Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety

Rena Bina; Drorit Levy; Samira Alfayumi-Zeadna; Ana Raquel Marcelino Mesquita; Raquel Costa; Sara Domínguez-Salas; Claire A Wilson; Ana Osorio; Eleni Vousoura; Ana Uka; Camellia Hancheva; Yolanda Contreras-García; Pelin Dikmen-Yildiz; Andri Christoforou; Emma Motrico

doi:10.1016/j.midw.2025.104295

Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety

Rena Bina, Drorit Levy, Samira Alfayumi-Zeadna, Ana Raquel Marcelino Mesquita, Raquel Costa, Sara Domínguez-Salas, Claire A Wilson, Ana Osorio, Eleni Vousoura, Ana Uka, Camellia Hancheva, Yolanda Contreras-García, Pelin Dikmen-Yildiz, Andri Christoforou, Emma Motrico

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: During the perinatal period, risk of depression and anxiety (D&A) increases. As in other crisis events, the COVID-19 pandemic, imposed social distancing measures, diminished social support and changes in perinatal healthcare provision which heightened this risk. This study aimed to examine how changes in social and healthcare provider support during the pandemic affected coping strategies and depression and anxiety symptoms (D&As) among perinatal women.

METHODS: A cross-sectional international study included 7,368 pregnant and postpartum women up to six months postpartum from 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Between June and October 2020, women answered an online survey regarding D&As (measured by the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7), level of social and healthcare providers' support, changes to these types of support and coping strategies.

RESULTS: Main findings show that 24.6% of women had symptoms of depression and 20.2% of anxiety. Higher levels of D&A were associated with lower social and provider support, negative changes to social support and use of negative internal coping strategies. Positive coping strategies mediated the relationship between increased social and provider support and decreased D&As, while negative coping strategies mediated the relationship between negative changes to social support and increased D&As.

CONCLUSION: Social and provider support can promote coping strategies and reduce emotional distress. Healthcare providers should screen perinatal women for D&A, discuss ways to improve their coping strategies and social support as a preventive measure, and offer initial emotional well-being support.

Original language	English
Article number	104295
Pages (from-to)	104295
Journal	MIDWIFERY
Volume	142
DOIs	https://doi.org/10.1016/j.midw.2025.104295
Publication status	Published - Mar 2025

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Bina, R., Levy, D., Alfayumi-Zeadna, S., Mesquita, A. R. M., Costa, R., Domínguez-Salas, S., Wilson, C. A., Osorio, A., Vousoura, E., Uka, A., Hancheva, C., Contreras-García, Y., Dikmen-Yildiz, P., Christoforou, A., & Motrico, E. (2025). Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety. MIDWIFERY, 142, 104295. Article 104295. https://doi.org/10.1016/j.midw.2025.104295

@article{6d4c910790c64517a8e783780eb45d4f,

title = "Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety",

abstract = "BACKGROUND: During the perinatal period, risk of depression and anxiety (D&A) increases. As in other crisis events, the COVID-19 pandemic, imposed social distancing measures, diminished social support and changes in perinatal healthcare provision which heightened this risk. This study aimed to examine how changes in social and healthcare provider support during the pandemic affected coping strategies and depression and anxiety symptoms (D&As) among perinatal women.METHODS: A cross-sectional international study included 7,368 pregnant and postpartum women up to six months postpartum from 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Between June and October 2020, women answered an online survey regarding D&As (measured by the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7), level of social and healthcare providers' support, changes to these types of support and coping strategies.RESULTS: Main findings show that 24.6% of women had symptoms of depression and 20.2% of anxiety. Higher levels of D&A were associated with lower social and provider support, negative changes to social support and use of negative internal coping strategies. Positive coping strategies mediated the relationship between increased social and provider support and decreased D&As, while negative coping strategies mediated the relationship between negative changes to social support and increased D&As.CONCLUSION: Social and provider support can promote coping strategies and reduce emotional distress. Healthcare providers should screen perinatal women for D&A, discuss ways to improve their coping strategies and social support as a preventive measure, and offer initial emotional well-being support.",

author = "Rena Bina and Drorit Levy and Samira Alfayumi-Zeadna and Mesquita, {Ana Raquel Marcelino} and Raquel Costa and Sara Dom{\'i}nguez-Salas and Wilson, {Claire A} and Ana Osorio and Eleni Vousoura and Ana Uka and Camellia Hancheva and Yolanda Contreras-Garc{\'i}a and Pelin Dikmen-Yildiz and Andri Christoforou and Emma Motrico",

