Maternal-fetal bonding during the COVID-19 pandemic

Abstract

Background The pregnant population experienced unique COVID-19 physical and psychosocial stressors such as direct health concerns related to the virus and loss of access to resources since the COVID-19 emerged as a global pandemic in early 2020. Despite these COVID-19-related stress and concerns, the maternal experience of bonding with their unborn children has not been well studied. This work aimed to study the association between mental health history, current mental health symptoms, psychological factors, COVID-19-related worries, and self-reported maternal-fetal bonding of pregnant women. Methods This online, survey-based cross-sectional study focused on women pregnant during the pandemic and assessed 686 women using data collected from May 19, 2020 to October 3, 2020. Enrolled respondents completed assessments in which they self-reported maternal-fetal bonding, mental health symptomatology, psychological factors, and COVID-19-related worries regarding health, pregnancy, and resources. Results Depressive symptoms in pregnant women were associated with lower quality maternal-fetal bonding, while a higher level of anxiety was positively associated with bonding; however, past history of depression or generalized anxiety diagnosis did not appear to be as relevant as active symptomatology. Maternal resilience, but not distress tolerance, appeared to be a protective factor resulting in improved bonding. Higher levels of worry regarding impact of COVID-19 on health were significantly associated with improved bonding, while worries regarding the impact of COVID-19 on the pregnancy or resources were not significantly associated with bonding. The study also found associations between different sociodemographic variables and bonding, including a strong positive association between first time motherhood and bonding and a negative association between higher education and income and bonding. Conclusions This study was the first to report potential protective and risk factors to the maternal-fetal bonding process in women pregnant during the COVID-19 pandemic. Unique COVID-19 concerns exist; however, anxiety and COVID-19 concerns do not appear to undermine maternal-fetal bonding while active depressive symptomatology may negatively influence bonding; interventions increasing maternal resilience may be particularly valuable.

The effect of the COVID-19 pandemic on UK parent experiences of pregnancy ultrasound scans and parent-fetal bonding: A mixed methods analysis

“…However, research studies exploring the effect of the COVID-19 pandemic on prenatal bonding have focussed predominantly on mothers and are generalised to consider the whole pregnancy experience, including labour and childbirth [20][21][22]. Whilst some do acknowledge antenatal ultrasound as part of the wider analysis, drawing more specific conclusions around the effect of ultrasound scanning during the pandemic on bonding is challenging because of the additional and external moderators.…”

“…optimal bonding score is challenging because whilst a score may be statistically significant within an analysis, this may not represent clinical significance [32]. Previous studies using the MAAS define a threshold of 80% of the global score to differentiate between low and high bonding [9,20]. Using this definition, the average scores of parents completing the modified PAI in this study would be classified as low bonding.…”

Factors influencing maternal-fetal attachment in pregnant women during the COVID-19 pandemic: a cross-sectional study

“…For instance, an international study found that maternal-fetal attachment in high-risk pregnant women was higher than normal pregnant women, and high-risk situations such as high-risk pregnancies increased adaptation to pregnancy and strengthened maternal-fetal attachment [ 39 ]. Furthermore, previous studies have suggested that COVID-19 stress could lead to an increase in maternal-fetal attachment by wanting to care more for the fetus and provide protection [ 40 ]. Childbirth during traumatic situations like the COVID-19 pandemic has also been reported to trigger maternal psychological growth by presenting feelings of gratitude for life and individual capacity, and thus bringing about better mother-infant attachment [ 41 ].…”

Influence of the COVID‐19 pandemic on prenatal and postpartum patient experiences and well‐being

“…42,43 Members of perinatal care teams may find it helpful to discuss with patients and families factors that may contribute to maternal stress, including perceptions of prenatal and postpartum support and adaptive, rather than maladaptive, coping mechanisms to mitigate stress related to public health emergencies. As maternal resilience and prenatal stress-response has been shown to be important to fetal and infant bonding 44,45 and child health, [46][47][48] strategies to promote resiliency and healthy coping should be encouraged, including referral to a mental health practitioner. Notably, one-in-ten of our respondents reported being unable to discuss postpartum mood changes and nearly one-fifth of our respondents felt that access to a mental health practitioner was an important form of support during COVID-19.…”