Peer-reviewed article
Labour and delivery characteristics, maternal birth satisfaction and early relational health among COVID-19 pandemic-born children.
Warmingham JM, Lavallée A, Lanoff M, Russo J, Atwood G et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how birth experiences and maternal satisfaction affect the early relationship between mothers and infants born during the COVID-19 pandemic. Researchers followed 384 mothers and babies at U.S. hospitals, collecting information about labour and delivery from medical records and measuring maternal satisfaction and mother-infant bonding in the first months of life. The study found that maternal and infant medical complications, unplanned caesarean sections, and escalated care during birth were linked to lower maternal birth satisfaction, which in turn predicted weaker bonding and emotional connection between mother and infant in the early months.
Key points
- Maternal and infant medical risks during labour and delivery were associated with lower maternal birth satisfaction
- Lower maternal birth satisfaction predicted lower mother-reported bonding at 4 months postpartum
- Lower maternal birth satisfaction also predicted lower observed emotional connection between mother and infant at 4-6 months
- The study included mothers with and without SARS-CoV-2 infection during pregnancy
- Data were collected from medical records, maternal surveys at 2 months, and observed mother-infant interactions via video at 4-6 months postpartum
Limitations
This study is observational and cannot establish causation, only associations. The study was conducted at U.S.-based academic medical centres, which may not represent all birth settings or populations globally.
Abstract
Aims/background Medical events during birth and self-reported birth experience may influence early relational health (ERH) in the postpartum period. Limited longitudinal work has been conducted in this area, particularly among women who gave birth during the COVID-19 pandemic. The goal of this study was to assess labour and delivery characteristics and maternal birth satisfaction as predictors of ERH domains of mother-reported bonding and observed emotional connection in the first year of life among women who gave birth during the COVID-19 pandemic. Design/methods Participants included mothers (n = 384) with and without SARS-CoV-2 infection during pregnancy who gave birth at three U.S.-based academic medical centres who were enrolled in the Epidemiology of Severe Acute Respiratory Syndrome Coronavirus-2 in Pregnancy and Infancy COVID-19 Mother Baby Outcomes (ESPI COMBO) Study. Labour and delivery information was abstracted from medical records. Mothers completed surveys assessing birth satisfaction (2 months) and bonding (4 months postpartum). A remote (Zoom) video visit was conducted at 4-6 months postpartum and observed mother-infant emotional connection was coded using the Welch Emotional Connection Screen. We evaluated study aims using structural equation models. Results Maternal and infant medical risks (e.g. maternal complications, unplanned caesarean deliveries, care escalation) were associated with lower maternal birth satisfaction, which in turn predicted lower mother-reported bonding and observed emotional connection in infancy. Conclusion Results provide insight into perinatal determinants of early relational health among infants born during the COVID-19 pandemic and inform transdisciplinary clinical care approaches to support families and children in the transition to motherhood.