Stress in Pregnancy

Perinatal mental health issues cause tremendous suffering for women, strain intimate relationships and increase risk for emotional and behavioural problems in their children. For this reason, the widespread psychological distress caused by the COVID-19 pandemic is particularly worrying for those with an interest in the wellbeing of pregnant women, new mothers and infants.  However, evidence is lacking concerning best practice for supporting pregnant women through a global health pandemic to reduce risk of poor outcomes. Our team have conducted research examining the impact of stress in pregnancy during disasters (floods, hurricanes and wild fires) for over 20-years. We have identified how the objective, subjective and cognitive aspects of stress impact children’s cognitive, behavioural, physical, and motor functioning across development in both positive and negative ways. We have started to understand what interventions may reduce stress, and the subsequent impact of that stress, including social and emotional support and certain models of maternity care. 

 

Our Study: 

Our study will use interviews and surveys to increase understanding of the perspectives of women who are pregnant during the COVID-19 pandemic, with a particular focus on their experience of maternity care, how their mental health was supported during the pandemic, and how the system may be enhanced to best meet their mental health needs.  We will also investigate the experiences of family members and maternity care workers. Our study will have two phases:

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Phase 1: 

In-depth qualitative interviews with pregnant women and maternity care workers (midwives, student midwives, general practitioners and obstetricians).

 

Phase 2: 

Informed by Phase 1, a prospective cohort study will use an online survey to assess objective hardship and subjective distress associated with COVID-19.  Hair cortisol samples will be obtained to examine the physiological stress response in women pregnant during this time.  We will examine the extent to which the effects of stress related to COVID-19 during pregnancy on postnatal maternal and infant wellbeing may be buffered by (a) greater continuity of maternity care, and (b) social support.

 

Progress to Date:

Interviews with pregnant women and midwives have been completed.  A total of 3191 women have completed the BITTOC 2020 survey and we have had over 4000 responses to the BITTOC 2021 survey to date.  Women recruited as part of the BITTOC 2020 cohort have completed follow-up surveys at 2 months, 6 months, and 12 months postpartum, with 24-month follow-up surveys planned.   BITTOC 2021 participants have completed surveys at 2 months and 6 months follow-up, with 12-month follow-up soon to commence.  

 

Anticipated Outcomes: 

Our results will improve understanding of how Australia’s health care system can reduce or prevent adverse perinatal impacts of stress arising from a global pandemic, or other large-scale crisis, for pregnant women and their unborn children. These findings will inform evidence-based recommendations for the maternity and mental health care of all pregnant, birthing and postnatal women and infants during a crisis.