Current status of perinatal care and efforts to enhance online visitation amid the COVID-19 pandemic

Abstract

This article is my practice report. I have practiced as a clinical psychologist at various sites, including a counseling room at a private junior/senior high school as part of its school counseling program and at a psychiatric hospital established in the area since long. In 2011, I joined the department of pediatrics at a general hospital. As a clinical psychologist, I work in the pediatrics departmentʼs Neonatal Intensive Care Unit (NICU) that admits preterm low-birthweight infants requiring intensive care immediately after birth and other newborns in need of medical treatment. In a womanʼs life cycle, dynamic physical and mental changes occur over the period from pregnancy and delivery to childcare. While it is an opportunity for to develop and grow, this period also triggers a form of psychological crisis associated with those changes (Nagata, 2011; Okamoto, 1999). In medical terms, from the 22nd week of gestation to after delivery is called the perinatal period. However, psychologically speaking, this period begins when a woman becomes aware that she is pregnant, going through the fetusʼs development, and may include the entire transition period from fetus to baby (Hashimoto, 2011). During this period of major changes, a perinatal psychologist conducts clinical psychology activities to support the child and their family experiencing the childʼs sudden and unexpected admission to NICU, attending on the process through which the parent-child relationship is built. Clinical psychology activities should ideally be carried out in settings such as NICU and in communities comprising medical staff who offer NICU care, and after discharge, within families and local communities that look after the parent/child. In my view, these structures differ from those for individual psychotherapy provided by psychiatrists. The COVID-19 pandemic that began at the end of 2019 brought about dramatic changes at perinatal care sites and for families experiencing the birth and NICU admission of their child. Its impact continues to this day. The tidal wave of changes has naturally impacted the form of perinatal clinical psychology activities. In this paper, I will first describe these activities from the perspective of a psychologist specializing in this period and then discuss them from macro-counseling perspectives and investigate their characteristics. In the latter half of my paper, I will report on COVID-19ʼs impact on perinatal care, especially during the pandemicʼs initial stages, and describe some of the efforts made to enhance online visitation that was launched in 2020.