“I do not want to do that alone”: couples’ experiences navigating hybrid perinatal care during a public health crisis

Abstract

The COVID-19 pandemic challenged healthcare systems to balance infection prevention with equitable, patient-centered perinatal care. Risk-mitigation policies including restricted visitor access and rapid adoption of telehealth were intended to protect maternal and infant health. While many studies focus on the birthing individual, few studies have examined the perspectives of both members of a couple or how hybrid models of care may address gaps exposed during a public health crisis. We conducted a qualitative study of couples early in the pandemic to examine perinatal care experiences among pregnant/postpartum women and their partners. Participants were drawn from a prior pilot study focused on reducing anxiety and depression; eligible pregnant women screened positive for elevated symptoms (GAD-7 or PHQ-9 ≥ 10) and were cohabiting with a consenting partner. All trial participants were invited to an interview; data were collected from all who accepted. Semi-structured interviews were conducted individually via Zoom and explored experiences of healthcare engagement, perceptions of pandemic-related policy, and the role of perinatal support people. Forty-two interviews with 20 women and 9 partners were audio-recorded, transcribed, and analyzed using inductive thematic analysis supported by team-based coding and a consensus-driven analytic process. Three major themes emerged with virtual care functioning as a crosscutting element across themes: (1) Inclusion of Support People, including isolating experiences, fear of receiving traumatic news, partner perspectives, and the role of doulas; (2) Virtual Care: Necessity and Promise , highlighting both the benefits and limitations of telehealth; and (3) Navigating Perinatal Care , encompassing perceptions of care quality, policy inconsistencies, and adaptations to safety measures. Emergency perinatal policies must be clear, consistent, and adaptable to meet patient needs while preserving the presence of essential support people. In this study we found hybrid prenatal care models that combine telehealth and in-person support were valued for clear communication, and support presence. However, their effects on experience, satisfaction, and preparedness cannot be assumed from these data and require further study among perinatal couples.