Summary: The COVID-19 pandemic has significantly increased stress among pregnant and postpartum women in the United States. Researchers warn that heightened prenatal stress may interfere with fetal brain development and worsen existing maternal health disparities.
Source: Washington State University
COVID-19 has introduced new and serious challenges for pregnant people in the United States, a population that already faced one of the highest maternal mortality rates among developed countries prior to the pandemic.
A Washington State University study published in BMC Pregnancy and Childbirth found that many pregnant women fear their baby contracting the virus. Some reported anxiety about going to the hospital to give birth, worrying that hospital exposure could lead to infection and force separation from their newborn.
“Pregnant women are very worried about contracting COVID-19,” said lead author Celestina Barbosa-Leiker, vice chancellor for research at WSU Health Sciences Spokane. “They have many questions for their health care providers. There is still a lot we don’t fully know, and that uncertainty is especially stressful for expectant mothers.”
The study also documented pandemic-related increases in financial strain, difficulty obtaining healthy food, and missed prenatal appointments. These burdens were particularly pronounced among women of color and lower-income participants, highlighting a widening of preexisting health disparities.
“We know prenatal stress affects fetal development, so these findings are concerning,” Barbosa-Leiker added.
The WSU team analyzed survey responses collected between April 28 and June 30, 2020, from 162 perinatal women (125 pregnant and 37 postpartum). The study used quantitative surveys across the full sample and gathered more detailed qualitative responses from a subset of participants.
Among respondents, 52% of pregnant women and 49% of postpartum women worried about their baby contracting COVID-19. Nearly half (46%) sought extra information about hospital COVID-19 protocols related to their planned or actual delivery.
Qualitative responses revealed deep fears and practical concerns. Some participants reported being afraid of contracting COVID-19 and dying; others feared infection during delivery or that hospital policies would require they be separated from their newborn or that partners would be excluded from the birthing room.
Barbosa-Leiker noted that hospital policies varied widely early in the pandemic, although current recommendations emphasize keeping mothers and newborns together when possible.
During the survey period, 27% of pregnant respondents said they were unable to obtain healthy food, and 25% missed prenatal appointments. Financial hardship was common: 19% reported reduced income, 9% had been laid off, and another 10% said someone in their household had lost a job.
The study found pregnant respondents engaged less frequently in healthy stress-coping behaviors—such as regular exercise, taking breaks from news, and scheduling relaxation—than postpartum women who had already delivered.
Even before COVID-19, U.S. pregnant women faced more social and environmental stressors than many peers in other industrialized nations. Reports from multiple maternal mortality review committees indicate a higher maternal mortality rate in the U.S., and social determinants of health contribute to the risk of maternal death within the first year after pregnancy. Previous international comparisons also showed higher anxiety, depression, and psychological stress among U.S. pregnant women than in several other countries.
The WSU findings underline the urgent need for expanded resources and support for pregnant people, particularly during the pandemic, Barbosa-Leiker said.
“Health care providers should routinely discuss all sources of stress with expectant mothers, because mental health and emotional well-being are crucial during pregnancy,” she said. “Providers can keep referral information handy—for example, wraparound services for families facing job loss—and quickly connect patients to those supports.”
Support from family and friends also matters, even when delivered at a physical distance. Many participants reported guilt about keeping relatives, especially grandparents, away from a newborn. Barbosa-Leiker encouraged others to respect parents’ decisions about visitors and to offer support consistent with protecting the health of the mother and infant.
About this prenatal stress research news
Source: Washington State University
Contact: Celestina Barbosa-Leiker – Washington State University
Image: The image is in the public domain
Original Research: Open access. “Stressors, coping, and resources needed during the COVID-19 pandemic in a sample of perinatal women” by Celestina Barbosa-Leiker, Crystal Lederhos Smith, Erica J. Crespi, Olivia Brooks, Ekaterina Burduli, Samantha Ranjo, Cara L. Carty, Luciana E. Hebert, Sara F. Waters & Maria A. Gartstein. BMJ Pregnancy and Childbirth.
Abstract
Stressors, coping, and resources needed during the COVID-19 pandemic in a sample of perinatal women
Background
Psychological stress and coping during pregnancy influence both maternal and infant health, and these impacts differ across racial, ethnic, and socioeconomic groups. This study assessed pandemic-related stressors, coping strategies, and the resources needed by 162 U.S. perinatal women (125 pregnant and 37 postpartum) to better understand their experiences during COVID-19.
Methods
Using a mixed-methods approach, researchers collected quantitative data on stressors and coping behaviors and analyzed qualitative responses to open-ended questions about stress and resource needs. Logistic and linear regression models evaluated differences between pregnant and postpartum participants and across demographic groups. Qualitative content analysis identified themes in open responses.
Results
The pandemic created barriers to accessing healthy food and increased missed prenatal appointments, though many participants used telemedicine for care. Financial strain and difficulties securing childcare were commonly reported. After adjusting for demographics, pregnant women were less likely than postpartum women to use healthy coping strategies. The study also detected increased stress and reduced social support among racial and ethnic minority participants and those with lower incomes. Qualitative responses echoed these findings: participants worried about hospital-acquired infection, potential exclusion of partners from deliveries or key appointments, and expressed a desire for support from family, friends, and educational resources.
Primary needs reported included financial assistance, reliable COVID-19 information related to maternal-infant outcomes, safe access to healthcare, and essential baby supplies such as formula and diapers.
Conclusions
To better protect perinatal mental health during the pandemic, healthcare providers should screen consistently for stressors, discuss access to essential resources, and refer patients to counseling (including telehealth) and virtual support groups. Prompt identification and referral for needed services can help mitigate the added burdens placed on pregnant and postpartum women by COVID-19.