Analysis: women's self-reported distress has increased significantly above that of women pregnant before the pandemic

Being pregnant is a bit like being on a rollercoaster. The highs can be exhilarating, like hearing the baby's heart beat for the first time. However when things don’t go to plan or we feel under-supported, the lows can really knock the wind out of us. Women’s pregnancy journeys are always characterised by these ups and downs, though the Covid-19 pandemic seems to have altered the rollercoaster trajectory. Since the onset of the pandemic, pregnant Irish women are reporting more lows than their pre-pandemic counterparts.

It is estimated that up to 30% of women experience stress, anxiety and/or depression during their pregnancy and this is often referred to as prenatal distress. Prenatal distress can be caused by multiple sources, including psychological, medical, economic, social and/or physical factors. Stressful life events, such as bereavement, natural disasters and pandemics can also cause increased levels of prenatal distress.

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From RTÉ Radio 1's Today with Claire Byrne, Prof Christine Loscher from DCU and Yvonne Williams GP on pregnancy, Covid and vaccines

Prenatal distress is problematic because it is associated with adverse outcomes for the health and well-being of women and their infants. During the pandemic, women’s self-reported distress has increased significantly above that of women pregnant before the pandemic. Research has identified low levels of mental and physical health, and higher levels of stress, anxiety and depression among women pregnant during the pandemic.

The impact of the pandemic has been significant for many pregnant women and there are multiple contributing factors that impact on women’s prenatal well-being during the pandemic. Here are three important factors that can be better supported.

Risk of infection

From the beginning of the pandemic, there have been concerns about the risk of infection for both women and their infants. While possible, there is evidence that the risk of mothers transmitting infection to their infants is low. However women remain concerned about contracting Covid-19, passing it on to their infant and the implications of infection on their pregnancy and birth experience. Lack of clear information about infection risk and the potential implications has contributed to these ongoing fears. We have also more recently seen reported concerns and vaccination hesitancy among pregnant women, despite current evidence that vaccines are safe for pregnant women and infants.

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From RTÉ Radio 1's Today With Claire Byrne, Suzy Griffin and Amy Morgan on the things you are likely to hear when you're expecting during a pandemic

Changes to maternity service

Access to appropriate maternity services are a key contributor to women’s mental and physical health outcomes during pregnancy. However, these have been completely upended during the pandemic. In Ireland and elsewhere, there have been restrictions on the presence of partners at antenatal appointments, during early labour and/or on the in-patient wards in maternity hospitals. Recent protests against these restrictions and advocacy for improvements in access to care from groups such as the Association for Improvements in Maternity Services (AIMS) are unsurprising, given evidence that restrictions are causing distress for women as well as their partners.

Reduced social support

Restrictions on partner attendance to maternity care has also impacted on women’s feelings of support during their pregnancy, with ratings of perceived social support significantly lower than before the pandemic. In addition, many women are reporting that public health guidelines around social distancing have adversely impacted on their social networks and their access to support. While the importance of these measures to combat spread of transmission is indisputable, reduced access to supports has left many pregnant women feeling isolated and lonely. This is important because good support from partners, family and friends is important during pregnancy, as it is associated with positive maternal mental health, and birth outcomes.

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From RTÉ Radio 1's Morning Ireland, materntiy care campaigner Caroline Cummings on changes in HSE policy around allowing partners of pregnant women to attend 20-week scans

Taken together, these factors provide a perfect storm for pregnant women to experience significant distress, with reduced supports, during the pandemic. However, they each provide important and accessible opportunities to improve the experiences of pregnant women and their partners. For instance, clear and accessible provision of information on risk and implications of prenatal infection, and safety of vaccinations for pregnant women is essential. Easing of restrictions on partner access to antenatal appointments and the birth is also likely to reduce experiences of prenatal distress and increase women’s feeling of being supported.

There is no standard operating procedure for how to navigate pregnancy and prenatal distress during a pandemic. Similarly there is no clear guidance for how maternity services should function in this context, and Irish maternity staff have continued to provide high quality care and support under difficult circumstances. With the current easing of restrictions nationally, there is scope for significant improvements in pregnant women’s experiences. All the time, it remains important to listen to women as they voice their experiences to ensure they are fully supported in their pregnancies in the ongoing pandemic.


The views expressed here are those of the author and do not represent or reflect the views of RTÉ