Bs Research

NUTRITIONAL & HEALTH PRACTICES ON PREGNANCY DURING COVID-19
PANDEMIC
A Research Presented
to the Faculty of School of Health and Allied Sciences
University of Saint Louis
Tuguegarao City, Philippines
In Partial Fulfillment
of the Requirements for the Degree
BACHELOR OF SCIENCE IN NURSING
Krizza Marie A. Antonio

Rhea Juren Mae B. Castillo
Jane Olive T. Simangan
Prince Harold T. Tulauan
June 2021
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| i

Acknowledgement
We would like to extend our special thanks to the study participants, University
Research Department Center, Department of Health and to our research instructor,
statistician and adviser.
Dedication
We, the researchers would like to dedicate this study to the pregnant women of
Tuguegarao City because they served as the inspiration and source of information of the
researchers.
To our families who continually provide us their moral, spiritual, emotional and
financial support. To our friends and classmates who inspired and encourage us
throughout the process along with our hardworking and respected teachers.
And most of all to our Almighty God who gave us guidance, strength and
knowledge to make this possible.
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| ii

ABSTRACT
The COVID-19 pandemic had significantly influenced the health and well-being of
populations especially the vulnerable groups including the pregnant women. Studies in the
early pandemic have shown that the pandemic adversely affected their prenatal practices.
However, there are limited studies investigated the long term effect of the pandemic to their
lifestyle behaviors. Therefore, this study aimed to investigate the changes and factors affecting
prenatal practices now that people are more resilient on the pandemic as compared on the early
pandemic.
The researchers utilized a researcher-made interview guide focused mainly on

nutritional and health practices during pregnancy, such as physical activity, sleep quality, and
access to prenatal care. A total of 21 pregnant women were included. As a result of the
thematic analysis of the interviews, 3 major themes were generated namely, physical health,
psychological health, and prenatal visits.
The results of the study show that prenatal practices of the majority of the respondents
were not directly affected by the pandemic but some of them became health conscious. They
had also experienced adverse changes on their access to prenatal care and nutrition. The
findings of this study can be used to construct behavioral and policy-level interventions to
enhance health outcomes for mothers and babies during the COVID-19 pandemic and future
pandemics by optimizing health habits among pregnant women.
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| iii

Table of Contents
Title Page
Title Page ------------------------------------- i
Acknowledgement ------------------------------------- ii
Dedication ------------------------------------- ii
Abstract ------------------------------------- iii
Table of Contents ------------------------------------- iv
List of Tables ------------------------------------- v
List of Figures ------------------------------------- vi
INTRODUCTION
Background of the Study ------------------------------------- 1
Research Questions ------------------------------------- 1
Significance of Study ------------------------------------- 2
Literature Review ------------------------------------- 2
Research Paradigm ------------------------------------- 7
METHODS
Research Design ------------------------------------- 8
Locale of the Study ------------------------------------- 8
Respondents of the Study ------------------------------------- 8
Instrumentation ------------------------------------- 10
Data Gathering Procedure ------------------------------------- 10
Data Analysis ------------------------------------- 11
Ethical Consideration ------------------------------------- 11
RESULTS ------------------------------------- 11
DISCUSSION ------------------------------------- 14
CONCLUSION ------------------------------------- 15
RECOMMENDATIONS ------------------------------------- 16
REFERENCES ------------------------------------- 16
APPENDICES ------------------------------------
A. Literature Matrix ------------------------------------ 21
B. Variable Matrix ------------------------------------ 42
C. Research Instrument/s ------------------------------------- 46
D. Schedule of Activities ------------------------------------- 50
E. Communication and Certifications ------------------------------------- 54
F. Author Contribution ------------------------------------- 58
G. Research Forms ------------------------------------- 60
H. Minutes of the Defense ------------------------------------- 69
I. Curriculum Vitae ------------------------------------- 71
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| v

List of Tables
Table
Table Title Page
No.
1 Table 1. Characteristics of study ---------------------------------- 9

participants
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| v

List of Figures
Figure
Figure Title Page
No.
--------------------------------------
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| vi

INTRODUCTION
With the emergence of the Covid-19 Pandemic, UNICEF (2020) indicated that
the effects of this pandemic have significant influence on the diets, and nutrition practices and
services for pregnant women. Many women throughout the world do not meet their
nutritional demands, which have negative effects to their own nutrition, health, and
immunity, as well as infants’ nutrition, growth, and development. In the context of COVID-
19 pandemic, women may face additional risks impacting diets, nutrition practices, and
access to maternal services (Akseer et al., 2020).
According to Zhang et al. (2020) one of the general medical problems during
pandemics is reproductive wellbeing. A few investigations showed that pregnant ladies are
not just prone to be at a higher danger of getting truly sick from Coronavirus but also, the
changes in their bodies may expand the danger of different sicknesses, like viral respiratory
contaminations as well as emotional eating. During the said pandemic it was revealed that
proportional number of pregnant women in China who are living in a severely affected areas
which make them strongly worried and who had lower physical activity levels had
experienced emotional eating. Moreover, the implementation of preventive measures to
control and mitigate the pandemic pose a threat to the access of antenatal services for
pregnant women (Iyengar et al., 2015; McQuilkin et al., 2017).
Additionally, University of the Philippines Population Institute (UPPI) and the

United Nations Population Fund (UNFPA) conducted a study on the impact of Filipino’s
reproductive health and rights revealed that maternal mortality cases in 2020 could rise by up
to 670 or 26 percent higher from the reported cases in 2019 due to pandemic. Moreover,
increased levels of perceived stress, including those associated with social distancing and
isolation during a pandemic, are linked to poor dietary habits, lack of physical activity and
reduced sleep duration (Elran-Barak & Mozeikov, 2020; Kim et al., 2007; Ng et al., 2003).
To better understand the impact of the pandemic on alterations in health-related behaviors
during pregnancy, more research is required (Whitaker, Hung, Alberg, Hair, Liu, 2020).
Therefore, the objective of this research study is to identify the long-term effects
of the pandemic to the nutrition and health practices of the pregnant women in Ugac Sur,
Tuguegarao City. The findings of this study will be used as a benchmark for future
comparative studies and to better understand the impact of COVID-19 pandemic on health-
related behaviors during pregnancy. Furthermore, increasing our understanding on the factors
that influence pregnant women’s health behaviors may allow us to better understand high-risk
groups for the management in current pandemic and for pandemics to come.
Research Questions
Generally, this study aims to explore how the COVID-19 pandemic affected the prenatal
health practices of pregnant women. Specifically, it aims to answer the following questions:
1. What is the profile of the respondents with regards to:

a. Personal Profile
b. Socio-demographic Profile
c. Obstetric Profile
Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 1

