The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support

Background Experiences of prenatal trauma exacerbates vulnerability to negative health outcomes for pregnant women and their infants. We aimed to examine the role of: 1) anxiety, depression, and stress related to COVID-19 in predicting the quality of antenatal attachment; 2) perceived social support and COVID-19 appraisal in predicting maternal anxiety and depression.Methods A sample of 150 UK expectant women were surveyed during the COVID-19 pandemic. Questions included demographics, pregnancy details, and COVID-19 appraisal. Validated measures were used to collect self-reported maternal antenatal attachment (MAAS), symptoms of anxiety (STAI), depression (BDI-II), and stress related to the psychological impact of COVID-19 (IES-r). Results We found that the pandemic has affected UK expectant mothers’ mental health by increasing prevalence of depression, anxiety and stress. Women for whom COVID-19 had a higher psychological impact were more likely to suffer from depressive symptoms. High depressive symptoms were associated with reduced attachment to the unborn baby. Whilst women who appraised the impact of COVID-19 to be more negative showed higher levels of anxiety, higher social support acted as a protective factor and was associated with lower anxiety.Limitations The cross-sectional nature of the study hinders conclusions about causality. Future research should include paternal prenatal mental health. Conclusions Direct experience of prenatal trauma, such as the one experienced during the COVID-19 pandemic, significantly amplifies mothers’ vulnerability to mental health symptoms and impairs the formation of a positive relationship with their unborn baby. Health services should prioritise interventions strategies aimed at fostering support for pregnant women.