Covid-19 and perinatology

Pregnancy represents a critical and potentially stressful event that can negatively impact on prospective mothers’ psychological well-being. Indeed, a growing body of studies reported high rates of clinical conditions such as anxiety, depression, and severe fear of childbirth during pregnancy across countries. Several variables, both at an individual and interpersonal level, have been found to be associated with pregnant women’s mental health, representing important risk or protective factors. Specifically, many studies have progressively highlighted the association between expectant mothers’ psychological well-being and practical and emotional social support, both from the partner, the extended formal, and informal network. The Covid-19 pandemic and the restrictive measures adopted to contain the virus’ spread may act as additional stressor on pregnant women, thus increasing the physiological vulnerability of an already fragile population and causing disruptive effects on both pregnancy outcomes as well as expectant mothers’ mental health. In particular, the outbreak shrunk women’s social and support networks and hindered their access to both pregnancy as well as mental health care facilities. Moreover, both care provision and care seeking behaviors have changed dramatically, for example leading to an increase in telehealth consultations and to the exclusion of birth companions from maternal units. In this chapter, after summarizing the state of the art regarding mental health in pregnant women and outlining the main effects of the pandemic on expectant mothers’ psychological well-being, we discuss the changes in maternal settings and the consequent behaviors adopted by prospective mothers. The final paragraph of the chapter is devoted to the discussion of guidelines and implications for clinical practice and mainly provides guidance of four areas: information, promotion, care, and coordination.