From lockdown to cradle: Navigating the psychological challenges of childbirth during the COVID-19 pandemic in Italy– Evidence from a 3-year analysis

Abstract This cross-sectional study investigated the mental health of Italian women who gave birth during the three years of the COVID-19 pandemic. The study focused on the impact of the partner’s presence during childbirth, the time point of birth in relation to pandemic waves, hospital restrictions, and individual attitudes regarding the pandemic. In addition, the study aimed to determine potential risk or protective factors for postpartum depression. 1,636 Italian women who gave birth between 2020 and 2022 in a hospital-restricted setting were surveyed anonymously online. Standardized questionnaires were used to evaluate depression, post-traumatic stress, and psychological well-being. Women who gave birth in 2020 had the highest percentage of unaccompanied births and higher levels of depression and fear of COVID-19. Women who gave birth alone reported higher depression and post-traumatic stress and lower psychological well-being. Furthermore, they were more frightened by COVID-19 and less in agreement with pandemic restrictions than women who gave birth with their partner present. The main risk factors for postpartum depression were childbirth in 2020, high COVID-19 anxiety, discomfort with pandemic restrictions, and the partner’s absence during birth. Protective factors were the partner’s presence during childbirth and satisfaction with the partner relationship. This study emphasizes the importance of targeted support to women who give birth during crises such as the COVID-19 pandemic to reduce risk factors and enhance protective factors, particularly by strengthening the partner’s presence. Future research should focus on children born during these tumultuous periods, assessing potential impacts on their developmental trajectories and relationships with primary caregivers.