The threat of COVID-19 during the early days of the pandemic created high levels of dangerous stress, anxiety and depression for pregnant women across the United States and in six other high-income Western nations, according to a new study led by a Stony Brook University professor.
The study, conducted April 17 through May 31, 2020, of more than 8,100 expectant mothers from the United States, Germany, Switzerland, Spain, Poland, Italy and Israel revealed the mental health risks faced by pregnant women at the onset of the pandemic.
"The stress that they experienced was the kinds of things that other people found stressful during the pandemic — feeling isolated and concerned about infection," said Marci Lobel, a Stony Brook University professor and director of I-COPE. "But some of the unique things that are stressful for pregnant women include things like having their prenatal care appointments changed or moved online or canceled and not being able to deliver a baby with a partner but having to do so by oneself."
While the pandemic had unprecedented wide-scale impact on mental health — including increased rates of alcohol and drug abuse, suicide and depresssion — COVID-19 had a unique effect on pregnant women because of the then-unknown effects of the virus on fetuses and from the altered prenatal care, labor and delivery practices, the authors said.
The findings are part of the International COVID-19 Pregnancy Experiences study, known as I-COPE, and is the first to compare stress and mental health in pregnant women in these seven nations. The study is expected to be published Wednesday in Social Science & Medicine, an academic journal.
Among the seven nations, expectant mothers in the United States, Germany and Poland demonstrated the highest levels of anxiety and depressive order — in some cases with rates exceeding 30% — and well above ranges examined before the pandemic, the study found.
While high rates of infection in the United States in the spring of 2020 may have contributed to stress and anxiety levels, Lobel said other factors could have also played a role.
"We know that the U.S. is a country that doesn't provide the kinds of support for pregnant women and women who've just had children as other countries do," said Lobel, adding that some of the women in the study, along with their babies, did eventually contract COVID.
"We don't have universal health care. We don't have support for child care payments. We don't even have commitment to paid maternal leave. Being pregnant at any time is stressful for women in the U.S., but especially during a global pandemic when those kinds of stresses are heightened by everything else."
Kathryn Cannino, program director of the EAC Network's Long Island Parenting Institute in Garden City, said the pandemic forced many expectant mothers to deal with their anxiety alone.
"We tend to do this parenting thing in isolation, on a good day, no less during a global pandemic," Cannino said. "What we've been missing for quite some time now is that village support that pregnant women, in particular, need, especially if they have other children."
Expectant mothers who were young, pregnant with their first child, with high-risk conditions and those with limited access to spending time outdoors reported the highest levels of stress and mood disturbances, the report said.
A previously published 2021 report by Lobel and her colleagues found that U.S. participants in the I-COPE study had a greater likelihood of preterm birth, delivering a newborn small for their gestational age or an unplanned cesarean section delivery.
The authors, she said, are continuing to follow the progress of the U.S. mothers and their babies to determine if the stresses from the pregnancy play a role in the child's development.
The study's findings, Lobel said, suggest that the impact of stress on a pregnant women’s mental health is a universal phenomenon, especially during times of peril, and poses a "long-term threat" to the health and well-being of mother and child.
"Prevention and reduction of maternal stress, especially among vulnerable groups such as first-time mothers and those with a high-risk pregnancy, should be prioritized," the report concludes. "Supports to childbearing women, including affordable health care, mental health screening and services, child care, and employment accommodations for pregnancy, childbirth, and infant care are cost-effective and produce a range of benefits to societies at large."
Laura Siddons, co-founder of the Nesting Place, a Farmingdale motherhood wellness center, said expectant mothers have long struggled to obtain the help they need — a problem exacerbated by the pandemic.
"We've seen firsthand just how many more parents have experienced, and continue to experience, feelings of anxiety as well as depression during pregnancy and postpartum as a result of the COVID-19 pandemic," Siddons said. "The onset of the pandemic was sudden, leaving many families without support and no time to prepare for the lack of support to come."
WHAT TO KNOW
- A new report, authored by a Stony Brook University professor, found that early stages of the COVID-19 pandemic contributed to high levels of stress, anxiety and depression among expectant mothers
- The study was conducted April 17 through May 31, 2020 of more than 8,100 women from the U.S., Germany, Switzerland, Spain, Poland, Italy and Israel
- A previously published 2021 report found that U.S. participants in the study had a greater likelihood of preterm birth, delivering a newborn small for their age or an unplanned C-section delivery.