2. What changes have COVID-19 pandemic brought to prenatal health practices of
pregnant women along the following?
a. Nutrition and dietary practices
b. Physical Activity and sleep quality
c. Access to Prenatal Care
3. What factors contributed to the changes in prenatal health practices?
4. How should these changes be addressed to help promote health and wellness of
pregnant women during the pandemic?
Significance of the Study
The focus of this study is to determine the long-term effect of this pandemic to the
nutritional practices, primarily on the dietary practices and access on medications and
supplements as well as to the health practices which is focused on physical activity, sleep
quality and access to antenatal care. This will provide better understanding on the potential
impact of the said pandemic on health-related behaviors during pregnancy. Moreover, the
findings of this study may form a basis for health-related programs that will be implemented by
the university and will be helpful for the government and the healthcare system in order to
create a national and local policy intervention to enhance health behaviors and maternal care
services among health results for both the mother and the baby.
Additionally, future researchers could utilize this study for the direction of related
future studies about the long-term effect of certain pandemics on the health of the pregnant
women.
Literature Review
Underpinning Theory
This study is based on the “Health Belief Model” implemented during the early 1950’s.
It is one of the most widely used paradigms in health education and promotion to describe
improvement and maintenance of health-related behaviors and serves as a guide for health
behavior interventions. In relation to this study, the theory provides a framework on studying
pregnant women’s perceptions of nutrition and health practices particularly during the Covid-
19 pandemic as well as on how they perceive the pandemic susceptibility while pregnant. This
model elucidates possibilities to intervene and increase access to quality and respectful care
during a woman’s pregnancy and childbirth by revealing the intersectional effects of
childbearing norms, sociocultural beliefs and trust in the health system. Moreover, there is also
more to learn about their behavior in terms of the obstacles they face in completing
recommended health actions such as prenatal checkups and other heath related services
especially during this crisis (Diddana et al., 2018).
Covid-19 Pandemic indeed posed a detrimental impact to the society. It has undeniably
influenced our lives and is considered as a major public health problem. In response to the
growing number of infected cases and death toll, the government imposed several preventive
measures to control and mitigate its transmission.
Consequently, these preventive strategies and situation posed a threat to the health of
the pregnant women primarily to their nutrition and health practices such as physical activity,
sleep
quality and their access to antenatal care as well.
Rashidi, Fakari and Simbar (2020) pointed out that pregnant women may be more
susceptible to lifestyle changes during the pandemic because of many factors that perceive
stress. This has significant implications on the health of both the mother and the child.
The researchers reviewed valuable literatures related to the current study and organized
it thematically according to the various themes or concepts of the current study. We believed
that this facilitates better understanding for the readers. The researchers also made sure that the
literatures cited were all from reliable sources in the internet.
Effects of COVID-19 Pandemic on Nutrition and Dietary Practices
An adequate nutrition is critical for one’s health and well-being particularly during
pregnancy when women undergo major changes on their body such as biological, physical,
psychological and social modifications. Various researchers have documented certain changes
happened on the diet and nutrition on pregnant women during the pandemic.
Whitaker, Hung, Alberg, Hair, Liu (2020) stressed that 42 percent of the pregnant
women stated that their diets improved during pandemic while 41 percent stated no changes and
17 percent reported that their diet worsened. Pregnant women during the pandemic tend to be
more conscious on what they eat as compared to before the pandemic which contributed to the
improvement of their health primarily to their nutrition. Moreover, because of the spreading
virus, pregnant women started to eat healthily, such as vegetables and fruits in order to
strengthen their immune system.
On the contrary, there are several studies concluded that significant number of pregnant
women during the quarantine have had their diets worsened. According to Zhang et al. (2020),
they had greater tendency of emotional eating that’s why many of them had beyond the normal
body mass index during the lockdown. Sidor and Rzymski (2020) also found out that pregnant
women are more likely eating during quarantine and reported frequently snacking between
meals and there was an increase in the frequency and consumption of processed meals and
snacks, such as potato chips and sugary drinks (Pietrobelli et al. 2020). This is the reason why
many of them have higher body mass index compared to before the pandemic which then poses
a risk on their health as well as the health of the baby. Moreover, Cuervo et al. (2014) conducted
a cross- sectional study involving 13,845 women and discovered that their protein, dairy
products, vegetables, and cereal consumption were lower than recommended. The loss of
income, as well as the lockdown affected their nutrition. They also observed that half of the
respondents did not meet the recommended consumption of necessary nutrients from legumes,
cereals, milk, and dairy products. Thus, there is a tendency that pregnant women also modify the
type of diet they ate during confinement which makes them knowledge deficit on nutrition.
Akseer, Kandru, Keats and Bhutta (2020) further emphasized that persistent
disruptions to routine and requisite maternal care and nutrition could lead to adverse fetal
outcomes including preterm birth, low birth weight and small-for-gestational-age newborns.
Pregnant women did not meet the required nutrition because of the difficulty in maternal care
services such as availing of medication and supplements needed (Mascarenhas et al., 2020).
These studies were all conducted during the early implementation of lockdown in the
year 2020 and considering their opposing claims, we want to explore more on how did the
pandemic affect the nutrition of the pregnant women now that people are more resilient on the
pandemic as compared before, as well as the reasons, concerns or problems they encounter in
relation to their dietary practices and nutrition.
Effects of COVID-19 Pandemic on Physical Activity and Sleep Quality of Pregnant women
The researchers also looked into studies that showed the impact of the pandemic on
health practices of pregnant women specifically on their physical activity and sleep quality.
Biviá-Roig et al. (2020) stated on their study that regarding exercise, the results
showed a significant decrease in engagement in all three types of physical activity (vigorous,
moderate, and walking) by the participants during the lockdown as compared before the
COVID-19 pandemic. Majority of women participated on their study had a decreased level of
physical activity due to the confinement and few of the women stated that they had not changed
their physical activity. The study also showed that pregnant women doubled the number of
hours they spent sitting and doing nothing.
However, Whitaker et al. (2020) observed that physical activity patterns were
consistent before and during the COVID 19 pandemic. Approximately 25 percent of the
pregnant women reported that their physical activity has been improved while the rest of them
remained the same. However, they concluded that this is due to their pregnancy status and not
on the pandemic. Pregnant women in 2 nd or 3rd trimester tends to reduce their physical activity
compared to those in first trimester. This is similar to the study of Muhaidat et al. (2020)
wherein, half of their participants (56.04%) did not perform their physical activity during the
lockdown but they did not identify the reasons behind it. Therefore, this study aims to identify
if there are certain factors brought by this pandemic that can affect the physical activity of the
pregnant women in Tuguegarao City aside from the mentioned above.
Moreover, there are several studies conducted about the sleep quality of the pregnant
women during the pandemic. On the study conducted by Whitaker, et al. (2020) approximately
one-third of the participants has inadequate sleep due to pandemic-stress related stressors.
Many of the respondents worried a lot about the pandemic and the increase of anxiety
contributed to the reduction of sleep duration and quality. Similarly, with the study of Talbot,
Charron, Konkle (2020) also reported that significant number of pregnant women experienced
sleep difficulties due to anxiety brought by the pandemic. Lin et al. (2020) also reported that
cases of poor sleep quality and insomnia significantly increases during the pandemic compared
to before the pandemic. Gupta et al. (2020) studied on pregnant mothers’ current and previous
sleep schedules during the lockdown and revealed that the respondents manifest sleep
deprivation based on nighttime sleep.
Similarly, Mindell et al. (2015) also have the same findings and concluded that
inadequate sleep is a common concern among pregnancy with nearly 80% of the respondents
reported poor sleep across pregnancy trimesters compared to the study of Asghari et al. (2012);
Beaudreau et al. (2012); Ko et al. (2010) which revealed 35-52% percent among non-pregnant
women. Thus, it is concerning that the pandemic related stressor potentially contributes to the
additional adverse changes in sleep among the respondents. Zhang et al. (2021), found out that
that there is a significant association between unhealthy lifestyle and risk of miscarriage among
pregnant women during the covid-19 pandemic. The lack of physical activity, inadequate
nutrition, sleep deprivation and psychological problems (depression and anxiety) during the
pandemic are caused by the excessive use of social media. Thus, they concluded that pregnant
women with excessive media use and poor sleep quality were with a higher risk of miscarriage.
Indeed, sleep quality of the pregnant women have been altered on the beginning on this
pandemic where fear, stress and anxiety have significantly increase. Various researchers have
recommended that further studies should be conducted in order to better understand the impact
of this pandemic on their sleep. Hence, we, the researchers aim to identify the long-term effect
of this pandemic to their sleep quality. We want to determine if the sleep quality of the pregnant
women is still affected by this pandemic now that we have been exposed and used to it.
Effects of COVID-19 Pandemic on Prenatal Care
Before the emergence of this pandemic, there has been limited maternal care services
especially to low-income countries. There has been difficulty of accessing these services
because of unavailability, and financial constraints. Today that preventive measures were
imposed in order to control and mitigate the transmission of coronavirus and considering the
vulnerability of the pregnant women, these may exacerbate the limited access to antenatal care
and can adversely impact their health (Ombere et al., 2021). They further added that the
maternal and neonatal morbidity have significantly increased in Kenya during this pandemic
and this finding was supported by Hussein et al. (2020) and Takemoto et al. (2020). They also
found out that the fear of contracting the said virus is one of the reasons why many women
don’t want to attend maternal care services, similar to the findings of Kimani et al. (2020).
Additionally, they recommended that more research should be conducted to explore the
experiences of mothers during this pandemic.
Indeed, healthcare systems around the world are overwhelmed on this pandemic and
scarcity on resources were seen. Some health facilities were closed and antenatal care services
have declined (Iyengar et al., 2015; McQuilkin et al., 2017). In order to prevent the virus from
spreading, even people seeking health services have been restricted in certain nations. The
epidemic has halted the import and export of many basic goods, resulting in a shortage of
essential supplies and a significant impact on health care services, notably sexual and
reproductive health care (Kumar, 2020). According to the study of Peahl et al. (2020) the
average weekly prenatal visit of the pregnant women have significantly decreased by 16.1%
from 898 to 761 weekly visits while the prenatal visits conducted online increased from 10.8%
(97 of 898) to 43.3% (330 of 761) but they have not identified the reasons behind the decrease
of prenatal visits during this pandemic.
Similarly, Muhaidat et al. (2020) reported significant decline on the provision of

