COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems
Open accessAbstract
Background Knowledge of women's experience of childbirth in the outbreak of the coronavirus (COVID-19) pandemic and associated maternal health outcomes is scarce.Methods A sample of primarily American women who gave birth around the height of COVID-19 (n = 1,611) and matched controls, i.e., women who gave birth before COVID-19 (n = 640), completed an anonymous Internet survey about recent childbirth, birth-related traumatic stress (peritraumatic distress inventory; PTSD-checklist), maternal bonding (maternal attachment inventory; mother-to-infant bonding scale) and breastfeeding status. Groups (n = 637 in each) were matched on demographics, prior mental health/trauma and childbirth factors to determine the unique contribution of COVID-19 to the psychological experience of childbirth.Results Mothers in COVID-19-exposed communities endorsed more clinically acute stress response to childbirth than matched controls (Z = 2.65, p = .008, OR= 1.38). A path mediation model revealed that acute stress mediated the relationship between study group and postpartum outcomes. Specifically, higher acute stress response in birth was associated with more childbirth-related posttraumatic stress disorder symptoms (β = .42, p < .001) and less bonding with the infant (β = .26, p < .001), including breastfeeding problems (β = .10, p < .01).Limitations Use of a convenient internet sample introduces bias towards more educated women and reliance on retrospective self-report assessments may entail recall bias.Conclusions COVID-19 is a major stressor for delivering women. It can heighten traumatic childbirth experiences and interfere with successful postpartum adjustment. Clinical attention to traumatic stress in childbirth and problems with caring for the young during this pandemic is important.
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The sample includes women who gave birth before and during the COVID-19 pandemic, and this heterogeneity may have affected our results and warrants replication in other postpartum samples.
“The sample includes women who gave birth before and during the COVID-19 pandemic62,63. This heterogeneity, including the possibility that women used different language in their narratives during the pandemic, may have affected our results and warrants replication in other postpartum samples.”
From AI and narrative embeddings detect PTSD following childbirth via birth stories (2024) · cites this paper as [62]
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- Authors
- Mayopoulos, G. A., Ein-Dor, T., Dishy, G. A., Nandru, R., Chan, S. J., Hanley, L. E., Kaimal, A. J., & Dekel, S.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Corresponding author
- Dekel, Sharon
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 282
- Pages
- 122-125
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7889625
- OpenAlex
- W3114924204
- Cited by
- 151
- References
- 26
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 30 · 2023: 34 · 2022: 39 · 2021: 22
- FWCI
- 17.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Massachusetts General Hospital
- National Institute of Child Health and Human Development
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- COVID-19 pandemic, traumatic birth, mother-infant bonding, maternal attachment, breastfeeding difficulties, acute stress response, postpartum adjustment, maternal mental health, childbirth experience
- MeSH terms
- COVID-19, SARS-CoV-2, Female, Humans, Infant, Mothers, Pregnancy, Retrospective Studies, Stress Disorders, Post-Traumatic, Parturition
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