The Psychological Impact of the COVID-19 Pandemic on Pregnant Women

Abstract

Background: The COVID-19 pandemic has meant significant precautions and changes in delivering healthcare services. The aim of the study was to explore the lifestyle changes of pregnant women during the COVID-19 pandemic in Romania, the changes in prenatal care and delivery during the pandemic and the psychological impact on women and to determine how healthcare providers can help them to overcome this period. Methods: A cross-sectional survey was conducted anonymously and distributed among pregnancy-related groups from Romania, recruiting 559 study participants, between May and October 2020. A total of 559 pregnant women completed an online 26-item questionnaire but we only validated 557 responses for study. The survey included basic demographic questions, pregnancy-related questions, questions regarding the pregnant women’s lifestyle changes during the pandemic and their perception of the COVID-19 pandemic and questions which evaluated the impact of the pandemic on prenatal care and delivery in Romania. Results: The pandemic restrictions affected women’s routine activities regarding professional, familial and social life. Therefore, for pregnant women who were emotionally vulnerable, these restrictions had a great impact on their mental health. The majority of the study participants (78.8%, N = 439) were emotionally affected by the pandemic. The fear related to the possibility of having their pregnancy affected by the virus was dominant in the group (45.8%). A high number of women (69.5%) felt safe when they accessed health services, but private hospitals were considered safer (53.1%) compared to public hospitals (14.4%). The majority of participants (53.7%) used to have prenatal care in a private healthcare system. During the pandemic, preventive measures were associated with low confidence in the healthcare system. Of the total group of participants, 123 women (22.1%) gave birth during the pandemic. Of these, a majority of the study participants considered that it was very difficult for them to cope without their partner during the hospitalization and labor period. Conclusions: The main anxiety of pregnant women were related to threats to their lives and their baby’s health because of the uncertainty caused by pandemic. It is important to know that the restrictions and the changes in maternity care had a negative impact on them. This conclusion must be taken into account when preventive measures will be decided for helping them to get through such a period. Additionally, psychological support will be essential for improving the mental health of pregnant women and for preventing a negative outcome of the pregnancy. These feelings must be taken into account when preventive measures will be established during pandemic and a psychological support will be essential for improving their mental health for preventing negative outcome of pregnancy.

Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review

“…Restricted access to maternity healthcare services was associated with a higher risk of psychological distress and mental health impairment [62] . In-person appointments were often suspended, rescheduled, or converted to virtual or telemedicine [31] , [37] , [49] . The suspension of in-person pregnancy-related services led to some mothers giving up on pregnancy care [31] , [37] , and caused others to feel anxious, neglected, sad, frustrated [37] , lonely [30] , and fearful of not receiving desired treatment [63] .…”

“…In-person appointments were often suspended, rescheduled, or converted to virtual or telemedicine [31] , [37] , [49] . The suspension of in-person pregnancy-related services led to some mothers giving up on pregnancy care [31] , [37] , and caused others to feel anxious, neglected, sad, frustrated [37] , lonely [30] , and fearful of not receiving desired treatment [63] . Altered appointments also reduced birth satisfaction [49] and maternal perception of quality of care [37] .…”

“…Overall, all the qualitative studies had high ratings on the MMAT, indicating that the studies have good quality. On the other hand, some of the quantitative studies were found to have a higher risk of nonresponse bias, and two studies [30] , [31] did not employ a sampling strategy that was suitable for addressing the research question. As quality appraisal was done to enhance the rigor of the review [32] , all studies were included regardless of their ratings.…”

Coping Strategies and Health-Related Quality of Life in Pregnant Women with SARS-CoV-2 Infection

“…Pregnant women who have COVID-19 are recommended to seek specialized treatment for diagnosis, management, and avoidance of problems for both mother and baby [ 9 ]. It is very probable that birth problems such as low birth weight, shorter gestational age, vomiting throughout pregnancy, preeclampsia, poor Apgar scores, and prolonged hospital stay have been linked to perinatal anxiety and depression, as well as affecting the overall quality of life [ 10 ]. The terms “quality of life” and “quality of care” are often used to describe both the health-related quality of life and the woman’s perception of the quality of care received in healthcare settings.…”

Fatal Association of Mirror and Eisenmenger Syndrome during the COVID-19 Pandemic

“…For many patients, restrictive measures, social life decline, the concern of getting infected, changes in healthcare services, and fear of substandard antenatal care have caused excruciating anxiety. Psychological support and proper prenatal care are essential for a positive pregnancy outcome [3].…”