key: cord-0971258-akzub21b authors: Robinson, Gail Erlick; Benders-Hadi, Nikole; Conteh, Nkechi; Brown, Kara M.; Grigoriadis, Sophie; Nadelson, Carol C.; Mittal, Leena P.; Wald, Marla title: Psychological Impact of COVID-19 on Pregnancy date: 2021-06-11 journal: J Nerv Ment Dis DOI: 10.1097/nmd.0000000000001339 sha: 07d2ef1d000f25073d67f07f94d03bd2b12b829a doc_id: 971258 cord_uid: akzub21b nan Many hospitals have restrictions on visitors during delivery. Extended family are generally excluded from attending. For some hospitals, at the beginning of the pandemic, partners or birth support persons were not allowed to attend deliveries at all and, even now, are allowed to stay for only 2 hours after delivery. This becomes even more difficult if there are problems for the woman or the baby that require inpatient stays. Visitors are typically not allowed to come and go, so the partner either has to stay full time or is not allowed to regularly visit. This becomes an added difficulty if there are other children at home. Postpartum is generally a stressful time with the woman dealing with hormonal changes, sleepless nights, and the responsibility of becoming a new mother or caring for a newborn and their other children. The CDC estimates that one of eight women at least may have a postpartum mood disorder. Most women look forward to the support they can get from parents, relatives, or friends. Concern about others transmitting the virus to the mother or the baby or fears that older parents coming out to visit may put themselves at more risk can interfere with the type of support that is often extremely helpful postpartum. Women often experience feelings of loss and grief related to the loss of the experience they had imagined their postpartum period to be and not being able to share milestones with their loved ones. These feelings of grief are associated with a risk of developing mental health symptoms (Liu et al., 2020) . Women may also have concerns about breastfeeding (Harvard Health Blog, 2020). It does seem as if it is possible to breastfeed even if the woman has COVID-19, as there is no evidence that it is transmitted via breast milk. Although scientifically this seems to be valid, the woman herself might feel very anxious about breastfeeding and, therefore, believe that this is something she is unable to do, which can be very disappointing. Health care providers need to be very aware of the additional psychological stressors that pregnant and postpartum women are experiencing during this pandemic. Although screening is increasingly challenging in the context of increased telehealth visits during pregnancy and postpartum, the increased risk for mental health symptoms during the pandemic underscores the need for increased efforts to screen women for mental health concerns during pregnancy and the postpartum period. It is important that they have access to supportive care and medication if necessary. Health care providers need to have up-to-date information about COVID-19 effects on the pregnancy, baby, and breastfeeding to help allay unreasonable fears. The following resources can provide valuable information for health care providers and pregnant and postpartum women: Centers Why were breastfeeding women denied the COVID-19 vaccine? Available at Anxiety patterns in Canadians mirror progression of pandemic COVID-19-NET Surveillance Team (2020) Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: A preliminary study COVID-19 is forcing women from the workplace in record numbers-And we don't know when they'll be back. Available at: forbes.com Pregnant and worried about COVID-19? Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 pandemic