antenatal care and revealed that 59.53 percent of their participants were not receiving their
antenatal care during the lockdown and only 28.07% have communication to their health care
provider over the phone without antenatal visits.
However, Temesgen et al. (2020) conducted a study in West Shoa zone, Central
Ethiopia have identified that 109 out of 297 participants stated that their fear of acquiring the
Covid-19 disease kept them from receiving antenatal care.
These literatures were all conducted during the beginning of the lockdown and they all
recommended that more studies should be conducted on this matter especially on the later of the
pandemic in order to determine if there are changes on the utilization of maternal services or
none. Hence, we want to identify the long-term effect of the pandemic and the factors that still
affect their access of antenatal care now that restrictions to mitigate the virus were loosened.

Factors Affecting Nutritional Status and Practices During Pandemic
Literatures showed that participant characteristics primarily the socio- demographic

factors and obstetric data of the pregnant women have an effect on the nutrition and health
practices during the COVID-19 Pandemic.
Whitaker, Hung, Alberg, Hair, and Liu (2020) indicated that experiences of pregnancy
complications, loss of income and jobs due to COVID-19, and changes in social relationships
due to COVID-19 are the factors that consistently linked with adverse lifestyle changes (worse
diet, stopped being active, and reduced sleep) of the pregnant women. They also claimed that the
changes in nutrition and practices during pregnancy could be due to the pregnancy stage and not
the pandemic. Thus, women in 2 nd or 3rd trimester were more likely to have physical inactivity
due to the discomfort during the pregnancy.
Akseer, Kandru, Keats and Bhutta (2020) also noted that COVID-19 has pushed
millions of households into economic despair and has been compared as more lethal that the
global financial crisis of 2008. As a result, the health and risk of under nutrition in pregnant
women, mothers and their children may significantly worsen, particularly if existing conditions
persist for an extended period of time. According to Han et al. (2021), the pandemic has brought
about changes to ordinary life and undermined social and monetary capability all over the world.
In any case, little is known regarding the impact of online media use, unhealthy habits, and the
likelihood of miscarriage among pregnant women during the coronavirus pandemic. Moreover,
the study also revealed that during the early days of the pandemic, pregnant women spent about
two hours a day reading new about the said virus which resulted to no active work, limited diet
and poor sleep quality. They concluded that pregnant women with excessive media use and poor
sleep quality were linked to a greater risk of miscarriage.
Moreover, Lim, Long, Lim and Soon (2018) revealed that there was a significant
relationship between monthly household income and nutritional knowledge score among the
respondents. It was also highlighted in their study that pregnant women with greater
occupational status or monthly income have better nutritional knowledge. Employed mothers
may have greater access to information sources such as internet, books and magazines. Cost is
considered a barrier for antenatal mothers from lower socioeconomic status to attend antenatal
follow-up visits. Hence, this may contribute to low maternal nutrition awareness as their
opportunities to gain complete nutritional information are reduced.
They also concluded that as the gestational week progressed, so did nutritional
awareness. There was also no correlation between age and nutritional knowledge among the
respondents. The same with the findings of Yassa et al. (2020) women at near term have positive
attitude toward the covid-19 outbreak regarding their knowledge and practices in nutrition. They
concluded that a wide variety of vitamins, mineral and other dietary supplements are beneficial
for the near-term mother in the fight against the pandemic. This data may guide obstetricians and
midwife regarding the mother obstetrics data in providing care.
Dule et al. (2021) discovered that almost all of the young primiparous are more
susceptible to experience stress during this COVID-19 pandemic. The study also found that that
pregnant mother’s fear on covid-19 affects their quality of life (QOL) additions to the burden of
physiological changes during pregnancy. The researchers concluded that perceived social
support has positively associated with QOL among pregnant women which should be
encouraged to get better quality of life and satisfaction during this physiological change.

Elran-Barak and Mozeikov (2020) reported that preventive measures during the
pandemic particularly the social distancing and isolation caused high level of stress among the
pregnant women and resulted to poor nutrition, physical inactivity and sleep deprivation.
Furthermore, Mortazavi and Ghardash (2021) reported that the stress, fear, worry and anxiety,
feelings of depression, and loneliness were common among pregnant women during the
pandemic which increased the risk of having miscarriage and contributed to the poor health of
the mother. Likewise, Corbett, Milne and O’Connell (2020) stated that anxiety among pregnant
women have elevated due to the pandemic which may have negative effects on their physical
and mental health.
Moreover, the in terms of accessing the antenatal care during this pandemic, educational
status, distance from the facility, monthly income during the pandemic, fear of acquiring
COVID-19, permission from the spouse to visit the facility and practicing prevention measures
for COVID 19 have significantly influenced the utilization of antenatal care (Temesgen, et al.,
2020).
These related literatures showed that the impact brought by the pandemic, especially
during the lockdown to the nutrition and health practices during pregnancy is undeniable.
Significant changes on the diet, nutrition and poor health practices in association with the effect
of pandemic as well as the obstetric data and socio- demographic factors of the respondents were
revealed. All of these have adverse effects on the mother’s and the baby’s health. Without any
intervention, there is possibility that the morbidity and mortality of pregnant women will
increase in times of COVID-19 crisis.
However, there are lack of studies on the long-term effect of this pandemic to the
aspects of nutrition, physical activity, sleep quality and access on antenatal care services of our
pregnant women. They all conducted these studies on the beginning of the pandemic, thus, this
study aims to identify the long-term effect of the pandemic as well as the factors that affect the
mentioned aspects in order to easily determine intervention that should be done in order to
address it to the government.
Research Paradigm
Figure 1. The effect of the pandemic to prenatal practices of the pregnant women.
Covid-19 affected our daily lives in so many ways, including the health of our pregnant
women. Nutritional as well as health practices may be affected due to factors such as increased
level of perceived stress as well as the preventive measures implemented during this pandemic
which can have an adverse effect on the health of pregnant women and the fetus.

