Stressors and coping mechanisms among pregnant women with psychiatric disorders during the COVID-19 pandemic.

BACKGROUND: Women with psychiatric disorders are vulnerable to relapse in pregnancy, and the COVID-19 pandemic has presented an additional stressor. METHODS: Data came from a supplemental study offered to women enrolled in the Massachusetts General Hospital Center for Women's Mental Health National Pregnancy Registry for Psychiatric Medications. Registry participants were also invited to complete an email questionnaire relating to their experiences of pregnancy during the pandemic. Prepartum experiences of 230 respondents were analyzed. RESULTS: The most common diagnoses in this group were depression (30%), anxiety disorders (29%), and bipolar affective disorder (17%). Common stressors included changes in employment, greater childcare and/or schooling responsibilities, more conflict in the household, and increased isolation. Participants reported negative impacts and/or coping mechanisms associated with the pandemic, such as sleep problems, reduced physical activity, changes in eating, and greater amounts of screen time. Positive impacts and/or coping mechanisms were also reported, including more quality time with family, more time in nature, and being more appreciative of aspects of life previously taken for granted. CONCLUSIONS: Our findings suggest that the COVID-19 pandemic has had an overall negative psychosocial impact on many pregnant women with preexisting psychiatric disorders. We also observed positive coping mechanisms, which could be drawn on as sources of resilience.

Perinatal experiences of pregnant women with psychiatric disorders during the COVID-19 pandemic.

OBJECTIVE: We sought to examine the impact of the COVID-19 pandemic on the pregnancy, delivery and postpartum experiences of women with histories of psychiatric disorders. METHOD: Women already enrolled in a United States registry which prospectively studies the relationship between the use of psychiatric medications during pregnancy and major congenital malformations were invited to participate in this study. Subjects were asked about their experiences across the pandemic through interviews during pregnancy and the postpartum period and through an emailed questionnaire. Data were collected between May 2020 and February 2021. RESULTS: Interview and email questionnaire data were collected from 488 individuals. Most participants reported disruption, or planned changes, to their perinatal care due to the pandemic. Women expressed concerns about reduced postpartum support, and the reduction of positive social interactions and opportunities for family/friends to bond with the baby. CONCLUSION: Our findings suggest that the pandemic has had a negative impact on the experiences of many pregnant women with pre-existing psychiatric disorders, particularly in relation to changes in care and perceived social support. Given that the risk of relapse of psychiatric disorders is already high in the postpartum period, it is important to identify what factors cause most distress for this at-risk population.