Pregnancy and childbirth in particular are times of high risk for poor mental health. The so-called mobile health program Essential coaching for all mothers (ECEM) was designed to meet the needs of mothers at this critical time, but its introduction was delayed due to the onset of the pandemic. Introduction recently posted to medRxiv * server describes the early results of the program compared to the mother’s self-efficacy and other important parameters, as well as its appropriateness.
Postpartum support
In the 2019 pandemic coronavirus infection (COVID-19), there is a potential for an increase in poor mental health due to a number of factors, such as anxiety about the potential and consequences of infection with the severe respiratory coronavirus syndrome 2 (SARS – CoV-2), social isolation, insecurity about employment, and lack of social support. During the postpartum period, women are still more vulnerable with the lack of access to up-to-date information and support, even without pandemic.
For example, many places in Canada stopped public health classes, including new mother classes, while friends and family could no longer visit. The inevitable result was postpartum depression and anxiety, with a loss of self-efficacy on the part of the new mother.
The ECEM program
The ECEM mobile health application was designed to help meet this need. It is a texting program that sends daily messages for the six weeks of the postpartum period. When the pandemic began, some messages were changed and new ones added, for a total of 56 messages.
These texts related to neonatal care and the mother’s own mental well-being, with new messages related to the pandemic, such as the safety of breastfeeding during this season. The program was designed in partnership with new mums and healthcare professionals and wanted to “immediate postpartum female psychosocial outcomes. ”
As originally planned, the program would send two messages per day for the first 14 days, with one per day for the remaining four weeks. The modified program sends a third message on three days in the first 14 days. Women can choose whether to breastfeed or formula feeding messages, flexibly, for the duration of the six weeks.
Study details
The pilot study was conducted on 88 mothers, with an average age of 31 years. Nearly 88% were white, and more than two-thirds were married, and more than a quarter were in ordinary legal relationships. More than half had high incomes, with 10% low incomes. About 88% said this was a planned pregnancy, usually completed in more than two-thirds, with an unplanned C-section in about 28%, and a C-section planned in 5 %. A third had been diagnosed with anxiety or depression.
Of these participants, only 4343% received all messages. About 90% chose breastfeeding messages. However, this did not appear to affect the results.
Positive results
When asked about the results, there was an improvement in self-efficacy between the first and second study, an average of 5 weeks apart, from the moderate to moderate clinical range. However, this may just be the result of mothers becoming accustomed to managing the care of their baby.
There was a significant reduction in anxiety over this period, as measured by the State-of-State Anxiety Disorder (STAI). Other measures, such as postpartum depression, COVID-19 specific anxiety, COVID-19-related stress, and social support, showed no change.
High capture
Interestingly, almost 90% of women said that the program was completely appropriate in terms of the number of messages, and ~ 85% accepted the information they received about neonatal care. Areas with incomplete information, according to participants, were breastfeeding and sleeping on newborns. Several commented that the length of time they received messages on a particular topic was just right.
Nearly 99% said they would recommend it to other new mothers. Many appreciated the support they received from these texts, when there was no personal support. “The texts felt like we were being cared for and giving advice that we thought our parents would give.. ”
Support and unity
Many commented that the program would have been helpful even in the absence of the pandemic, with several saying that they felt this information was more reliable than they could have been. for themselves with Googling theme. In addition, the information reassured them that it was expected and normal for that period. Mothers felt that their babies were meeting their milestones as expected, and they also had a sense of community.
The daily texting gave anchors to the new mothers as well as important confirmation of what they already knew or were doing right. They liked that it connected with information from other health care sources, and provided freely from a trusted source, and without asking for it. Many women wanted to be able to answer or ask questions, perhaps have a support person, and continue the ECEM program for a longer period of time.
Because Nova Scotia was a low-frequency region for COVID-19, participants sometimes felt disturbed by the texts related to the disease.
Conclusion
“Preliminary findings suggest that Essential Coaching for All Mothers may play a role in increasing maternal self-efficacy and reducing generalized anxiety, although future work with a control group is needed to truly explain the effect of the program beyond the changes occurring in the postpartum period in general.. ”
* Important message
medRxiv publish preliminary scientific reports that are not peer-reviewed and, therefore, should not be seen as final, guiding health-related clinical / behavioral practice, or be treated as information established.