The psychosocial impact of COVID-19 on pregnant and postpartum individuals: a mixed methods exploration

Abstract

Objectives To explore the psychosocial and behavioural responses of pregnant and postpartum individuals during the COVID-19 pandemic in order to develop strategies for healthcare providers to support patients through a pandemic. Methods Mixed-methods study of patients in an urban Toronto multidisciplinary Family Health Team who were between 20 weeks pregnant and 5 months postpartum from June to August 2020. Using a questionnaire and qualitative interviews, we explored psychosocial and behavioral impacts of the COVID-19 pandemic, including access to prenatal care, lifestyle changes, and strategies for mitigating distress. Results Forty-seven pregnant (and 62 postpartum individuals responded (response rate 52%)); 12 semi structured interviews were completed. Respondents indicated a loss of freedom (93%), lonely/lack of support (66%), and nearly/totally housebound (63%). About half (46-54%) were worried/very worried for themselves ortheir baby contracting COVID-19 and 13% scored > 13 on EPDS indicating depression. Helpful strategies included keeping busy (86%), exercise (84%), and talking to their healthcare provider (79%). Qualitatively, participants expressed profound feelings of loss and persistent fear, anxiety, loneliness/isolation, and uncertainty. Adaptive behaviours included seeking mental health services, participating in online support groups, connecting with family/friends, avoiding information fatigue, and exercising. Maladaptive behaviours included overeating, becoming sedentary, and social isolation. Conclusions Notwithstanding the “normal” stresses of pregnancy andparenthood, the added burden of pandemic-related stressors may impact parental mental health and relationships, parent-infant bonding, and infant development. Understanding psychosocial and behavioural responses to pregnancy during COVID-19 will enable healthcare providers to mitigate these impacts by providing appropriate supports.

Pregnant in a Pandemic: Connecting Perceptions of Uplifts and Hassles to Mental Health

“…The lack of differences found for women with or without other children indicates the importance of uplifting feelings about pregnancy, regardless of whether women are transitioning into motherhood or already have parenting experience. The COVID-19 pandemic introduced new stressors for pregnant women (Kolker et al, 2021;Wall and Dempsey, 2022), but our data suggest that there might also be some pandemic-related benefits, which, to our knowledge, have not been studied previously. In our sample, women who focused more on these pandemic-related uplifts than hassles were more positive, less lonely, and less depressed/anxious.…”

“…Loneliness is also detrimental to women’s and children’s health and is often co-occurring with prenatal depression (Luoma et al, 2019). Nascent survey research has found that pregnant women frequently report feelings of loneliness during social distancing policies (Giurgescu et al, 2022; Kolker et al, 2021).…”

“…For instance, a geocoded and age-matched comparison of pregnant women before and during the COVID-19 pandemic found that women were nearly twice as likely to experience depression during the pandemic (King et al, 2021). Additionally, with social distancing policies in place, pregnant women are also more likely to report feeling lonely (Kolker et al, 2021).…”

“…Nascent survey research has found that pregnant women frequently report feelings of loneliness during social distancing policies (Giurgescu et al, 2022;Kolker et al, 2021). Decades of research have documented the myriad ways poor prenatal mental health impacts women and fetal development (Graignic-Philippe et al, 2014;McManus et al, 2017;Zijlmans et al, 2017).…”

“…With social distancing, women may feel more isolated in daily life and when seeking medical care (e.g. check-ups alone) as well as have fears related to this new disease (Kolker et al, 2021). However, women may enjoy aspects of pandemic-related policies and practices, such as spending more time at home, having easier access to bathrooms, nap spaces, and comfortable clothing, and feeling a less hectic pace to daily life.…”