Delivering Alone in a Pandemic: Anticipated Changes to Partner Presence at Birth Are Associated With Prenatal Distress

Public Significance Statement During the COVID-19 pandemic, pregnant women faced many changes to their birth plans, including restrictions on who could attend the birth. During the first wave of COVID-19 lockdowns (spring 2020), we found significantly higher rates of distress in pregnant women anticipating changes to their partner's presence at the birth and the timing of their delivery. These findings highlight an unintended mental health consequence of COVID-19 mitigation efforts on obstetric care. Introduction: The COVID-19 pandemic has impacted individuals across the world, and in particular, dramatically affected the experience of pregnancy and childbirth for many expectant mothers. The transition to parenthood is a time of increased risk for mental health problems, and maternal prenatal stress is associated with long-term maternal and infant health implications. The current study explored whether COVID-19 related changes to mothers' childbirth plans and prenatal health care experiences during the first wave of pandemic lockdowns in the U.S. were associated with self-reported depression, anxiety, and stress. Method: In spring 2020; we surveyed 641 pregnant women on their pregnancy and birth plans, as well as their mental health, during the COVID-19 pandemic. Results: Women anticipating changes to the presence of their partner at birth also reported heightened symptoms of depression, anxiety, and stress. Additionally, women who anticipated changes to the timing of delivery reported both higher anxiety and higher perceived stress. Discussion: These findings extend initial work suggesting increased risk for mental health problems in pregnant women during the COVID-19 pandemic by highlighting specific pandemic-related disruptions to pregnancy and birth that may have contributed to prenatal distress. Monitoring and intervention for these mothers and their infants are warranted.