The goal of this thesis was to better understand the lived experiences of an ethnically and linguistically diverse sample of mothers who gave birth during the COVID-19 pandemic. Pregnant women experience higher risk for severe COVID-19 outcomes compared to non-pregnant women. Yet the impact on women’s psychosocial wellbeing may be just as problematic, given new mothers’ increased risk for depression postpartum coupled with the loss of multiple forms of support so critical during the postpartum period and new stressors created by the pandemic. A universal testing strategy at a Labor & Delivery Unit at a hospital in the Southwestern U.S early in the pandemic identified that Communities of Color – particularly resettled refugee women - experienced COVID-19 infection at higher rates compared to White women. Therefore, this study investigates stressors and coping strategies specific to the pregnancy, birth, and postpartum periods in a linguistically diverse sample of 140 women (Swahili n=18 , Kinyarwanda n=18 , Burmese n=13, Arabic=11, Spanish n=35, English n=45) who gave birth between May and December 2020. Across groups, the most severe health stressor was fear of self or infant contracting COVID-19, leading to strict adherence to prevention measures among women, and feelings of social isolation. This was followed by anxiety for lack of social support at birth, and, in some women, management of other health concerns related to increased risk for adverse pregnancy or severe COVID-19 outcomes. Coping strategies included looking to religion or spirituality for comfort, as well as spending more time with family. This analysis of how the pandemic affected women’s psychosocial wellbeing from pregnancy to postpartum informs adaptation of care for linguistically and ethnically minoritized groups and their infants.

The goal of this thesis was to better understand the lived experiences of an ethnically and linguistically diverse sample of mothers who gave birth during the COVID-19 pandemic. Pregnant women experience higher risk for severe COVID-19 outcomes compared to non-pregnant women. Yet the impact on women’s psychosocial wellbeing may be just as problematic, given new mothers’ increased risk for depression postpartum coupled with the loss of multiple forms of support so critical during the postpartum period and new stressors created by the pandemic. A universal testing strategy at a Labor & Delivery Unit at a hospital in the Southwestern U.S early in the pandemic identified that Communities of Color – particularly resettled refugee women - experienced COVID-19 infection at higher rates compared to White women. Therefore, this study investigates stressors and coping strategies specific to the pregnancy, birth, and postpartum periods in a linguistically diverse sample of 140 women (Swahili n=18 , Kinyarwanda n=18 , Burmese n=13, Arabic=11, Spanish n=35, English n=45) who gave birth between May and December 2020. Across groups, the most severe health stressor was fear of self or infant contracting COVID-19, leading to strict adherence to prevention measures among women, and feelings of social isolation. This was followed by anxiety for lack of social support at birth, and, in some women, management of other health concerns related to increased risk for adverse pregnancy or severe COVID-19 outcomes. Coping strategies included looking to religion or spirituality for comfort, as well as spending more time with family. This analysis of how the pandemic affected women’s psychosocial wellbeing from pregnancy to postpartum informs adaptation of care for linguistically and ethnically minoritized groups and their infants.

Refugee women face many challenges to obtaining maternal, reproductive, and sexual health post-resettlement including the language barrier, navigating the healthcare system, finding childcare to attend appointments, and cultural mismatches between their beliefs and practices around the prenatal, childbirth, and postpartum periods and that of the healthcare system in which they resettle into. This cultural barrier poses a challenge to healthcare providers as well as it necessitates that they respect their patients’ cultural beliefs while still providing them with the highest standard of care. Cultural competency training has been used to assist providers in understanding and responding to cultural differences, but gaps still exist when it comes to navigating specific scenarios. The objective of this research was to conduct a literature review of studies pertaining to refugee maternal, reproductive, and sexual healthcare post-resettlement to investigate the following questions: how tensions between biomedically accepted best practices and cultural norms present themselves in these healthcare fields, how healthcare providers take into consideration their patients’ cultural beliefs and norms when providing maternal, reproductive, and sexual healthcare to refugee women, and what can be done to continue to improve the provision of culturally appropriate care to refugee women. Findings from twenty different studies that focused primarily on eight cultural groups identified that Cesarean sections, inductions, and certain family planning methods are significant points of contention regarding cultural norms for refugee women and that they prefer certain foods, birthing positions, and other cultural practices during the delivery. Healthcare providers consider their refugee patients’ cultural beliefs by creating relationships with them built on trust, utilizing community liaisons, and through attempts to accommodate cultural practices when possible. Some potential improvements offered to improve cultural competency were improved cultural competency training that focused on how healthcare providers ask questions and interact with their patients, increased partnership with refugee communities, and an emphasis on patient education surrounding interventions and procedures related to maternal and reproductive health that could cause hesitations. The results of this literature review accentuated the importance of relationships within the field of refugee women’s healthcare, between both refugee patients and their providers and refugee communities and the healthcare systems. Providing refugee women access to more culturally competent healthcare can increase their trust in the healthcare systems of the countries they resettle in and healthcare utilization that can contribute to improved health outcomes for refugee women and their children.

During the COVID-19 pandemic, increased burdens have been placed on the Arizona healthcare system, and its healthcare providers. Using a survey with a sample of N=308 prescribing providers and nurses in the Arizona healthcare system, the impact of COVID-19 on the wellbeing of healthcare providers was assessed. The survey used measures to evaluate for physical and emotional wellbeing, burnout, stressors associated with COVID-19, and work-life experiences, and found an overall negative impact on the wellbeing of healthcare workers during the COVID-19 pandemic with increased levels of reported stress and tiredness, concern for the health of family and loved ones, concern for the hardships of patients, lack of alignment between organizational priorities and personal values, and low levels of support and appreciation from socially and from leadership at work.

This study attempts to answer the following questions: Is civic engagement a social activity among 18-25-year-old college students? How are opinions regarding civic and political engagement impacted by social settings? How are civic and political engagement atmospheres impacted by social distancing and isolation protocol? In this study, the researcher hypothesized that civic and political engagement are social activities, so they are therefore susceptible to changing social context. Since the COVID-19 pandemic disrupted typical social interaction through social distancing and isolation protocol, the researcher hypothesized that it also altered mechanisms of civic and political engagement. Political engagement would be more prevalent among students who participate with others even in pandemic conditions that may otherwise decrease close contact and social interactions. These findings seem to disagree with the literature that suggests young people are supplanting voting with other forms of engagement (Zukin et al., 2006). Rather, the “complexity” denoted in interviews and in reports of engagements on the pre- and post-election surveys suggests that young people are voting as well as dedicating their time to other activities. Voting does seem to be a social activity according to the interviews, poll observations, and the surveys. This is consistent with the literature regarding social norms and group predictors. However, this social aspect of engagement seems to manifest in a wider variety of formats that originally thought. Finally, students continued to engage in the context of the pandemic that surrounded the election in question. It seems that the formats through which students engaged have expanded to maintain the connections that are crucial to civic participation.