The impact of the coronavirus disease 2019 outbreak on decision-making styles and breastfeeding of pregnant women: a cross-sectional study

Karaahmet, Aysu Yıldız

doi:10.1590/1806-9282.20230216

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Original Article • Rev. Assoc. Med. Bras. 69 (8) • 2023 • https://doi.org/10.1590/1806-9282.20230216 copy

The impact of the coronavirus disease 2019 outbreak on decision-making styles and breastfeeding of pregnant women: a cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This study was planned to examine the factors affecting the decision-making styles of pregnant women in the coronavirus disease 2019 epidemic, their choice of birth environment, and their decision to start breastfeeding.

METHODS:

The study was conducted in a cross-sectional descriptive type. The study was conducted with 631 pregnant women who voluntarily participated between January 2020 and April 2021 and met the sample selection criteria. Women aged 18–45 years who had healthy singleton pregnancies were included. Pregnant women with signs or symptoms of coronavirus disease 2019 or suspected or diagnosed with birth were excluded from the study. The data were collected by the questionnaire method through the links shared with the pregnant women. Data Collection Form, Questionnaire for Birth and Breastfeeding in the coronavirus disease 2019 Period, and Melbourne Decision-Making Styles Scale-II were used as data collection tools.

RESULTS:

The mean age of the pregnant women was found to be 28.56±6.36 years. Approximately 50.71% of the participants reported that they preferred normal vaginal delivery. It was reported that 56.1% of the pregnant women had a say in the decision-making process of the delivery method. It has been determined that there is a significant difference between the education status, employment status, pregnancy planning, family type, and the person who has a say in deciding the mode of delivery (p<0.05). The results of the analysis of worrying about starting breastfeeding according to the decision-making styles of the pregnant women in the sample group are examined. The difference between the scores of avoidant and procrastinating decision-making style, which is the sub-dimensions of the scale, and worrying about starting breastfeeding is statistically significant (p<0.029 and p<0.029, respectively).

CONCLUSION:

The research findings show that situations such as epidemics affect the decisions of pregnant women, and breastfeeding situations and decision-making styles affect each other. For this reason, education programs and guides including guidance services and support systems should be published and pregnant women should be guided correctly.

KEYWORDS:
COVID-19; Pregnancy; Decision making; Breastfeeding

Parameters		Mean+SD
Age (years) X±SD (95%CI)		28.56±6.36 [27.03–28.92]
Time of marriage (years) C±SD (95%CI)		3.72±1.20 [3.01–4.48]
Number of pregnancies mean±SD (95%CI)		2.17±1.72 [2.29–2.48]
		n	%	MDMS-I–II Mean+SD	p-value
Education		27	4.2	4.27±1.22	0.000
	Primary school	128	20.2	5.01±1.30
	Secondary school	231	36.6	5.16±1.21
	High school	246	38.8	5.13±1.56
	University and above	27	4.2	4.27±1.22
Working status
	Yes	200	31.7	5.09±1.60	0.000
	No	431	68.3	4.98±1.23	0.000
Income status
	Miscarriage	323	51.2	5.08±1.12	0.000
	Middle	272	43.1	3.83±2.20
	High	76	5.7	3.83±2.51
Family type
	Nuclear family	535	84.8	5.09±1.60	0.000
	Extended family	96	15.2	4.98±1.23	0.000
Planning pregnancy
	Yes	379	60.1	4.48±2.12	0.008
	No	252	39.9	4.92±1.93	0.008
Post-COVID-19 mode of delivery preference
	Vaginal	320	50.7	4.74±2.16	0.276
	Cesarean	311	49.3	4.56±1.95	0.276
Who was influential in the choice of birth
	Doctor	354	56.1	2.65±2.01	0.569
	Midwife	71	11.3	5.24±2.03
	Myself	136	21.6	6.82±2.0
	My family and others	70	11.1	5.65±2.04

Parammeters		n	%	MDMS-I–II Mean±SD	p-value
Disrupting their control	Yes	460	72.90	6.80±.2.76	0.000
Disrupting their control	No	171	27.09	5.62±2.69	0.000
I didn’t go out unless I had to	Yes	589	93.34	5.87±1.85	0.347
I didn’t go out unless I had to	No	42	6.65	5.69±1.78	0.347
I consumed foods that would strengthen my immunity	Yes	515	81.61	5.89±2.79	0.573
I consumed foods that would strengthen my immunity	No	116	18.38	5.76±1.76	0.573
I wore a mask and took care of hand hygiene	Yes	575	91.12	5.79±2.73	0.002
I wore a mask and took care of hand hygiene	No	56	8.87	5.49±2.96	0.002
Have you considered ending your pregnancy due to COVID-19?	Yes	26	4.12	5.77±1.79	0.675
Have you considered ending your pregnancy due to COVID-19?	No	605	95.87	6.79±1.88	0.675
Is there a difference compared to your other pregnancies due to COVID-19?	Yes	459	72.74	5.80±2.76	0.000
	No	173	27.41	5.62±2.69	0.000

Variables		Self-esteem* X±SS	Careful Decision Making* X±SS	Avoidant Decision Making X±SS	Procrastinating Decision Making* X±SS	Panic Decision Making* X±SS	MDMS I-II Total avarage X±SS
Worrying about starting breastfeeding	Yes	5.98±2.56	9.86±1.56	5.64±1.57	4.48±2.48	4.69±1.54	6.56±2.11
Worrying about starting breastfeeding	No	6.68±2.12	8.87±2.34	4.32±2.42	3.51±1.32	3.50±2.32	6.79±2.24
p		0.121	0.174	0.029	0.003	0.119	0.028
Worrying about the choice of birth environment	Yes	6.41±2.42	10.86±1.34	5.04±1.37	4.20±1.48	5.10±1.47	6.96±2.31
Worrying about the choice of birth environment	No	8.58±2.33	9.87±2.38	4.06±1.42	4.11±1.52	3.50±2.11	6.77±2.65
p		0.032	0.089	0.039	0.002	0.443	0.000
Birth environment preference	Home	6.79±2.95	8.87±1.36	3.06±1.39	4.22±1.49	3.12±1.49	6.21±2.23
Birth environment preference	Hospital	6.68±2.56	9.78±1.31	5.90±2.39	6.03±1.54	5.90±2.41	5.98±2.45
p		0.032	0.061	0.004	0.007	0.001	0.002
Choice of obstetrician	Midwife	5.98±2.34	8.37±1.66	3.76±2.26	4.22±1.36	3.43±1.21	6.54±2.66
Choice of obstetrician	Doktor	6.17±2.76	10.48±1.43	4.94±2.21	3.43±1.34	4.67±2.65	6.68±2.43
p		0.056	0.170	0.114	0.231	0.570	0.176

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[1] *Corresponding author: aysuyildiz@halic.edu.tr