METHODS
Research Design
The researchers used a basic qualitative approach by Merriam and Tisdell (2016) to
gain a deeper understanding of the experiences of the pregnant women during the pandemic and
how it has affected their nutrition and health practices, including their access to prenatal care.
Locale of the Study
The study was conducted in Tuguegarao City, specifically from the barangay Ugac Sur
which is accessible for the researchers and also, according to POPCOM Pregnancy data of 2020,
this area is considered one of highest population of pregnant women.
Informants of the Study
The researchers utilized purposive sampling for data collection. Respondents were
chosen based on their likelihood of providing information about the changes in their nutrition,
health practices, and access to prenatal care during the pandemic and these are pregnant women
aged 18-40 years old, with contact information available, regardless of the gestational age,
ethnicity, socio-economic profile, and comorbidities they have. The sample size is 20-30 or until
data saturation was achieved.
The researcher seek appropriate permission from the Barangay Health Center to access
such data. The researchers collaborated with the barangay health center of Ugac Sur to identify
the list of possible respondents of the study and their contact number.
They contacted these respondents via text message to inform them about the research
and why they are being contacted. Those who responded to the messages or call of the
researchers and voluntarily agreed were included in the study. The researchers contacted the
respondents via phone to schedule an interview for data collection on a date and time that is
most convenient for them.
The researchers gave a letter of informed consent directly to the respondents who are
accessible for them, still, observing the Inter Agency Task Force protocols ( wearing of Face
mask with or without Face shield) albeit having completed the covid-19 Vaccine to inform them
about the research and seek their permission to participate in the study and the informed consent
was obtained from the participant after being permitted to do so.
The researchers continued to collect data from the respondents until they have gathered
enough information or find no new information or themes in the data.

Table 1. Characteristics of study participants
Variable Number (n=21) Percentage (%)
Age in years
18-24 11 52.4
25-34 9 42.8
35-44 1 4.8
Marital Status
Married 18 85.7
Not married 3 14.3
Ethnicity
Tagalog 4 19.0
Ilocano 8 38.1
Ibanag 3 14.3
Itawes 6 28.6
Educational Attainment
Less than Bachelor Degree 10 47.6
Bachelor Degree 11 52.4
Employment Status
Working 13 61.9
Not working 8 38.1
Income Classification
Poor 2 9.5
Low-income but not poor 5 23.8
Lower-Middle 6 28.6
Middle 0 0
Upper middle 0 0
Upper middle but not rich 0 0
Rich 0 0
N/A 8 38.1
Out of the 20-30 planned respondents, 21 pregnant women were interviewed. Most of the
respondents are young mothers aging from 18-24 years old (11, 52%) and all are Roman Catholic.
Most of the women were married (18, 85%), their ethnicities varies (Tagalog, Ilocano, Itawes,
Ibanag). As for the Education attainment, 11 pregnant women (52%) have finished their bachelor
degree, 13 of respondents (62%) have jobs, the respondents income ranges from lower-middle,
low income and poor, 11 women have not yet undergone delivery while 10 women have already
birthed, 9 mothers are in their last three (3 rd trimester) months of pregnancy, 8 are in the second
three months (2nd trimester) and lastly 4 are in the first three months (1 st trimester). Most of the
pregnant women have a normal weight (20, 95%). While most of them were not experiencing
pregnancy complication (14, 67%) there are also few whom have experienced pregnancy
complications (Hypertension, Anemia, and Depression).
Instrumentation

The researchers utilized a researcher-made interview guide. The questions were focused
mainly on nutritional and health practices during pregnancy, such as physical activity, sleep
quality, and access to prenatal care. The researcher designed a two-item open-ended questions to
generate a more profound and better understanding of how the pandemic has affected these
practices. The researchers also considered the additional responses of the respondents and asked
for follow-up questions to obtain further information.
The interview guide was submitted to our statistician for validation by expertly reviewing
the questions, evaluating whether it measures the research study’s characteristic or trait of
interest, and was approved.
Data Gathering Procedure
Before interviewing the eligible informants of the study, the researchers seek permission
from the School Dean and Vice President of Academics. After which, the researchers headed to
the Barangay Hall, indicating the purpose of the study to seek permission to conduct the research
and obtain personal information (age, address, contact information) about the clients of the
Barangay Health Center in Ugac Sur. Once approved, the researchers then collected the data from
the chosen respondents. The respondents were first informed on the purpose of the study and their
voluntary participation, which gives them the freedom to withdraw at any time. The researchers
maintained confidentiality and identification in any publication arising from the study. Lastly,
they obtained informed consent directly, via phone call or google form from those who agreed to
participate in the study.
Data collection was done through answering questionnaires and in-depth interview via
phone call. The interview was focused mainly on nutrition, health practices, access to prenatal
care, and the profile of the respondents during the pandemic. The interview took at least 15-20
minutes and was recorded.
Data Analysis
The researchers used Thematic Analysis to analyze the data collected. First, they
familiarized themselves with the acquired data and then transcribed the audio recordings and
reading notes taken from the respondents. They coded or highlighted any interview transcript that
appears relevant and intriguing to their research. Once they have pointed out the main points of
the codes, the researchers then generated themes by combining those with the same concept. They
made sure that the themes are relevant and accurate. After that, they named and described each
piece in a way that is easy to grasp and understand. Finally, the researchers write up the data
analysis in a proposal paper from the introduction to the conclusion of the findings.
Ethical Considerations
This research study was evaluated and approved by an accredited research board. The
researchers made sure to maintain the confidentiality of the research data, which was collected
anonymously from the respondents to protect their privacy by ensuring that digital and paper
document access is only authorized and granted to the researchers and the participant herself to
limit unnecessary exposure. To protect the participant’s data privacy the documents will be
stored in a locked cabinet that is only accessible to those who need to know and digital data will
have a strong security password that the researchers only know. When the data is no longer
necessary for University related purposes, all the digital data will be securely erased and the

paper documents will be shred and burned to avoid breaching of the participants confidentiality.
Eligible informants were given informed consent after informing them of the purpose of the
study, the voluntary nature of their participation, and that they can withdraw at any time. The
researchers ensured to follow the ethical guidelines of the University of Saint Louis strictly
which is patterned with the Philippine Health Research Ethics Board.
The researchers do not have any conflict of interest in this study, either financial,
proprietary, or professional. Also, there is minimal to no risk for the respondents in this study.
The research or data collection will not cause any physical harm to the respondents and the fetus.
However, they may feel uncomfortable answering some questions provided. Therefore, the
researchers made sure that any information shared by the respondents will be kept confidential
and that no individual will be identified in any publication arising from the study. Moreover, the
respondents were given mobile data/ prepaid load allowance amounting to 50 pesos each
depending on the budget for the project, and a box of facemask will be coordinated to the
barangay hall after the data collection process so that they can give it to the participants as a sign
of gratitude for participating in the study. Furthermore, the study results will be beneficial in
helping the researchers understand any issues or problems that the pandemic has caused in the
nutritional and health practices of pregnant women and in developing programs to help address
these issues or concerns.
RESULTS
Changes in Prenatal Health Practices during the Covid-19 Pandemic

The themes examined includes nutritional and dietary practices, physical Activity, sleep
quality and access to prenatal care
Nutritional and Dietary Practices

14 out of the 21 respondents answered that their nutritional practices did not change
during the pandemic and reported that their practices varies from having a Healthy
dietary lifestyle like eating on time, eating a combination of fruits, vegetables, meat,
fishes less intake in fatty foods and also taking multivitamins on a daily basis reasoned
out that because of the help of their parents during the pandemic and having source of
income.
“None, my eating practices during pregnancy in the times of the pandemic had not
changed because I have the support of my family and my partner’s parents that’s why
I can still eat healthy foods like lean meats, fruits and vegetables despite the fact that
my labor is nearing and still be reminded of to eat slowly and in time and that is why I
can still stay healthy” (R12). “My eating practices was not affected by the covid-19
pandemic because I have a source of income to buy the needs of my baby. My meal is
a combination of chicken meat, fish and also vegetables I consumed less unhealthy
fatty food and with the help of my physician I bought multivitamins to strengthen my
immune system and to protect the baby’s nutrition too.” (20). “My nutritional practices
was not affected by the pandemic, we have money to buy our food. I can be able to eat
a healthy meal that includes meat, fruits, vegetables and an extra vitamins so that I
and my baby will be healthy in this disastrous pandemic” (R8).

