis which taking a global perspective aims to synthesize the prevalence of perinatal depression and anxiety during the pandemic. The study includes 25 SR&MA, and 198 primary studies from 45 countries, covering five continents. The study suggests that, during the COVID-19 pandemic, antenatal (29%) and postpartum (26%) depression affected one in four women, whereas the prevalence of antenatal and postnatal anxiety was 31%, affecting one in three women. The implications of the whole project for the research, clinical practice, perinatal healthcare services, and national/international policies are discussed.

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