Pregnancy overshadowed by the pandemic

A pregnancy constantly overshadowed by the unknown. That is how women in Sweden who have been pregnant during the pandemic describe it. A study lead by researchers from University of Gothenburg highlights the insecurity and loneliness they have been experiencing.

The study, published in the scientific journal Women and Birth, is based on in-depth interviews with 14 women in Sweden. The purpose was to clarify how women who have not been infected with SARS-CoV-2 experienced being pregnant during the pandemic. The interviewees had given birth during the period from August to November 2020, and were interviewed in March and April 2021.

Being pregnant is a life-changing event. It transforms a woman's existence, whether she is expecting her first baby or a mother already. Restrictions aimed at stemming the spread of SARS-CoV-2 have affected pregnant women in various ways.

Globally, the emotional well-being of pregnant women has deteriorated in conjunction with concerns about COVID-19 and national lockdowns to prevent the spread of infection. In Sweden, a measurable rise in health-related anxiety among pregnant women was found at the outset of the pandemic, but how this has affected these women since then has been unclear.

Feeling uncertain and lonely

Verena Sengpiel, associate professor in obstetrics and gynecology at Sahlgrenska Academy, University of Gothenburg, and also an obstetrician at Sahlgrenska University Hospital:

"We've known for some time that pregnant women are especially affected by mental stress during natural disasters or other traumatic events, since they're responsible for not only their own health and safety, but also the well-being of the unborn child," she says.

"Globally, we've seen indications that pregnant women's emotional well-being has suffered during the COVID-19 pandemic. But since Sweden chose a different strategy to prevent infection, it's uncertain whether these results are applicable to Swedish conditions."

Karolina Linden, Ph.D., midwife and researcher in health and care sciences at the University of Gothenburg's Sahlgrenska Academy, is the study's lead author. She relates how the pregnant respondents felt "constantly overshadowed by the unknown," as they put it.

"The experience was characterized by having to deal with the uncertainties caused by the pandemic and the need to constantly take in new information relating to COVID-19 and pregnancy. Women felt lonely and abandoned when their partner was not allowed to attend medical consultations, especially in cases where complications had arisen during the pregnancy," Linden says.

"At the same time, the women had great trust in the prenatal and maternity care services, although they stated that they were not receiving enough information about pregnancy and COVID-19 from their health-care providers."

Up-to-date information vital

The researchers, who believe the study results have a potential bearing on the care of pregnant women, advise these women to proactively raise issues concerning anxiety, uncertainty, and how they should relate to the constant flow of information and knowledge.

Linden again: "I urge all pregnant women to talk to their midwife about any worries they have about COVID-19. Today, we know more about how SARS-CoV-2 affects both the expectant mother and the unborn child during pregnancy. It's important for the maternity care services to communicate up-to-date information directly to pregnant women, especially since advice and recommendations change as we gain more knowledge.

"This is especially vital now in terms of vaccination against SARS-CoV-2, given that we've seen relatively low vaccination coverage of pregnant women, compared with the rest of the population.

"Now that the restrictions have eased care providers also need to take note of the importance of allowing the pregnant woman's partner to attend care visits," Linden concludes.

This recent research is part of the COPE (COVID-19 in Pregnancy and Early Childhood) study, a colloration involving researchers all over Sweden, in a variety of disciplines, who are jointly evaluating how SARS-CoV-2 infection and the COVID-19 pandemic affect pregnancy outcomes and the health of the woman, child, and (if any) partner.