7 out of 21 pregnant mothers answered that they became more health conscious because
on the fear of having disease and to ensure the safety of their baby. They began to have a
balanced and healthy dietary lifestyle and began to consume more than what is
recommended during pregnancy.
“I eat a lot of healthy foods and eat it at the right time, I also drink the medicine and
vitamins my doctor prescribed to me to strengthen my immune system because of the
pandemic. I’m so afraid to get sick especially, there is a pandemic.'' (R6). “I eat a
balanced meal like meat, fish and some vegetables too, I consume more healthy food
because there is a baby in my womb. I want my baby to be healthy that’s why.” (R3).
Physical Activity
18 out of 21 respondents said that their physical activities were not affected by the
pandemic and still practiced walking outside/inside their homes, doing yoga, doing
chores that does not put too much strain on their body like sweeping and folding clothes.
“I did not experience any issues in my physical activities brought by the pandemic. I
walk around our neighborhood every morning wearing mask. Mask provides
protection so, I’m not afraid to walk around the neighborhood. Since this is my
second pregnancy and in order to deliver my child safely I really needed to do some
exercises like what I did with my previous child I believed that taking up a simple
walking exercises like walking up and down the stairs to strengthen my body in
preparation for my second child’s birth in the midst of the pandemic” (R7). “None,
there were no changes in my physical activities because of the pandemic. I can still do
my exercises inside the house. I watched in YouTube for references in yoga and other
exercises because it is very essential for pregnant mother like me to be physically
active despite the pandemic because I want to have my baby delivered safe and sound”
(R20). “I can say that my physical activities is not affected by the pandemic. I can
perform my exercises such as walking outside the house without being worried by the
pandemic. Sometimes, walking around the house. Though I can do a minimum of
chores I can still manage to be physically fit so the baby will come out healthy and
strong even during the pandemic.” (R8).
3 out of 21 pregnant mothers whose physical activities said had changed is not due to the
pandemic but it is the pregnancy discomfort that limited their physical activities.
“I cannot move that much because it’s really difficult to move while pregnant.” (R1).
“I only do simple exercise like walking and for example in the outside but if there a
lockdown I change my activities from walking to doing chores in the house like
sweeping and folding clothes” (R4). “Now that I’m in my third trimester, I don’t
exercise that much compared to when I was in my first pregnancy. I changed to avoid
f moving a lot because I get tired easily.”(R5)
Sleep Quality

19 out of 21 pregnant women answered that they did not have difficulty sleeping and
had enough sleep or are sleeping early during their pregnancy in the times of Covid-19.
“I did not experienced any changes in my sleep quality during the pandemic because
whenever I’m in my home I always felt relaxed, like just a simple nap in my bed will
turn to a full sleep for like the whole 8 hours during the night and I avoid getting
stressed.” (R16). “I was still able to sleep early and always feel energized in the next
day. It felt relaxing to know that I can be able to sleep without any problems during
pregnancy and I avoid stress. The pandemic did not affect my sleep. I’m used to it
already and I don’t think much about it anymore.” (R12). “I really avoid overthinking
and worrying on the things that are happening on our surroundings. My priority is
my baby right now so, as much as I can, I really sleep early.” (R13)
While the other respondents had difficulty sleeping is not due to the pandemic but other
factors like noisy surrounding and pregnancy discomfort.
For the past few days, I had trouble sleeping. My neighbors are too noisy at night and
I’m disturbed.” (R19) “I do have difficulty sleeping but not because I was anxious
about the things that are happening this pandemic. I think it’s because of my
pregnancy. I can feel the kicks of my baby especially in the middle of the night.”
(R15).
Access to prenatal care

18 out of the 21 pregnant respondents answered that they were still able to go their
scheduled prenatal checkup and have been given services by their physician like giving
them medication and giving advice to accommodate the pregnant mother’s
pregnancy .They prefer to walk because the health center is easily accessible due to its
location in the center of the barangay. There were no changes on the participant’s
prenatal care practices and they reasoned out that because of the need for prenatal visits
during pregnancy that they need the services of the nearby health center to guide them
despite the on-going pandemic.
“I did not experienced any changes nor challenges on my prenatal visits

since I only live nearby even in the midst of the pandemic there is a need for
accessing the prenatal services during pregnancy but I still bring my mask and face
shield because it’s a requirement of the health center to avoid infecting other
pregnant women and the health workers” (R20). “I observed that my access to
prenatal care is not affected by the pandemic because I can still go to the health
center without any problems. It is very essential for me, as a first time pregnant
mother, I need the doctors’ advices, their medication and certain services so that I
can deliver safely and my baby would be born healthy, since there are not so much
cases of covid in these area I will prioritize to go to my scheduled prenatal visit but
still maintain some distance” (R9).

Other pregnant mothers answered that their schedule for visitations for prenatal checkup
was interrupted by the sudden lockdown.
The only time I did not attend my prenatal checkup was when there was a lockdown
in our barangay” (R4). “Going to the clinic is really difficult especially if there’s a
lockdown. That's why sometimes, my scheduled prenatal visits were canceled but I
was able to reschedule it.” (R19)
One pregnant women answered that because of the expensive fare for transportation that
she opted not to go to the clinic;
“The fare for the transportation here is so expensive that I can't go to the clinic
sometimes and sometimes I think it should be better if I walk on my own” (R13)
DISCUSSION
In the sample of 21 pregnant women, we sought to better understand self-
reported changes in the prenatal practices of pregnant women during the COVID-19
pandemic. We identified 4 major themes namely, nutritional and dietary practices,
physical activity, sleep quality and access to prenatal care. This study showed that the
significant number of the pregnant women reported no changes on their prenatal
practices during the pandemic.
Some of them had experienced both positive and negative changes on their
prenatal practices during the pandemic. These should all be considered when designing
interventions to promote health and wellness of pregnant women during pandemic.
Nutritional and dietary practices during pregnancy play an important role to

determine the long-term health and nutritional status of both the mother and her growing
fetus (Nana & Zema, 2018). Significant number of the pregnant women did not
experience any changes or challenges in terms of their nutritional and dietary practices
during COVID-19 pandemic. This is mainly because of the support of their parents and
having a source of income to meet their nutritional needs. Therefore, the socioeconomic
status primarily the employment status and source of income is seen as one of the factors
can affect the nutrition and dietary practices of pregnant women. This is supported by
the study of Northstone, Emmett & Rogers (2021) who claimed that the nutritional
health of pregnant women is associated with their socio-demographic characteristics and
lifestyle factors. The household food security depends highly on the source of income
meaning, the more secured the source of income is, the greater the tendency of having
good nutrition throughout the pregnancy. One of the pregnant women reported that she
relied on canned goods because of no source income this pandemic, thus negatively
affected her nutrition. This findings suggest that providing support for the pregnant
women such as giving free vitamins, healthy foods as well as financial assistance are
important especially this trying times to promote health and wellness. Moreover, their
fear of having disease in times of pandemic positively affected their nutrition and had

motivated them to become health conscious and practice healthy eating as well as taking
supplemental vitamins for their baby’s health and growth.
Furthermore, this study shows that the pandemic did not negatively
affect the physical activity and sleep quality of the pregnant women. Physical
activity during pregnancy helps improve posture and lessen common discomforts such
as backaches and fatigue according to the study of Johnson (2020). It is noteworthy that
pregnant women did not experience changes brought by the pandemic on their physical
activity. Their resiliency on the pandemic positively affected their physical activity.
They can still perform their exercises such as walking, doing yoga and doing household
chores. Wearing facemask as their protection, they walk around and outside their houses,
without being worried about the pandemic and contracting covid-19 virus.
Similarly on their physical activity, their resiliency on the pandemic positively

affected their sleep quality. Pregnant women claimed that they avoid getting stressed by
not thinking and being worried about the pandemic to have a good and enough sleep. It
is evident on the previous studies that stress is linked to poor sleep quality. On the study
conducted by Whitaker, et al. (2020) and also by Talbot, Charron, Konkle (2020) during
the early pandemic, approximately one-third of the participants have inadequate sleep
due to pandemic-stress related stressors. Many of the respondents worried a lot about the
pandemic and the increase of anxiety contributed to the reduction of sleep duration and
quality. Therefore, it is important for the health care professionals to provide
psychological support for our pregnant women in future pandemics to be able to reduce
the risk of poor sleep quality that can have an adverse effect on the health of the mother
and the baby.
On their access to prenatal care, significant number of the pregnant women do

