Reducing Pregnancy Stress in the Time of COVID

Family Wellness Reducing Pregnancy Stress

Stress-reduction is the key to a healthy pregnancy as moms-to-be adapt to pandemic life.

As beautiful and transformative as pregnancy can be, it often comes with its own unique set of anxieties. Layer the grim realities of a global pandemic on top of the normal stressors of pregnancy, and the results can be overwhelming.

A small national survey found that anxiety among pregnant women has nearly tripled since the start of the pandemic — even among healthy, low-risk mothers whose babies were developing normally.

While it is important to remain vigilant and cautious in the face of an ever-growing COVID-19 threat, it is equally important to stay centered and calm. Effectively managing stress can lower a mother-to-be’s blood pressure, protect her immune system and contribute to a healthy, full-term pregnancy.

Proper stress management can also promote healthy physical and cognitive development. And once the baby is born, a more relaxed mom has an easier time breastfeeding and caring for her newborn.

But there is a difference between knowing how important it is to reduce stress and actually reducing stress. In fact, one study conducted before the pandemic found that 65 percent of pregnant women stress out … about being stressed out!

In these uncertain times, to reduce stress about COVID-19, it first helps to understand what’s at stake. While much is still unknown about the disease, the research suggests that the risk of COVID-19 transferring during pregnancy to the developing baby is highly unlikely and similarly the risk of a newborn contracting the illness from a COVID-19-positive mother is low. And according to the Centers for Disease Control and Prevention, most newborns who do test positive have mild or no symptoms. A mother’s diagnosis of COVID-19 during pregnancy is not associated with birth defects and the illness has not been shown to be transmitted to the unborn child.

That said, Hoag and other hospitals have implemented stringent new policies since the start of the pandemic intended to protect new families from contracting COVID-19. Private hospital entrances for laboring women who have tested positive for COVID-19, visitation restrictions for all patients and expedited hospital stays have helped keep new families safe.

To increase safety before labor, many hospitals have moved their parenting and maternal education classes online and encouraged women to take proactive steps to protect themselves and their unborn babies. Universal advice for pregnant and non-pregnant women include wearing a face mask, maintaining six feet of social distance, frequent hand washing and avoidance of touching one’s face. While reducing one’s risk of infection for an expectant woman is no different than for the general population, women tend to take infection-prevention precautions more seriously when planning to or upon learning they are pregnant.

This enhanced awareness of potential risk(s) is a good thing. Empowered women take charge of their health and safety, thereby feeling more confident and in control, and as a result, less stressed. Many doctors and health care providers are shifting their approach to pregnancy and delivery, bringing a woman’s agency more prominently into play. For example, over the past two years, Hoag has been designing a new birthing experience based on feedback from women in the community. The result of the focus groups and made possible through tremendous philanthropic support, the Fudge Family Birthing Suites were scheduled to open in Irvine in December 2020. This facility will offer single-room maternity care whereby pregnant women will experience labor, delivery and the first precious moments with their newborns all in the same room. Each of the 12 spacious birthing suites offers a home-like environment, with spa-like amenities, including access to a walking garden, rain shower and labor tubs, and a high-tea every afternoon.

While it can seem at times that nothing is “normal” anymore, pre-pandemic advice for managing stress is just as relevant as ever:

Practice self-care. Eat regularly and nutritiously, get plenty of rest and physical activity while avoiding alcohol, cigarette smoking and illicit drug use.
Minimize negative responses to stress. Excessive worry and feelings of being overwhelmed and stressed may lead to social withdrawal, skipped meals, overeating or use of harmful substances, such as alcohol or drugs, during pregnancy.
Schedule time for yourself. Read a book. Go for a walk. Take time for yourself to rejuvenate. Engage in meditation and/or mindfulness sessions, which are widely available with mobile applications or with live-streaming through Hoag for Her | Center for Wellness.
Ask for help. Now’s not the time to be a superhero. Ask for help with day-to-day activities when you need it. And if you find yourself feeling sad, lethargic or anxious for more than two weeks, reach out to a professional.

Pre- and post-natal yoga and meditation and clinical hypnotherapy may also decrease the physical and psychological stressors many expectant mothers are experiencing. Guided imagery is another option for relieving and managing stress. Hoag has recently developed the first virtual reality (VR) program for expectant moms, NurtureVR, to provide an immersive prenatal education, pain management and relaxation program for women from 28 weeks of pregnancy through the first few months of the postpartum period.

Socializing is an essential aspect of stress management that has changed significantly with the pandemic. Human connection and social networks are critical to one’s sense of well-being and emotional health. But with the ongoing concerns related to the COVID-19 pandemic, gatherings outside of one’s “bubble” are discouraged. This limitation has negatively impacted many women’s sense of connectivity, and has reduced the opportunities for sharing, providing and receiving reassurance, not to mention much needed physical contact and laughter. Unfortunately record numbers of pregnant women report feeling isolated, anxious and chronically stressed. Virtual platforms such as Zoom or Skype have become essential in our “new normal” — allowing spontaneous social connections or planned events such as gender reveal celebrations and baby showers and even virtual visitation of the new mom in the hospital. These accessible and safe alternatives should be used whenever possible.

Getting outside and being exposed to fresh air and nature, with socially distanced walks or outdoor yoga (while wearing a face mask) will help minimize feelings of isolation, allow one to safely enjoy the physical presence of supportive family and friends, and increase feelings of contentment and well-being.

Of course, sometimes talking to a friend isn’t enough. Anxiety, depression and mood swings during pregnancy and the postpartum period are particularly common for women with a history of depression before pregnancy. Because depression is a serious medical condition that poses risks for both mother and baby, it’s important for women who have had a history of depression, or are taking antidepressants, to speak with their doctor about available resources and safe, effective treatment options.

Hoag Maternal Mental Health Program, for example, helps women who are experiencing mental health conditions during and after pregnancy. Women experiencing extreme stress or duress, including thoughts of harming herself or her baby, should contact 911 or ask a friend or family member to bring her to the emergency department.

This is an extraordinary time to be pregnant, but it doesn’t have to be extraordinarily stressful. By practicing self-care, availing herself of the right medical team and staying in touch with friends and family, a woman will take charge of her health, keep anxiety at bay and experience the wonder and joy of becoming a new mom.

Allyson Brooks, M.D., is the Ginny Ueberroth executive medical director endowed chair and chief quality officer at Hoag Women’s Health Institute.

(Photo Courtesy of Anastasiia Chepinska/Unsplash)