Mental Health and Prenatal Bonding in Pregnant Women During the COVID-19 Pandemic: Evidence for Heightened Risk Compared With a Prepandemic Sample

Abstract

We compared 572 pregnant women (319 first-time mothers) surveyed in spring 2020, during the first wave of COVID-19 lockdowns in the United States, with 99 pregnant women (all first-time mothers) surveyed before the pandemic (2014–2020). Compared with the prepandemic sample, women assessed during the pandemic showed elevated depression, anxiety, and stress and weaker prenatal bonding to their infants. These findings remained significant when restricting the pandemic sample to first-time mothers only and held after controlling for race/ethnicity, education, and pregnancy stage. Average levels of depression and anxiety within the pandemic group exceeded clinically significant thresholds, and women who estimated that the pandemic had more negatively affected their social relationships reported higher distress. However, pandemic-related changes to social contact outside the household were inconsistently associated with mental health and with some positive outcomes (fewer depressive symptoms, stronger prenatal bonding). Given that prenatal stress may compromise maternal and child well-being, the pandemic may have long-term implications for population health.