Pregnancy and stress during COVID-19
Midwife and lecturer Billie Bradford discusses the impact of stress on pregnant women, and why social support for low-income families is so important right now.
The COVID-19 pandemic has turned our society upside down; it is a stressful time for everyone. This stress and change is likely to impact pregnant women in New Zealand in many ways.
We know from research conducted during natural disasters that the resulting stress pregnant women experience can impact the fetus. It is unclear exactly what mechanism causes a fetus to be affected by stress, but it is believed to be caused by fetal programming.
In other words, exposure to stress during pregnancy leads to changes in fetal metabolism during development that can increase the risk of preterm birth, small-for-gestational-age, stillbirth, and an increased likelihood of children developing obesity later in.
Another possible mechanism contributing to these effects is behavioural changes in response to stress. For example it has been shown that some pregnant women increase risk behaviours such as overeating, smoking, and alcohol or drug use in response to stress.
The social factors that contribute to stress for pregnant women during an event like this are often underappreciated. Exposure to domestic violence, food insecurity, financial stress, and relationship stress can all be harmful for pregnant women and their babies. Women are more likely to be victims of domestic abuse during pregnancy than at any other time in their lives and Women’s Refuge have already reported an increase in women seeking their support since the COVID-19 lockdown began.
As is often the case in healthcare, interventions can bring unwanted side effects. In the case of the current pandemic response in New Zealand, controlling spread of the virus has meant pregnant women have been spared largescale exposure to COVID-19 illness and the stress and grief of losing loved ones to the disease. However, the economic and social impact of the lockdown and economic downturn will have other effects, including increased exposure to financial hardship.
Some agencies supporting low-income families have reported that access to food is a problem for many since the lockdown started. Low-income families will not have had the means to put aside extra groceries in the lead up to the lockdown and are now more likely to be dealing with impacted jobs and income. Affordable sources of healthy food such as vegetable markets, hunting, fishing, and sharing gathered and harvested food between family groups have disappeared.
This will impact pregnant women and young families disproportionately. The Ministry of Health Report on Maternity 2017 released in 2019 showed that half of women giving birth in New Zealand that year were living in our poorest neighbourhoods.
As a society any effort we can make to mitigate these financial pressures on low-income families will pay dividends in protecting the health and wellbeing of future generations. The government’s efforts to reduce financial pressure on families are likely to prove essential in holding together the fabric of our society as we come through this pandemic.
For women who are pregnant at this time maintaining a healthy diet and getting exercise are really important, both for physical and mental wellbeing. Keeping up with regular antenatal appointments, routine blood tests and scans, as well as having a flu vaccination are also important.
Those with a pregnant woman in their whānau or in their bubble, your support can help to reduce the effects of stress during this time. Try to use the time at home to prepare healthy meals, get your hāpu māmā out for regular walks or other exercise and help keep her space smoke-free. The good news is that international research has also shown that good social support can reduce the harmful effects of stress on pregnant women. So to use the words of our Prime Minister, ‘be kind’, especially to pregnant women. Your support makes a difference.