Unexpected changes in birth experiences during the COVID-19 pandemic: Implications for maternal mental health

PURPOSE: This study examined the rates of unexpected birth experiences due to the COVID-19 pandemic and its association with women’s postpartum mental health symptoms (depression, generalized anxiety, and PTSD). METHODS: Our cross-sectional analysis included postpartum women (N = 506) who reported on birth plan changes attributed to the COVID-19 pandemic through the PEACE (Perinatal Experiences and COVID-19 Effects) Study, an online survey that took place between May 2020 and May 2021. Covariates included sociodemographic variables, number of days since the pandemic, pre-pregnancy mental health history, and protective factors such as social support, distress tolerance, and resilience. RESULTS: Prevalent COVID-19 pandemic changes in the birth experience included not having support people (e.g., partners and friends) permitted to participate in the baby’s delivery (33.5%), reduced access to preferred medications before or after delivery (9.7%), unavailable health care providers for the baby’s birth as planned (9.6%), and other changes (13.8%). The reduced access to medications was associated with those reporting higher levels of depressive (β = .10, p < .01) and PTSD symptoms (β = .07, p < .05). Separation from their baby for a long period after delivery (β = .10, p < .05) and other changes (β = .10, p < .01) were associated with higher levels of PTSD symptoms. CONCLUSION: Unexpected changes to the birth experience due to the COVID-19 pandemic may have small but persistent effects on depressive and PTSD symptoms. Given increased vigilance and its association with subsequent PTSD, acknowledging any fear of viral contagion within the hospital setting but informing women the plans for ensuring safety may be preventive for later mental health symptomatology.