The psychosocial impact of COVID-19 on pregnant and postpartum individuals: a mixed methods exploration

To explore the psychosocial and behavioural responses of pregnant and postpartum individuals during the COVID-19 pandemic in order to develop strategies for healthcare providers to support patients through a pandemic. Mixed-methods study of patients in an urban Toronto multidisciplinary Family Health Team who were between 20 weeks pregnant and 5 months postpartum from June to August 2020. Using a questionnaire and qualitative interviews, we explored psychosocial and behavioral impacts of the COVID-19 pandemic, including access to prenatal care, lifestyle changes, and strategies for mitigating distress. Forty-seven pregnant (and 62 postpartum individuals responded (response rate 52%)); 12 semi structured interviews were completed. Respondents indicated a loss of freedom (93%), lonely/lack of support (66%), and nearly/totally housebound (63%). About half (46-54%) were worried/very worried for themselves ortheir baby contracting COVID-19 and 13% scored > 13 on EPDS indicating depression. Helpful strategies included keeping busy (86%), exercise (84%), and talking to their healthcare provider (79%). Qualitatively, participants expressed profound feelings of loss and persistent fear, anxiety, loneliness/isolation, and uncertainty. Adaptive behaviours included seeking mental health services, participating in online support groups, connecting with family/friends, avoiding information fatigue, and exercising. Maladaptive behaviours included overeating, becoming sedentary, and social isolation. Notwithstanding the “normal” stresses of pregnancy andparenthood, the added burden of pandemic-related stressors may impact parental mental health and relationships, parent-infant bonding, and infant development. Understanding psychosocial and behavioural responses to pregnancy during COVID-19 will enable healthcare providers to mitigate these impacts by providing appropriate supports.