Even in ordinary times, stress issues are a common occurrence for pregnant women. Pregnancy is a particularly crucial time for the mental health of a woman. The coronavirus pandemic is a global health problem for modern history’s most extensive infectious illness. The ongoing pandemic has created numerous stressful conditions for all people worldwide, especially for vulnerable populations such as pregnant women. Pregnant women are a high-risk population due to the dual impact on the fetus and the mother. Anxiety and depression are some of the morbidities that have increased since the pandemic began. The high levels of stress have been linked to exposure to the pandemic.
The pandemic is a risk to the paternal and reproductive health of the mother through infection and indirectly through consequences that have resulted from changes in social policies, healthcare, and economic and social circumstances. The pandemic has resulted in chronic fear of infection in the pregnant woman and the fear of the fetus’s health (Kotlar et al., 2021). There has been stress related to the unpreparedness of birth due to the pandemic and fear of the infection of the child when it is born.
Previous studies have indicated that paternal stress related to preparation for childbirth and fear of childbirth disrupts preparation for delivery and the delivery process itself and may result in adverse birth outcomes such as preterm delivery and low birth weight. Another recent study has shown that stress related to the pandemic is a significant construct that can highly affect the mental health of a pregnant woman (Ilska et al., 2021). These effects are such as an increase in symptoms of anxiety and depression.
There has been a growing body of evidence that has confirmed the harmful impact of the pandemic on mental and physical health. A review carried out by Chmielewska et al. (2021) has indicated that global and fetal outcomes have worsened with an increase in stillbirths, maternal deaths, maternal depression, and ruptured ectopic pregnancies. Numerous factors during the pandemic have intensified the worries in pregnant women, such as the present limited scientific research and knowledge on the safety and well-being of the fetus during the pandemic, the wide range of complications and symptoms resulting from the illness, changes in the regular daily routine, social isolation, transformation of social life and the prenatal care interruptions.
When the pandemic unfolded in the first wave, protective measures were implemented, such as social isolation and limitation of movement, which limited access to medical care, rescheduling of medical appointments, and new consultation methods such as using the telephone, etc. Changes consequently occurred in the new functioning of delivery rooms and maternity wards due to social distancing policies, resulting in births without companions and suspension of appointments. Other pregnant women were scared to go to hospital appointment meetings due to fear of infection.
The lockdown, social isolation, and social distancing adversely affected the mental health of pregnant women. During pregnancy, there is a need for great social support from family and friends and other activities such as outdoor exercises and workouts (Ilska et al., 2021). The effect resulted in loneliness, fatigue, burnout, and a rise in depression, anxiety, and post-traumatic stress disorder cases. The policies implemented due to the pandemic concerning the support of pregnant women and the postpartum stay that isolated the women during labor and delivery may have affected their mental health. Institutions recommended very few or no visitors and an expedited discharge. Given the advantages of labor support, the reduced access to supper increased the need for delivery through C-section and reduced maternal satisfaction with delivery and labor experiences. The expended discharge may have also reduced the ability to identify and provide treatment for postpartum complications.
The state of pregnancy compromises the immune system of pregnant women. Pregnant women are at the fear that they may be at higher risk of infection resulting from stress. Research showed that pregnant and postpartum women who were infected with COVID-19 were six times more likely to be admitted to the ICU than non-pregnant women who were infected with the virus (Luo et al., 2022). It is well known that pregnancy boosts the risks of being infected with serious diseases resulting from respiratory infections. The viral infection may be more severe as the pregnant woman’s immune system is geared toward taking care of both her health and the fetus. The coronavirus affects the lungs and the cardiovascular system, which a pregnant woman has already strained. As the fetus grows, it occupies space and reduces lung space, resulting in frequent shortness of breath. The woman needs to supply oxygen for the fetus and themselves, and the virus compromises this function. Pregnant women have an increased tendency to clot as a result of the need to quickly stance bleeding after delivery of the baby
The nature of pregnancy may result from too many women not being employed during this period or changes in income methods to accommodate the burden. The pandemic has resulted in an adverse effect on the economy of the nation. Many individuals experienced unemployment, including pregnant women. Low economy and unemployment result in difficulties and strain on household finances. Low income may result in stress for the pregnant woman and a risk of depression during the period of the pandemic. Instances of not also going to work increase the time spent at home and reduces interpersonal communication and socialization, increasing the risks of stress to pregnant women.
