Partners' childbirth experiences during the COVID-19 pandemic - findings from the Swedish COPE prospective cohort study

BACKGROUND: The COVID-19 pandemic disrupted maternity care and limited partner involvement during childbirth. While partners play an important role during pregnancy and birth, their own experiences remain understudied. This study aimed to measure partners’ childbirth experience during the COVID-19 pandemic and examine associations with relevant variables. METHODS: This cross-sectional, prospective cohort study was part of the Swedish multicentre COVID-19 during Pregnancy and Early Childhood Study (COPE). Data were collected through electronic questionnaires and national health and quality registers. Childbirth experience was measured using the Fathers for the First Time Questionnaire (FTFQ), comprising of four dimensions: ‘Worry’ (concerns about safety and emotional reactions), ‘Information’ (perceived adequacy and relevance of information), ‘Acceptance’ (feeling welcomed and acknowledged by staff), and ‘Emotional support’ (experiences of guidance and reassurance during birth). Hierarchical multiple linear regression was used to examine associations with selected variables. RESULTS: A total of 365 partners (54.5% first-time parents) were recruited between June 2020 and December 2022. Mean (SD) FTFQ scores (range 0–4, lower scores indicate a more positive experience) were: ‘Worry’ 2.1 (0.7), ‘Information’ 1.7 (0.5), ‘Acceptance’ 1.3 (0.4), and ‘Emotional support’ 2.1 (0.7). Partners who did not experience the birth as expected, were exposed to a complicated birth, or reported symptoms of anxiety and/or depression during pregnancy had more negative childbirth experiences, particularly regarding ‘Worry’ and ‘Information’. CONCLUSIONS: During the COVID-19 pandemic, partners who reported unmet expectations of childbirth, exposure to birth complications, or antenatal symptoms of anxiety and/or depression appeared to be particularly vulnerable to more negative childbirth experiences, especially in the dimensions ‘Worry’ and ‘Information’. These findings underscore the importance of identifying psychological vulnerability and unmet informational needs among partners during pregnancy and birth, and of fostering communication strategies that promote inclusion and emotional safety in the childbirth setting. TRIAL REGISTRATION: NCT04433364 06/02/2020.