not have any issues or concerns about it and were able to attend to their scheduled
pregnancy follow-ups. This only indicates that they have no problem in terms of their
prenatal visits because they have a working barangay health center during the pandemic
that is accessible for them and located nearby their houses. We also observed that the
obstetric profile of the respondents is associated with their adherence to prenatal checkup.
The nulliparous (first pregnancy) women tend to adhere on the prenatal check up to seek
for professional help and advice. Therefore, this findings suggest that it is important to
strengthen the Barangay Health Centers for future pandemics to ensure easy access on the
health care needs of the pregnant women.
Three of the pregnant women also said that the lockdown and the expensive
fare of transportation negatively affected their prenatal visits but were able to reschedule
it. Compared to the studies conducted on the early pandemic, Muhaidat et al.(2020),
approximately 60 percent of their participants were not receiving their antenatal care
during the lockdown. This only suggest that pregnant women have adjusted on the effect
of the pandemic and are more resilient.
CONCLUSION
This study investigated the impact of the COVID-19 pandemic to pregnant women

and significant number of the respondents said that the COVID-19 pandemic did not directly
affected their pregnancy. Nutritional practices, physical activities, sleep quality, and access to
prenatal care were not found to be affected by the pandemic due to the reason that they had
already adjusted to the new normal and had gain support from their families especially
financially. The easy access on their working barangay health center during the pandemic had
helped them on their prenatal care. The findings of this study suggests on future pandemics the
importance of having an accessible and working barangay health station for our pregnant women,
as well as financial support to promote their health and well-being.
RECOMMENDATIONS
A research study on the specific effects of the COVID-19 pandemic to the pregnant women
should be conducted. Government may use this as their basis to identify and cater need of the
pregnant women such as giving of free medicines and vitamins, distribution of clinical equipment
to health centers, and providing of transportation specifically for pregnant women for easier
access of clinics during COVID-19 pandemic and any other future pandemics. This may use as a
basis for conducting counseling for pregnant women who developed or may develop fear and
stress during the pandemic.
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APPENDIX A LITERATURE MATRIX
BIBIOGRLAPHY OBJECTIVES DELINEATING METHOD MAJOR FINDINGS

FACTORS/ VARIABLES/
THEMES
Ahlers-Schmidt, To better Mental Status, behavior Electronic During the COVID-19 pandemic, this
C., Hervey, A., understand changes, knowledge, Survey research offers preliminary insight into
Neil, T., knowledge, attitudes and practices, pregnant and postpartum women's
Kuhlmann S., attitudes and pregnant women, mothers awareness, behaviors, and practices.
Kuhlmann, Z. practices of of infants, postpartum It is restricted because participants are
(2020). Concerns pregnant women, employment and from a single Midwest group, and
of women women and financial statues, alcohol responses may have been influenced by
regarding mothers of consumption, health care social desirability response bias.
pregnancy and infants around access, Covid-19 The findings, on the other hand, could
childbirth during coronavirus pandemic help to shape potential approaches to
COVID-19 disease 2019 help pregnant women and mothers of
pandemic. (COVID-19) infants during pandemics. pandemics.
Patient Education
and Counseling:
Volume 103,
Issue 12, 2578-
2582.
https://www.scien
cedirect.com/scie
nce/article/abs/pii
/S073839912030
5292
Nutri
tiona
l and
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FACTORS/ VARIABLES/
THEMES
BIBIOGRLAPHY
Akseer, OBJECTIVES
N., Highlights key Covid-19, DELINEATING stunting, METHOD
Cross- They suggested MAJORthat FINDINGS
protecting the
BIBIOGRLAPHY OBJECTIVES FACTORS/ DELINEATING
VARIABLES/ METHOD MAJOR FINDINGS
Kandru, G., areas of nutrition, interventions, sectional health and nutrition of vulnerable
FACTORS/
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Keats, E. C., & concern for children, women study women and children is a key policy
Anikwe, Z.C. A. C., maternal THEMES
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Corbett, G.A., et To assess Health Anxiety, Pregnancy, Online, The pandemic of COVID-19 caused a
al. (2020). Health how maternal Pregnant Women, Cross- rise in anxiety among pregnant women.
anxiety and anxiety and Behavioural Changes, sectional A large number of respondents had
behavioural behavior of COVID-19 pandemic, survey severe health anxiety, which has been
changes of the pregnant Mental Health shown to have an indirect negative
pregnant women women were impact on their physical and mental
during the affected by health.
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Cuervo, M., Evaluate Diet, Health, Lifestyles, Cross- In terms of eating habits, the majority of
Sayon-Orea, C., dietary Score, Preconception, sectional the food groups examined were not
Santiago, S., & patterns and Pregnancy, Lactation study eaten in accordance with the Spanish
Martínez, J. A. lifestyles dietary guidelines.
(2014). Dietary according the Women pursuing pregnancy, on the
and health perinatal other hand, had generally poorer health
profiles of physiological habits.
Spanish women status in a This data may be used to develop
in preconception, large sample educational strategies for each
pregnancy and of Spanish demographic group, as well as
lactation. women. nutritional education and interventions
Nutrients, 6(10), during prenatal visits.
4434-4451.
https://www.mdpi.
com/2072-
6643/6/10/4434
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Mizrak Sahin, B., Concerns, Covid 19 pandemic, the As a Three primary themes and 11 sub-
& Kabakci, E. N. challenges, experiences of pregnant qualitative themes emerged from the content
(2021). The and attitudes women, Pregnant women, study analysis of the interviews. Lack of
experiences of of pregnant prenatal care method, awareness of the gravity of the situation
pregnant women women content and dread of the unknown, Interruption
during the regarding analysis is of prenatal care due to pandemic, and
COVID-19 illnesses in performed (3) disturbance of routines and social
pandemic in the pandemic . Because life.
Turkey: A phase will be of the
qualitative determined in coronaviru
study. Women this study s
and birth: journal through pandemic'
of the Australian extensive s social
College of talks based isolation
Midwives, 34(2), on their regulation
162–169. individual s,
https://doi.org/10. experiences, interviews
1016/j.wombi.202 as well as with
0.09.022 increased pregnant
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of what were
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encounter in conducted
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women
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study.
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Mortazavi, F., To gain a Stress, Pregnancy, Descriptiv During the COVID-19 outbreak,
Ghardashi, F. better of Pregnant Women, COVID- e pregnant women were under a lot of
(2021). The lived pregnant 19 pandemic, Lived phenomen stress, according to the report. In such
experiences of women’s experiences ological circumstances, a large mobilization of
pregnant women experiences approach the healthcare system is needed to
during COVID-19 during the relieve the difficulties that pregnant
pandemic: a COVID-19 women face.
descriptive pandemic.
phenomenologica
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Muhaidat N, The Purpose Pregnancy, COVID-19 A cross- Although many of these women had
Fram K, of this study is Outbreak, Lockdown, sectional significant underlying health issues or
Thekrallah F, to assess the Pregnant Women, Middle- survey of serious pregnancy complications that
Qatawneh A, Al- impact of Income Country, Antenatal Jordan required close antenatal surveillance,
Btoush A. Jordan’s Healthcare women the percentage of pregnant women not
Pregnancy lockdown on who are receiving antenatal care increased
During COVID-19 antenatal care currently significantly from 4% to 59.53 percent (p
Outbreak: The services and pregnant 0.001) during the lockdown period. The
Impact of pregnant was study also revealed that the lockdown
Lockdown in a women’s conducted had an influence on the participants'
Middle-Income health during for this physical, social, and emotional well-
Country on this time. study. being.
Antenatal Jordanian
Healthcare and pregnant
Wellbeing. Int J mothers
Womens Health. were
2020; 12:1065- given an
1073 internet
https://doi.org/10. survey to
2147/IJWH.S280 complete.
342 The
results of
944
completed
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BIBIOGRLAPHY OBJECTIVESFACTORS/ DELINEATING
VARIABLES/
THEMES METHOD MAJOR FINDINGS
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the a childofTHEMES
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facility-M.D-Risti
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major impact in outpatient
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bett
in
BIBIOGRLAPHY
Temesgen K, V., ThisOBJECTIVES
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during & the
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Risti Women,
women, Ethiopa,
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of
understanding
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TheDuringdata will this study
antenatal
of
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Whitaker,
Wakgari K.,
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THEMES Behaviors,
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communit cross found be the
to early COVID-19
uncommon in has pandemic,
this study.
The Konkle,
Utilization
Woerkum,
Effectiveness
COVID-19: of
C.
a a
impact
and
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evidence of
andglobal
the
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awareness,
application Isolation,
healthwithsectional
a face-to-
pre- skills COVID-19
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improvein The
treatment pandemic
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Yassa, M.,Women
Birol, use The THEMES
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Debelo
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protocol
P.,
BT, Alberg,
Tafa
Feeling
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M.D-Risti
for sample main
changes
COVID-19
askills pregnancy
women’s
of in
of
and in
Attitude,
knowledge,
ofPandemic,
Depression,
behaviors,
concerns, and
attitudes,
Pregnnact, Sleep Astudy
post
cross-
sectional
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twitter
faceonly
Non-infected
wasrisk. large
Moreover,
women
During
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maternal
COVID-19,
theeatingandof after
Life
women
pregnant
education
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womea
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Zhang
P.,
A., Hair,
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theAlemu J.,
Yirmibes,N.,Zhang
C.,
Liu,
G, of This
objective
lifestyle
maternal studyof COVID-19
knowledge,
practices (sleep pandemic,
patterns, online
sectional
internet- Emotional
viable
reported pregnancy
negative were was
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to
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ApplicationVoid:asLack
awareness
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Y., Huo, S.,before
an Ma,
tweets care
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information,
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placed indeedof
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encouragin
event
the
wome
Usta,
J.
Wondimu C., Haydar,
(2020).
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etfor
al. in this study
behaviors
health is toin Non-infected
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activity), survey
based positive
During attitude
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for antenatal
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of antenatal those
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Nutri
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h
APPENDIX B VARIABLE MATRIX
Nutri
tiona
l and
Healt
h
Nutritional Dependent This refers to the practices Nutritional practices will be assessed
practices made by the respondent thru an online structured questionnaire
during pregnancy that is that will be conducted.
necessary for growth and
development.
It is primarily focused on the
dietary practices and their
access on medications and
supplements during the
pandemic that are necessary
for their health.
Obstetric Independent This pertains to the obstetric Parity and Pre-pregnancy

