Pandemic Has Increased Pregnancy Stress for US Women

Summary: The COVID-19 pandemic has had a significant impact on stress in both pregnant and postpartum women. Researchers say this is concerning as prenatal stress can hamper fetal brain development.

Source: Washington State University

COVID-19 has created new problems for pregnant women in the United States, a group that already faced the highest maternal mortality rate in the developed world even before the pandemic.

One of their biggest concerns is their baby contracting the disease, according to a Washington State University study published recently in the journal BMC Pregnancy and Childbirth. Some women expressed fears that simply going to the hospital to deliver would cause them to get the virus and then be forced to isolate from their newborn.

“Pregnant women are really stressed about contracting COVID-19,” said lead author Celestina Barbosa-Leiker, vice chancellor for research at WSU Health Sciences Spokane.

“They have a lot of questions for their health care providers. There’s a lot of we don’t know yet, which is understandable, but it’s especially stressful for the moms.”

Researchers also found that the pandemic increased pregnant women’s financial worries, made finding healthy food difficult and caused them to miss prenatal appointments.

The study revealed even greater levels of stress and lack of social support among women of color and low-income pregnant women, highlighting an increase in health disparities that already existed prior to the pandemic.

“We know that prenatal stress impacts fetal development, so these are really big concerns,” Barbosa-Leiker said.

For the study, the WSU research team analyzed survey responses from more than 160 pregnant and post-partum women from April 28 to June 30, 2020. They collected both quantitative survey responses from the whole group and more in-depth qualitative responses from a sub-set of women.

In the study, 52% of pregnant women and 49% of postpartum women worried about their babies contracting COVID-19, and 46% had sought extra information about COVID-19 protocols from the hospital where they had planned to deliver, or had delivered, their babies.

In the qualitative portion of the survey, women reported many serious concerns. For example, a participant noted that their main concern during the pandemic was contracting COVID-19 and dying. Others worried about contracting the virus in the hospital when they delivered and that COVID-19 policies would force them to isolate from their newborn or keep their partners out of the birthing room.

This shows the word mama, a drawing of a baby and a heart
U.S. pregnant women already face more stressors than many of their peers in industrialized countries. Image is in the public domain

Barbosa-Leiker said hospitals had varying policies especially at the beginning of stay at home measures though the recommendation now is to keep babies and mothers together.

During the survey period, 27% of pregnant women reported an inability to obtain healthy food and 25% had missed prenatal appointments. Finances also emerged as a substantial issue: 19% reported having their income reduced; 9% had been laid off and another 10% reported that someone in their household had lost their job.

Within the survey sample, the pregnant women appeared to be more stressed than post-partum women who had already delivered, as they were less likely to engage in healthy stress-coping behaviors, such as exercising, taking breaks from the news and making time to relax.

U.S. pregnant women already face more stressors than many of their peers in industrialized countries. According to a report from nine maternal mortality review committees, they have the highest maternal mortality rate in the developed world, and social and environmental stressors contribute to a U.S women’s risk of dying within the first year of pregnancy. Previous studies have also showed U.S. pregnant women have higher levels of anxiety and depression compared to Dutch women, and higher levels of psychological stress than British women – and this was before COVID-19.

The results of the recent WSU study reinforce the need for more resources and support for pregnant women, especially during the pandemic, Barbosa-Leiker said.

“Health care providers should continue to talk with moms about all their stressors as their mental health and emotional well-being is key during this time,” she said. “Providers can keep resources on hand. For instance, if they learn there is job loss in the family, they could quickly refer them to wraparound services.”

Other people can also provide more support but in a physically distanced way, Barbosa-Leiker said, as pregnant women and new mothers expressed a lot of guilt for keeping relatives, especially grandparents, away from the newborn.

“We heard a lot from our participants that they were stressed because they were afraid of offending family members,” she said. “Keeping in mind that new parents are doing everything they can to keep their baby and themselves safe and healthy, we should really try to support the parents’ wishes about how they want to deal with visitors during the pandemic.”

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


Stressors, coping, and resources needed during the COVID-19 pandemic in a sample of perinatal women


Psychological stress and coping experienced during pregnancy can have important effects on maternal and infant health, which can also vary by race, ethnicity, and socioeconomic status. Therefore, we assessed stressors, coping behaviors, and resources needed in relation to the COVID-19 pandemic in a sample of 162 perinatal (125 pregnant and 37 postpartum) women in the United States.


A mixed-methods study captured quantitative responses regarding stressors and coping, along with qualitative responses to open-ended questions regarding stress and resources needed during the COVID-19 pandemic. Logistic and linear regression models were used to analyze differences between pregnant and postpartum participants, as well as differences across key demographic variables. Qualitative content analysis was used to analyze open-ended questions.


During the COVID-pandemic, food scarcity and shelter-in-place restrictions made it difficult for pregnant women to find healthy foods. Participants also reported missing prenatal appointments, though many reported using telemedicine to obtain these services. Financial issues were prevalent in our sample and participants had difficulty obtaining childcare.

After controlling for demographic variables, pregnant women were less likely to engage in healthy stress-coping behaviors than postpartum women. Lastly, we were able to detect signals of increased stressors induced by the COVID-19 pandemic, and less social support, in perinatal women of racial and ethnic minority, and lower-income status.

Qualitative results support our survey findings as participants expressed concerns about their baby contracting COVID-19 while in the hospital, significant others missing the delivery or key obstetric appointments, and wanting support from friends, family, and birthing classes.

Financial resources, COVID-19 information and research as it relates to maternal-infant health outcomes, access to safe healthcare, and access to baby supplies (formula, diapers, etc.) emerged as the primary resources needed by participants.


To better support perinatal women’s mental health during the COVID-19 pandemic, healthcare providers should engage in conversations regarding access to resources needed to care for newborns, refer patients to counseling services (which can be delivered online/via telephone) and virtual support groups, and consistently screen pregnant women for stressors.

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