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Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic

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  • Preis, Heidi
  • Mahaffey, Brittain
  • Heiselman, Cassandra
  • Lobel, Marci

Abstract

Women pregnant during the COVID-19 pandemic are experiencing moderate to high levels of emotional distress, which has previously been shown to be attributable to two types of pandemic-related pregnancy stress: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress) and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). Objective. Given the well-documented harms associated with elevated prenatal stress and the critical importance of developing appropriately targeted interventions, we investigated factors predictive of pandemic-related pregnancy stress. Method. Between April 25 and May 15, 2020, 4,451 pregnant women in the U.S. were recruited via social media to complete an online questionnaire that included sociodemographic, medical, and COVID-19 situational factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Binary logistic regression was used to calculate odds ratios for high stress. Results. Nearly 30% of participants reported high Preparedness Stress; a similar proportion reported high Perinatal Infection Stress. Abuse history, chronic illness, income loss due to the pandemic, perceived risk of having had COVID-19, alterations to prenatal appointments, high-risk pregnancy, and being a woman of color were associated with greater levels of one or both types of stress. Access to outdoor space, older age, and engagement in healthy behaviors were protective against stress. Conclusions. Practices that may alleviate pandemic-related stress such as minimizing disruptions to prenatal care, ensuring access to outdoor space, and motivating engagement in health behaviors are of vital importance. Particular attention is needed for more vulnerable populations including women of color, women with a history of abuse, and those with high-risk pregnancy. Research focused on the short and longer-term impact of pandemic-related pregnancy stress on maternal mental and physical health, perinatal outcomes, and child development is critical to identify these effects and marshal appropriate resources to reduce them.

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  • Preis, Heidi & Mahaffey, Brittain & Heiselman, Cassandra & Lobel, Marci, 2020. "Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 266(C).
    • Handle: RePEc:eee:socmed:v:266:y:2020:i:c:s0277953620305670
    DOI: 10.1016/j.socscimed.2020.113348
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    Cited by:

    1. Karen Yirmiya & Noa Yakirevich-Amir & Heidi Preis & Amit Lotan & Shir Atzil & Inbal Reuveni, 2021. "Women’s Depressive Symptoms during the COVID-19 Pandemic: The Role of Pregnancy," IJERPH, MDPI, vol. 18(8), pages 1-13, April.
    2. Alang Tho & Tran Quang Tri, 2022. "Investigating female employees’ work-life balance practices under the Covid-19 pandemic," HO CHI MINH CITY OPEN UNIVERSITY JOURNAL OF SCIENCE - SOCIAL SCIENCES, HO CHI MINH CITY OPEN UNIVERSITY JOURNAL OF SCIENCE, HO CHI MINH CITY OPEN UNIVERSITY, vol. 12(1), pages 144-155.
    3. Devaraj, Srikant & Patel, Pankaj C., 2021. "Change in psychological distress in response to changes in reduced mobility during the early 2020 COVID-19 pandemic: Evidence of modest effects from the U.S," Social Science & Medicine, Elsevier, vol. 270(C).
    4. Bearth, Angela & Luchsinger, Larissa & Siegrist, Michael, 2021. "Reactions of older Swiss adults to the COVID-19 pandemic: A longitudinal survey on the acceptance of and adherence to public health measures," Social Science & Medicine, Elsevier, vol. 280(C).
    5. Habran, Yves & Küpers, Wendelin & Weber, Jean-Christophe, 2024. "Reconceiving vulnerabilities in relations of care how to account for and deal with carers’ vulnerabilities," Social Science & Medicine, Elsevier, vol. 340(C).
    6. Feng Huang & Hong Liu, 2023. "The impact of the COVID‐19 pandemic and related policy responses on non‐COVID‐19 healthcare utilization in China," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 620-638, March.
    7. Lobel, Marci & Preis, Heidi & Mahaffey, Brittain & Schaal, Nora K. & Yirmiya, Karen & Atzil, Shir & Reuveni, Inbal & Balestrieri, Matteo & Penengo, Chiara & Colli, Chiara & Garzitto, Marco & Driul, Lo, 2022. "Common model of stress, anxiety, and depressive symptoms in pregnant women from seven high-income Western countries at the COVID-19 pandemic onset," Social Science & Medicine, Elsevier, vol. 315(C).

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