Data information related to complications will be determined by an
pregnancy including parity, online interview.
gestational age, pregnancy
trimester, pre-pregnancy Gestational age is measured in weeks
BMI Category and any from the first day of the woman's last
pregnancy complications. menstrual cycle to the current date.
. Trimester will be determined by

calculating gestational age using
woman's estimated due date. Pre-
pregnancy BMI will be calculated using
self-reported Pre-pregnancy height
and weight and will be categorized as
underweight, normal weight,
overweight and obese.
Nutri
tiona
l and
Healt
h
Socio- Independent This pertains to Age, Marital Socio-demographic data is measured
Demographic Status, Educational thru online interview.
Factors attainment, annual
household income,
employment status, religion,
and ethnicity of the
respondents
Nutri
tiona
l and
Healt
h
Nutri
tiona
l and
Healt
h
APPENDIX C
RESEARCH INSTRUMENTS
GENERAL DIRECTIONS:
This study aims to identify the changes on the nutrition and health practices of the
pregnant women in Ugac Sur, Tuguegarao City. The following statements will
determine if there is/are long term effect/s of this pandemic on their nutritional and
health practices. For the items that require specific answers, please answer specifically.
Your participation is entirely voluntary. If there are items you do not feel comfortable
answering, please skip them. Thank you for your cooperation.
PROFILE OF THE PARTICIPANT
I. PERSONAL PROFILE
Name(optional):_________________________________________________________
Age: _________________ Address:__________________________________________
Religion: ___________________ Ethnicity: ___________________________________
Marital Status: Single _____ Married _______ Widowed ________
II. SOCIO-DEMOGRAPHIC PROFILE (put check(/) mark)
Educational Attainment:
Less than Bachelor Degree Bachelor or Graduate degree

Occupation:
Full-time employed Part-time employed Out of

work/homemaker
Monthly Estimated Income:
III. OBSTETRIC PROFILE

Parity: (the number of times that she has given birth to a fetus with a gestational age of
24 weeks or more, regardless of whether the child was born alive or was stillborn).
Nulliparous Multiparous
Gestational Age: (how many weeks you had been
pregnant)
Pregnancy Trimester: 1ST Trimeter ___2ND Trimester_____3rd Trimester_____

Pre-pregnancy BMI Category:
Underweight ____ Normal __ Overweight Obese
Pregnancy Complications:
High Blood Pressure HELLP
Gestational Diabetes Anemia
Placenta Previa Depression/Anxiety
Other Diagnoses (Please Specify)
Nutritional and Health Practices on Pregnancy during Covid-19 Pandemic | 46

INTERVIEW QUESTION
1. Were you able to observe any changes in your prenatal health-related

activities because of the pandemic in terms of:
i. Nutrition and dietary practices
ii. Physical activity and sleep quality
iii. Access to Prenatal Care
a. If yes, what are these changes in nutrition and dietary practices,

physical activity and sleep quality and access to prenatal care?
(Follow up questions on the specific activities mentioned)
i. What do you think caused or contributed to these

changes in your prenatal health practices?
b. If no, why do you think that there are no changes in your prenatal
health practices?
2. What do you think should be done by your barangay or the city in order
to help you with your prenatal health related activities during this
pandemic?
PANGKALAHATANG DIREKSYON:
Nilalayon ng pag-aaral na ito na matukoy ang pagbabago sa nutrisyon at mga
kasanayan sa kalusugan ng mga buntis ngayong pandemya sa barangay Ugac
Sur, lungsod ng Tuguegarao. Ang mga sumusunod na katanungan ay
naglalayong matukoy kung mayroong pangmatagalang epekto ang pandemikong
ito sa kanilang mga gawi sa nutrisyon at kasanayang pangkalusugan.
Ang iyong partisipasyon ay buong kusang loob. Kung may katanungan na hindi
ka komportableng na sagutin, mangyari lamang na laktawan ito. Salamat sa
iyong pakikiisa.
PROFILE NG PARTICIPANT
I. PERSONAL NA PROFILE
Pangalan(opsyonal): ____________________________________________________
Address: ___________________________ Edad: ________________________
Relihiyon: ___________________________ Etnisidad: ____________________
Katayuan sa pag-aasawa: Walang-asawa Kasal Biyuda

II. SOSYO-DEMOGRAPIKONG PROFILE
Nakamit sa Edukasyon:
_____Hindi nakapagtapos _____Nagtapos sa kolehiyo
Trabaho:____________________________
Katayuan sa trabaho:
____Full-time sa trabaho _____Part-time sa trabaho ____Walang trabaho o sa
bahay
lang
Buwanang Sahod: __________________________________
III. PROFILE SA PAGBUBUNTIS

Parity: (Bilang ng beses na nabuntis na umabot sa labindalawang lingo o higit pa, hindi
alintana kung ang bata ay ipinanganak na buhay o hindi.)
_______Hindi pa nakapanganak _____ Nakapanganak na
Edad ng pinagbubuntis: _____________________
Trimester ng pagbubuntis: Unang Trimester
Pangalawang Trimester
Pangatlong Trimester
Kategorya ng Index ng mass ng katawan bago magbuntis:

Underweight ______ Normal ______ Overweight ______ Obese ______
Komplikasyon sa pagbubuntis:
_____ Mataas na presyon ng dugo _____ Depresyon
_____ Gestational Diabetes ______ Anemya
_____________________ Ibang komplikasyon
MGA KATANUNGAN SA INTERBYU
1. Ano-ano ang mga prenatal na kasanayan sa kalusugan ang iyong nagawa sa
panahon ng pandemya?

