Fear of Giving Birth Alone: Experiences of Psychological Distress, Symptoms of Anxiety and Depression, and Coping-strategies of Childbearing Women During COVID-19

Background: Psychological distress experienced during pregnancy is a well-documented risk factor for adverse maternal outcomes. Pandemic-related distress may exacerbate vulnerability to negative mental health outcomes for pregnant women. Aim: To investigate pregnant women's subjective experiences of mental health outcomes, pandemic-related challenges, coping strategies, and positive mental health factors during the COVID-19 lockdown period. Methods: A mixed-methods study investigated anxiety, depression, and burnout, along with qualitative responses to open-ended questions regarding their current experiences with challenges, and buffering factors during the pandemic. Levels of mental health outcomes were calculated, and qualitative data was thematically analyzed. Results: About one-third (24%) of the respondents reported clinically significant levels of depression, 19% reported clinically significant levels of anxiety and 43% reported being burned out. Distress, fear, and worry related to several pandemic-related factors were reported by all of the women, including fear of giving birth alone, fear of the consequences of lockdown restrictions, insufficient information, disruption of prenatal healthcare services, and fear of miscarriage. Social support, financial stability, stable relationships, following daily routines, less stress and a calmer daily life, less social demands, physical activity, as well as less work-related stress and working from home, were experienced as buffering factors that helped the women to cope with the distress associated with the pandemic lockdown. Conclusion: Healthcare providers should emphasize the importance of ensuring stability, predictability, minimizing disruptions to prenatal care and offering broad-based screening to identify women at risk of depression and anxiety. Recommendations for clinical pathways aimed at pregnant women are discussed. Keywords: COVID-19 Pandemic; Childbearing Women; Experiences; Fear; Coping Strategies