Physical activities are essential during pregnancy and help manage mild and moderate mental health illnesses, especially in pregnant women. Physical training provides pregnant women with guidelines for exercise activities and recommendations for regular strength training. The restrictions have affected their participation in their physical activities, affecting pregnant women’s mental health. According to the pandemic’s effects, chronic illnesses have been stressed as a high risk of complications in cases of severe COVID-19 patients and an increase in disease severity and mortality rates. Pregnant women with a history of chronic illness may be more stressed, unlike those without such a history. Their women’s psychological distress may result in them opting not to receive antenatal care in a healthcare facility due to the fear of contracting the coronavirus. This challenge may increase stressful conditions for pregnant women who have existing chronic illnesses
The impact of the stress on some pregnant women has increased tendencies toward drug abuse among them, such as smoking and other forms of substance abuse. Self-isolation and other policies resulting in loneliness may increase the need for pregnant women to abuse drugs to reduce the stress associated with the pandemic to better their mood (Chmielewska et al., 2021). Studies have shown that pregnancy is an already stressful event that may alter a woman’s hormonal balance and make them respond to uncomfortable feelings by drinking and smoking. The effects of the pandemic may elevate the feeling.
The stress that occurs to pregnant women during this pandemic may be dangerous to them. The stress-related hormones in pregnant women may result in certain complications during pregnancy. If the stress on the pregnant woman is long-lasting, it may affect their immune system weakening the woman’s ability to protect herself and the child against infections. Normal pregnancy discomforts such as body aches, morning sickness, and troubled sleeping may feel worse than expected in cases of stress. The pregnant woman may suffer from eating disorders that make her overeat or have less than enough food (Garcia-Silva et al., 2021). The result of the eating disorder to the pregnant woman may be being underweight, or the woman may gain too much weight, which would increase the risk of preterm labor or gestational diabetes. An elevated amount of stress due to the pandemic may result from severe high blood pressure conditions called preeclampsia, low infant birth weight, or premature birth.
The pandemic may also result in post-traumatic stress for pregnant women, such as those who lost a close loved one or became infected by the virus and had gone through a near-death experience. The result of post-traumatic stress in pregnant women may be the birth of low-birth-weight or premature babies. The woman is likely to experience risks in health behaviors emotionally and socially, which increases the risks of pregnancy problems, which may additionally affect the baby’s brain development and immune system.
References
Chmielewska, B., Barratt, I., Townsend, R., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., & Khalil, A. (2021). Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis. The Lancet Global Health, 9(6), e759-e772.
Garcia-Silva, J., Caracuel, A., Lozano-Ruiz, A., Alderdice, F., Lobel, M., Perra, O., & Caparros-Gonzalez, R. A. (2021). Pandemic-related pregnancy stress among pregnant women during the COVID-19 pandemic in Spain. Midwifery, 103, 103163.
Ilska, M., Kołodziej-Zaleska, A., Brandt-Salmeri, A., Preis, H., & Lobel, M. (2021). Pandemic stress and its correlates among pregnant women during the second wave of COVID-19 in Poland. International Journal of Environmental Research and Public Health, 18(21), 11140.
Kotlar, B., Gerson, E., Petrillo, S., Langer, A., & Tiemeier, H. (2021). The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review. Reproductive health, 18(1), 1-39.
Luo, Y., Zhang, K., Huang, M., & Qiu, C. (2022). Risk factors for depression and anxiety in pregnant women during the COVID-19 pandemic: Evidence from meta-analysis. PloS one, 17(3), e0265021.