03 Jun Pregnant in a pandemic?
If you’re pregnant during the COVID-19 pandemic, you might be feeling a unique type of stress, writes Monique Robinson.
You might be uncertain about how an infection could affect your unborn baby. That’s over and above the stress you might be feeling about the pregnancy itself, and its impact on your relationship, job or lifestyle.
But there’s professional support to help you manage these stresses. And there’s lots you can do at home to ease your worries.
How will the coronavirus affect my unborn baby?
One of the first studies to look at the effect of coronavirus infection while pregnant found the health of unborn babies or newborns of women infected in their final trimester did not differ to those expected with uninfected pregnancies.
But this small study, from Wuhan in China, was rushed to publication and didn’t look at infection earlier in pregnancy.
A review of 41 pregnancies complicated by COVID-19, as well as another 38 complicated by other coronaviruses (SARS, severe acute respiratory syndrome and MERS, Middle East respiratory syndrome) gave us more information. It found a small but significant increase in preterm birth (before 37 weeks’ gestation) in COVID-19 pregnancies.
However, the researchers couldn’t differentiate between spontaneous preterm birth and babies who were induced to arrive before 37 weeks.
So far, the evidence of harm to you or your unborn baby is limited, and should not cause concern.
Pregnancy can be stressful anyway
Separate to the fear of being infected with COVID-19 is the fear and stress related to simply living through the pandemic while pregnant.
Pregnancy can often be stressful as lifestyle, relationship and income changes create challenges for families.
Worries about the baby’s health are present in any pregnancy, but adding concerns of what infection would mean for the unborn child can exacerbate feelings of anxiety. Before the pandemic, about 20% of women had a clinical anxiety disorder (for example, generalised anxiety, specific phobia) while pregnant.
We now have some early indicators of how the COVID-19 pandemic is affecting that statistic.
And when you add the pandemic into the mix
Canadian researchers surveyed nearly 2,000 pregnant women in April 2020 (in research yet to be peer-reviewed). They found 57% of pregnant women showed anxiety symptoms but 68% reported an increase in pregnancy-specific anxiety.
Only one of the 1,987 participants had a confirmed case of COVID-19, with another 25 cases suspected but not confirmed. So, for most participants, just being pregnant during the pandemic (without being infected) led to three times as many women being anxious during the pandemic than before it.
Pregnant women are also concerned about how the pandemic will affect their maternity care, including who can visit them in hospital and after the birth of their baby.
A review of pregnancy stress during previous infectious disease outbreaks, including SARS, MERS, Ebola and Zika, found that as well as feeling vulnerable, pregnant women were anxious about disruption to pre- and postnatal care, and exposure to treatments not fully tested in pregnancy.
We can’t avoid stress, but we can manage it
We know stress during pregnancy has been linked to a range of poor outcomes for the child, such as pre-term birth, being more susceptible to disease, and behavioural problems through childhood.
Post-traumatic stress symptoms in pregnant women following the September 11 attacks and various natural disasters have significantly affected both emotional and cognitive development in children later in childhood. But there is good news. While we cannot avoid the stress that comes with the COVID-19 pandemic, we can manage it.
In fact, it’s not necessarily the stressful event itself that can lead to poor outcomes. It’s how a pregnant woman assesses the stress of the event and how she chooses to move forward that might determine what happens to her child.
So, if we can manage our stress and not let it overwhelm us, we may be able to avoid the negative consequences of stress in pregnancy with benefits right through our children’s lives.
Here’s what you can do
Social support is key for managing stress, but social distancing makes it harder to gather with friends and loved ones who might typically provide that support.
Still, there are many online pregnancy support and birth groups targeted at particular stages of pregnancy. These could provide reassurance and a sense of belonging while the outside world looks different.
You can still exercise outside. But if you prefer to exercise at home, there are many online pregnancy yoga and pilates classes.
You can practise guided relaxation and meditation with an app. And if you can work from home, this might give you some much-needed flexibility.
You can also use local, evidence-based telehealth to access mental health care. There are also many free, online programs providing self-guided mental health support.
As long as the COVID-19 pandemic is here, with its accompanying uncertainty, we can best focus on limiting the long-term effects of stress on our mothers, babies and families.