Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
J Midwifery Womens Health. 2022 Jul;67(4):488-495. doi: 10.1111/jmwh.13338. Epub 2022 Mar 4.
Many studies have explored the impact of the coronavirus disease 2019 (COVID-19) pandemic on perinatal health, but few have examined the effects of the pandemic on birthing families through a rural lens. Given that the COVID-19 pandemic has reinforced long-standing disparities between urban and rural communities, it is important that the significance of place on the health and wellness of rural populations is made visible.
In-depth interviews and focus groups with 16 participants from rural communities in British Columbia, Canada, were performed. Participants included those who had been pregnant or given birth after March 11, 2020. Data from the interviews and focus groups were analyzed using the principles of thematic analysis to understand the perinatal experiences of rural families during the initial months of the COVID-19 pandemic.
Analysis of the data revealed 4 major themes: perceived risk of infection, navigating uncertainty, experience of care received, and resilience and silver linings. In general, participants conceptualized rural communities as safer bubbles. Exceptions included specific vectors of risk such as tourism travel and border communities. Challenges experienced by rural families including anxiety around changing health guidelines, reduced social support, and potential loss of their partners' support at births. Additional concerns specific to rural experiences added to this burden, including fear of traveling to referral centers for care and increased difficulties accessing resources.
Participants reported positive, compassionate care experiences that helped to mitigate some of the added stressors of the pandemic. These findings highlight the importance of perinatal care provision that integrates physiologic and mental health supports. This study provides a foundation for a comprehensive inquiry into the experiences of rural perinatal services during COVID-19.
许多研究探讨了 2019 年冠状病毒病（COVID-19）大流行对围产期健康的影响，但很少有研究从农村角度探讨大流行对分娩家庭的影响。鉴于 COVID-19 大流行加剧了城乡社区之间长期存在的差距，重要的是要让人们看到地方对农村人口健康和幸福的重要性。
在加拿大不列颠哥伦比亚省的农村社区对 16 名参与者进行了深入的访谈和焦点小组讨论。参与者包括自 2020 年 3 月 11 日以来怀孕或分娩的人。使用主题分析的原则分析访谈和焦点小组的数据，以了解农村家庭在 COVID-19 大流行最初几个月的围产期经历。
数据分析揭示了 4 个主要主题：感染的感知风险、不确定因素的应对、所接受护理的体验以及韧性和一线希望。总的来说，参与者将农村社区概念化为更安全的“泡沫”。例外情况包括旅游旅行和边境社区等特定的风险因素。农村家庭面临的挑战包括对不断变化的健康指南感到焦虑、社会支持减少以及在分娩时可能失去伴侣的支持。农村经历特有的额外问题增加了这种负担，包括对前往转诊中心接受护理的恐惧以及获取资源的困难增加。
参与者报告了积极、富有同情心的护理体验，有助于减轻大流行带来的一些额外压力。这些发现强调了提供围产期护理的重要性，这种护理需要整合生理和心理健康支持。本研究为全面调查 COVID-19 期间农村围产期服务的经验提供了基础。