2. May napansin ka bang pagbabago sa mga aktibidad na nauugnay sa kalusugang
prenatal dahil sa pandemya lalong lalo na sa:
i. Nutrition at kasanayan sa pagdidiyeta
ii. Pisikal na aktibidad at kalidad ng pagtulog
iii. Pag-access sa pangangalagang prenatal
a. Kung oo, ano ang mga pagbabagong ito?
i. Ano sa palagay mo ang sanhi sa mga pagbabagong ito sa iyong

prenatal na kasanayan sa kalusugan?
b. Kung hindi, bakit sa palagay mo walang mga pagbabago sa iyong mga

prenatal na kasanayan?
3. Ano sa palagay mo ang dapat gawin ng iyong barangay o lungsod upang

matulungan ka sa iyong mga aktibidad na nauugnay sa pangangalaga sa kalusugan
sa panahon ng pandemya?
APPENDIX D
SCHEDULE OF ACTIVITIES

APPENDIX E
COMMUNICATIONS AND CERTIFICATIONS

APPENDIX F
AUTHOR CONTRIBUTION
Please tick (/) the corresponding contribution as it applies to the members of the
research team including the research adviser.
Type of Authors
Contributio Description of Contribution 1 2 3 4 5 6
n
Conception Constructing an idea or hypothesis / / / /
for research and/or manuscript
Literature Searched, reviewed, and / / / /
search synthesized relevant literature.
Design Planning methodology to reach the / / / /
conclusion
Materials Prepared and/or acquired needed / / / /
acquisition materials, tools, or instruments for
data collection
Data Executing experiments/
acquisition administering research tools.
Data Ensuring completeness and
processing correctness of collected data before
analysis.
Data Applying statistical or qualitative
analysis analysis techniques to interpret and
present research results
Manuscript Constructing the whole body of the / / / /
preparation manuscript
Manuscript Ensuring the manuscript adheres to / / / /
editing specific university guidelines like the
use of APA, adhering to plagiarism
score limit, etc.
Manuscript Reviewing the content of the / / / /
review manuscript before defense or
submission
Supervision Organizing and supervising the / / / / /
course of the project or the article
and taking the responsibility
Funding Providing essential resources for the / / / /
completion of the research
Others,
please
specify and
provide brief
description

Certification of Author Contribution
This is to certify that the information stated above is correct and accurate and
that all members of the research team are in consensus of the identified
contributions of each member.
Name of Author Signature Date

June 1, 2020
1. Krizza Marie A. Antonio
June 1, 2020
2. Rhea Juren B. Castillo
June 1, 2020
3. Jane Olive T. Simangan
June 1, 2020
4. Prince Harold T. Tulauan
5.

APPENDIX G
RESEARCH FORMS

How could COVID-19 contribute to the burnout of health care workers | 66
APPENDIX H
MINUTES OF THE DEFENSE
Curriculum Vitae
I. PERSONAL INFORMATION
Name : Krizza Marie A. Antonio
Date of Birth : May 8, 2000
Place of Birth : Tuguegarao City
Marital Status : Single
Religion : Catholic
II. CONTACT INFORMATION

Home Address : Imurung, Baggao, Cagayan
Mobile Number : 09561506432
E-mail Address : krizzaantonio05@gmail.com
Social Media : Krizza Marie Abad Antonio
Account
III. EDUCATION AND EXPERTISE

Primary : Imurung Elementary School
Secondary : University of Saint Louis, Tuguegarao
Tertiary : University of Saint Louis, Tuguegarao
Specialization/ : Bachelor of Science in Nursing
Expertise
IV. PERSONAL INFORMATION

Name : Rhea Juren B. Castillo
Date of Birth : May 10, 2000
Place of Birth : Flora, Apayao
Religion : Roman Catholic
V. CONTACT INFORMATION
Home Address : 0520 Adelfa St. Pob. East Flora, Apayao
E-mail Address : jurs.cast10@gmail.com
Social Media : FB- Juren Castillo
Account
VI. EDUCATION AND EXPERTISE

Primary : Flora Central School, Flora Apayao
Secondary : Flora National High School, Flora Apayao
Tertiary : University of Saint Louis, Tuguegarao City
Expertise
VII.PERSONAL INFORMATION
Name : Olive T. Simangan
Date of Birth : July 30,1999
Place of Birth : Unag, Amulung, Cagayan
VIII. CONTACT INFORMATION
Home Address : Unag-buculan, Aamulung, Cagayn
E-mail Address : Olivesimangan7@gmail.com
Social Media : FB- Olive Simangan
Account
IX. EDUCATION AND EXPERTISE

Primary : Unag-Buculan Elementary School
Expertise
X. PERSONAL INFORMATION
Name : Prince Harold T. Tulauan
Date of Birth : June 21, 1999
Place of Birth : Clinica De Leon, Tuguegarao City
XI. CONTACT INFORMATION

Home Address : Caggay, Tugegarao City, Cagayan
E-mail Address : princetulauan9@gmail.com
Social Media : FB- Prince Tulauan
Account
XII.EDUCATION AND EXPERTISE

Primary : United Methodist Christian School
Expertise

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NUTRITIONAL & HEALTH PRACTICES ON PREGNANCY DURING COVID-19

Krizza Marie A. Antonio

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| i

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| ii

The researchers utilized a researcher-made interview guide focused mainly on

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| iii

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| v

1 Table 1. Characteristics of study ---------------------------------- 9

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| v

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| vi

Additionally, University of the Philippines Population Institute (UPPI) and the

1. What is the profile of the respondents with regards to:

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 1

Significance of the Study

Effects of COVID-19 Pandemic on Prenatal Care

Similarly, Muhaidat et al. (2020) reported significant decline on the provision of

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 6

Literatures showed that participant characteristics primarily the socio- demographic

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 7

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 8

Locale of the Study

Informants of the Study

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 9

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 10

Data Gathering Procedure

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 11

Changes in Prenatal Health Practices during the Covid-19 Pandemic

Nutritional and Dietary Practices

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 12

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 13

Access to prenatal care

“I did not experienced any changes nor challenges on my prenatal visits

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 14

Nutritional and dietary practices during pregnancy play an important role to

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 15

Similarly on their physical activity, their resiliency on the pandemic positively

On their access to prenatal care, significant number of the pregnant women do

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 16

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 17

Experience from a tertiary center. International Journal of Gynecology &

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 18

Muhaidat N, Fram K, Thekrallah F, Qatawneh A, Al-Btoush A. Pregnancy During COVID-19

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 19

Nutritional and Health Practices on pregnancy during COVID-19 pandemic| 21

BIBIOGRLAPHY OBJECTIVES DELINEATING METHOD MAJOR FINDINGS

Obstetric Independent This pertains to the obstetric Parity and Pre-pregnancy

. Trimester will be determined by

PROFILE OF THE PARTICIPANT

Less than Bachelor Degree Bachelor or Graduate degree

Full-time employed Part-time employed Out of

III. OBSTETRIC PROFILE

Pregnancy Trimester: 1ST Trimeter ___2ND Trimester_____3rd Trimester_____

Other Diagnoses (Please Specify)

Nutritional and Health Practices on Pregnancy during Covid-19 Pandemic | 46

1. Were you able to observe any changes in your prenatal health-related

a. If yes, what are these changes in nutrition and dietary practices,

i. What do you think caused or contributed to these

Katayuan sa pag-aasawa: Walang-asawa Kasal Biyuda

III. PROFILE SA PAGBUBUNTIS

Pregnancy Trimester: 1ST Trimeter _2ND Trimester_3rd Trimester___