year = "2025",

month = mar,

doi = "10.1016/j.midw.2025.104295",

language = "English",

volume = "142",

pages = "104295",

journal = "MIDWIFERY",

issn = "0266-6138",

publisher = "Churchill Livingstone",

}

Bina, R, Levy, D, Alfayumi-Zeadna, S, Mesquita, ARM, Costa, R, Domínguez-Salas, S, Wilson, CA, Osorio, A, Vousoura, E, Uka, A, Hancheva, C, Contreras-García, Y, Dikmen-Yildiz, P, Christoforou, A & Motrico, E 2025, 'Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety', MIDWIFERY, vol. 142, 104295, pp. 104295. https://doi.org/10.1016/j.midw.2025.104295

TY - JOUR

T1 - Changes to social and healthcare providers support in the perinatal period

T2 - Impact on coping strategies, depression and anxiety

AU - Bina, Rena

AU - Levy, Drorit

AU - Alfayumi-Zeadna, Samira

AU - Mesquita, Ana Raquel Marcelino

AU - Costa, Raquel

AU - Domínguez-Salas, Sara

AU - Wilson, Claire A

AU - Osorio, Ana

AU - Vousoura, Eleni

AU - Uka, Ana

AU - Hancheva, Camellia

AU - Contreras-García, Yolanda

AU - Dikmen-Yildiz, Pelin

AU - Christoforou, Andri

AU - Motrico, Emma

PY - 2025/3

Y1 - 2025/3

N2 - BACKGROUND: During the perinatal period, risk of depression and anxiety (D&A) increases. As in other crisis events, the COVID-19 pandemic, imposed social distancing measures, diminished social support and changes in perinatal healthcare provision which heightened this risk. This study aimed to examine how changes in social and healthcare provider support during the pandemic affected coping strategies and depression and anxiety symptoms (D&As) among perinatal women.METHODS: A cross-sectional international study included 7,368 pregnant and postpartum women up to six months postpartum from 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Between June and October 2020, women answered an online survey regarding D&As (measured by the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7), level of social and healthcare providers' support, changes to these types of support and coping strategies.RESULTS: Main findings show that 24.6% of women had symptoms of depression and 20.2% of anxiety. Higher levels of D&A were associated with lower social and provider support, negative changes to social support and use of negative internal coping strategies. Positive coping strategies mediated the relationship between increased social and provider support and decreased D&As, while negative coping strategies mediated the relationship between negative changes to social support and increased D&As.CONCLUSION: Social and provider support can promote coping strategies and reduce emotional distress. Healthcare providers should screen perinatal women for D&A, discuss ways to improve their coping strategies and social support as a preventive measure, and offer initial emotional well-being support.

AB - BACKGROUND: During the perinatal period, risk of depression and anxiety (D&A) increases. As in other crisis events, the COVID-19 pandemic, imposed social distancing measures, diminished social support and changes in perinatal healthcare provision which heightened this risk. This study aimed to examine how changes in social and healthcare provider support during the pandemic affected coping strategies and depression and anxiety symptoms (D&As) among perinatal women.METHODS: A cross-sectional international study included 7,368 pregnant and postpartum women up to six months postpartum from 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Between June and October 2020, women answered an online survey regarding D&As (measured by the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7), level of social and healthcare providers' support, changes to these types of support and coping strategies.RESULTS: Main findings show that 24.6% of women had symptoms of depression and 20.2% of anxiety. Higher levels of D&A were associated with lower social and provider support, negative changes to social support and use of negative internal coping strategies. Positive coping strategies mediated the relationship between increased social and provider support and decreased D&As, while negative coping strategies mediated the relationship between negative changes to social support and increased D&As.CONCLUSION: Social and provider support can promote coping strategies and reduce emotional distress. Healthcare providers should screen perinatal women for D&A, discuss ways to improve their coping strategies and social support as a preventive measure, and offer initial emotional well-being support.

UR - http://www.scopus.com/inward/record.url?scp=85215998390&partnerID=8YFLogxK

U2 - 10.1016/j.midw.2025.104295

DO - 10.1016/j.midw.2025.104295

M3 - Article

C2 - 39874648

SN - 0266-6138

VL - 142

SP - 104295

JO - MIDWIFERY

JF - MIDWIFERY

M1 - 104295

ER -

Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety

Abstract

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