Preparing for childbirth can be joyful and exciting, but Covid-19 restrictions cast a shadow on this transition into motherhood. For many, the pandemic disrupted their prenatal care and forced some to deliver their infants, without partner or family support. Others faced separation from their newborns immediately after birth.
Expectant parents also missed out on many celebrations and rituals that commemorate the transition into parenthood such as baby showers, christening ceremonies, or grandparents travelling to meet the newest family member.
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Over the past seven years, our lab - Neuroendocrinology of Social Ties lab at California's USC Dornsife College of Letters, Arts and Sciences - has studied new parents, following couples from pregnancy across the first year postpartum. COVID-19 lockdowns stopped our in-person data collection when our campus closed. But it created an opportunity to investigate a unique form of prenatal stress in real time.
It sparked the study in what the field researchers call “fetal origins of adult disease,” which explores links between pregnancy stress and later health. Scientists have linked large-scale societal crises – like the September 11 attacks, Hurricane Katrina and the 2005 earthquake in Chile – with long-term health consequences for mother and child.
The Covid-19 pandemic shares many similarities with these events, including widespread loss of life. But it’s also unique. Communities often unite to grieve and rebuild after natural disasters. The need to maintain social distance during the pandemic kept many people isolated from one another – especially many pregnant women, a high-risk population that may have elected to stick with stricter social distancing measures.
What happens when an expectant mother’s in-person social network shrinks or disappears overnight? Scientists know social support buffers the risk for mental health problems in mothers. So our lab wondered how the sudden isolation of lockdowns – coupled with the economic and health worries of the pandemic – might affect pregnant women.
We recruited 760 expectant parents (641 pregnant women and 79 fathers or partners) between April and July, 2020, to participate in our Coronavirus, Health, Isolation and Resilience in Pregnancy (CHIRP) study. We converted our usual in-lab questionnaires online, and posted on social media and online parenting and pregnancy groups.
Our preliminary findings showed that only about 5% of the pregnant women who responded to our survey had a suspected or confirmed case of Covid-19, and a similar number (4.7%) had experienced the death of someone close to them due to the pandemic.
However, 97% reported that their community had issued a stay-at-home. Moreover, 61% of women reported that the pandemic had had “very” or “somewhat” negative impacts on their social relationships. A majority of women estimated that at the time of the survey they had much less contact than before the start of the pandemic with neighbours and community members, co-workers, close friends and family members. On the other hand, 42% reported much more time spent with their partner than before the pandemic.
These changes in social contact appeared to take a mental health toll. Almost two-thirds of respondents said they had experienced at least some loneliness. A similar number felt more lonely than usual because of the pandemic. Moreover, about three-fourths of our sample reported that the Covid-19 pandemic had an overall negative effect on their mental health.
We were also surprised to see that the average score for pregnant women in our sample was higher than the threshold that clinicians typically use as an indicator for depression. Half of the women in the sample reported clinically significant symptoms of depression. Similarly, 62% said they were experiencing clinically significant anxiety symptoms. These proportions are more than twice as high as what we’ve seen in our pre-pandemic sample.
Given evidence that maternal stress during pregnancy can affect fetal development and shape long-term mother and infant health, our preliminary results are cause for concern. We are currently collecting birth charts from our sample to measure gestational outcomes, like birth weight and preterm birth, that have been linked with prenatal stress.
However, compelling evidence suggests that counseling interventions such as talk therapy can not only relieve but also prevent mood disorders in the period immediately before and after birth. Situations in which primary care and mental health care are integrated and expectant mothers can access psychotherapy through their gynecology practices can help treatments reach mothers most in need.
Although infants born in 2020 may not remember the pandemic firsthand, its effects may shape their early lives in ways that we are just beginning to measure.
Dr Darby Saxbe is associate professor of Psychology, and Alyssa Morris is PhD student in Clinical Psychology at the USC Dornsife College of Letters, Arts and Sciences.