Publications from PIPKIN

Birth is often seen as the starting point for studying effects of the environment on human development, with much research focused on the capacities of young infants. However, recent imaging advances have revealed that the complex behaviours of the fetus and the uterine environment exert influence. Birth is now viewed as a punctuate event along a developmental pathway of increasing autonomy of the child from their mother. Here we highlight (1) increasing physiological autonomy and perceptual sensitivity in the fetus, (2) physiological and neurochemical processes associated with birth that influence future behaviour, (3) the recalibration of motor and sensory systems in the newborn to adapt to the world outside the womb and (4) the effect of the prenatal environment on later infant behaviours and brain function. Taken together, these lines of evidence move us beyond nature–nurture issues to a developmental human lifespan view beginning within the womb.

While the secondary impact of the COVID-19 pandemic on the psychological well-being of pregnant women and parents has become apparent over the past year, the impact of these changes on early social interactions, physical growth and cognitive development of their infants is unknown, as is the way in which a range of COVID-19-related changes have mediated this impact. This study (CoCoPIP) will investigate: (1) how parent’s experiences of the social, medical and financial changes during the pandemic have impacted prenatal and postnatal parental mental health and parent–infant social interaction; and (2) the extent to which these COVID-19-related changes in parental prenatal and postnatal mental health and social interaction are associated with fetal and infant development.

​Background: In response to the COVID-19 pandemic, expectantparents experienced changes in the availability and uptake of bothNational Health Service (NHS) community and hospital-basedhealthcare.Objective: To examine how COVID-19 and its societal relatedrestrictions have impacted the provision of healthcare support forpregnant women during the COVID-19 pandemic.Method: A thematic analysis using an inductive approach wasundertaken using data from open-ended responses to the nationalCOVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP)Study online survey (n = 507 families).Findings: The overarching theme identified was the way in whichthe changes to healthcare provision increased parents’ anxietylevels, and feelings of not being supported. Five sub-themes, asso-ciated with the first wave of the pandemic, were identified: (1)rushed and/or fewer antenatal appointments, (2) lack of sympathyfrom healthcare workers, (3) lack of face-to-face appointments, (4)requirement to attend appointments without a partner, and (5)requirement to use PPE. A sentiment analysis, that used quantita-tive techniques, revealed participant responses to be predomi-nantly negative (50.1%), with a smaller proportion of positive(21.8%) and neutral (28.1%) responses found.Conclusion: This study provides evidence indicating that thechanges to healthcare services for pregnant women during thepandemic increased feelings of anxiety and have left women feel-ing inadequately supported. Our findings highlight the need forcompensatory social and emotional support for new and expectantparents while COVID-19 related restrictions continue to impact onfamily life and society.

Background: Expectant parents worldwide have experienced changes in the way they give birth as a result of COVID-19, including restrictions relating to access to birthing units and the presence of birthing partners during the birth, and changes to birth plans. This paper reports the experiences of women in England. Methods: Data were obtained from both closed- and open-ended responses collected as part of the national COVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP) Study online survey (n=477 families) between 15th July 2020 – 29th March 2021. Frequency data are presented alongside the results of a sentiment analysis; the open-ended data was analysed thematically. Results: Two-thirds of expectant women reported giving birth via spontaneous vaginal delivery (SVD) (66.1%) and a third via caesarean section (CS) (32.6%) or ‘other’ (1.3%). Just under half (49.7%) of the CS were reported to have been elective/planned, with 47.7% being emergencies. A third (37.4%) of participants reported having no changes to their birth (as set out in their birthing plan), with a further 25% reporting COVID-related changes, and 37.4% reporting non-COVID related changes (e.g., changes as a result of birthing complications). One quarter of the sample reported COVID-related changes to their birth plan, including limited birthing options and reduced feelings of control; difcul‑ ties accessing pain-relief and assistance, and feelings of distress and anxiety. Under half of the respondents reported not knowing whether there could be someone present at the birth (44.8%), with 2.3% of respondents reporting no birthing partner being present due to COVID-related restrictions. Parental experiences of communication and advice provided by the hospital prior to delivery were mixed, with signifcant stress and anxiety being reported in relation to both the fuctuating guidance and lack of certainty regarding the presence of birthing partners at the birth. The sentiment analysis revealed that participant experiences of giving birth during the pandemic were predominately negative (46.9%) particularly in relation to the frst national lockdown, with a smaller proportion of positive (33.2%) and neutral responses (19.9%). Conclusion: The proportion of parents reporting birthing interventions (i.e., emergency CS) was higher than previ‑ ously reported, as were uncertainties related to the birth, and poor communication, leading to increased feelings of anxiety and high levels of negative emotions. The implications of these fndings are discussed