Being pregnant Throughout a Pandemic: the Stress of COVID-19 on Pregnant Ladies and New Moms Is Displaying
By Jennifer C. Ablow, University of Oregon and Elinor Sullivan, Oregon Health & Science University
Pregnancy is stressful to say the least, but COVID-19 poses new challenges for parents of newborns. The Centers for Disease Control and Prevention has identified pregnant women as a vulnerable population. If infected, they are more likely to be hospitalized and ventilated, and the risk of premature birth increases.
Economists predict the US will have at least 500,000 fewer births due to the pandemic. The decision not to get pregnant during a pandemic is understandable, especially in the US, as it is one of five countries in the world and the only country classified as high-income by the World Bank that does not require paid maternity leave for non-federal workers .
As scientists studying prenatal and postnatal stress, maternal nutrition, and child brain development, we can tell you that the pandemic has dramatically changed the pregnancy experience.
We are part of an international study to understand how women who are expecting or have given birth are affected by stress related to the pandemic. We note that mothers are concerned about catching the virus, passing it on to their newborn, and protecting their infants. And this stress adds to an already high level of stress for pregnant women and young mothers.
COVID-19 positive pregnancies have been linked to abnormalities in the placenta. These abnormalities may affect the oxygen and nutrient supply to the fetus. The long-term impact of the virus on the developing child is not yet known.
However, it is unlikely that a developing fetus could receive COVID-19 from its infected mother. COVID-19 requires a receptor molecule to cause infection. A recent study suggests that the placenta contains very small amounts of the molecules needed to make the receptor. This finding could explain why the virus is rarely found in newborns with COVID-19 positive mothers.
There are other concerns, however, including the effects of stress on the expectant mother.
Man is confronted with stress every day. The physiological response to stress is well known. It leads to the release of hormones into the bloodstream, especially cortisol. Some stress is also necessary during pregnancy. During a typical pregnancy, maternal cortisol increases two to four fold. This is normal and critical to the development of organ systems in the fetus such as the lungs, liver, and central nervous system.
However, people react differently to identical stressful situations for a variety of reasons. Young age, racial and ethnic differences, poor education, poor preparation for pregnancy, and a history of trauma are some factors that can worsen the effects of stress. Adequate social support, access to supporting resources and economic stability are required to make stress tolerable.
Otherwise, continuous exposure to significant stress will lead to relentless activation of the stress response. Chronic stress, or toxic stress in pregnant women, has been linked to complications such as gestational diabetes, impaired fetal development, low birth weight, neurodevelopmental problems, and preclampsia (high blood pressure).
A lack of control and information makes stress worse. Things like not knowing how long the stress will last and how intense the stress will be add to the stress levels of a pregnant woman and a new mother.
The birth itself
The hospital experience for pregnant couples is very different now. Water baths are off. This is how it goes in the hospital. Most facilities only have one support person present at the birth. If a parent tests positive for COVID-19 during hospitalization, they fear separation from the baby. These things often add even more stress.
When the family comes home, there is still a risk. Infants could get the disease from an infected parent. While children with COVID-19 generally don’t get as sick as adults, infants are an exception. Because of their immature respiratory and immune systems, they are at increased risk of serious illness compared to older children.
Given this possibility, parents of infants are advised to isolate themselves socially. This may offer some benefits, but isolation also reduces access to childcare and other types of social support when they need it most.
The COPE study
As part of the COVID-19 and Perinatal Experience study, we are tracking women who are expecting or giving birth during the pandemic to understand how they are affected by pandemic-related stress. An initial review of data on over 500 Oregon women shows they are severely stressed. The level of depression and anxiety reported is bothersome.
About 75% say the pandemic is having an extreme impact on their daily lives. The stress, they tell us, is due to social isolation, loneliness, changes in hospital procedures, concerns about follow-up care, and a lack of social support from having to be quarantined.
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The good news: prenatal stress during the pandemic can be reduced. A robust social support network is vital. Friends and family are needed when new parents are exhausted and prone to postpartum depression. While COVID-19 makes personal support difficult, if not impossible, technology – like Facetime and Zoom – can be a connection. Online group provision is another option. Relaxation and mindfulness techniques are too. A healthy diet, adequate sleep, and exercise also help.
Why these women need more help than ever before
Community health workers with pregnant clients can reduce stress by ensuring that basic needs are met. It’s no longer just food, housing and insurance. Needs that used to be considered extras, like internet service, are now essential.
Unfortunately – and internet apart – federal programs for access to food, housing, and insurance vary significantly from state to state. Without a uniform federal mandate, the social health differences will increase even more.
The Family and Sick Leave Act offers 12 weeks of job-protected leave. But it is unpaid and only applies if you work in a company with more than 50 employees. Many families and especially single mothers decline this offer. You need the income. Parental leave is linked to healthier babies; They have better long-term results as they develop. Investing in parental leave would save money in the long run.
Restructuring national policies to meet basic needs can help alleviate the challenges facing this underserved group. Without this support, the stress from COVID-19 could have a lasting, intergenerational impact on pregnant couples and their children.
Jennifer C. Ablow, Associate Professor of Psychology at the University of Oregon; and Elinor Sullivan, Associate Professor of Psychiatry at Oregon Health & Science University
This article is republished by The Conversation under a Creative Commons license. Read the original article.