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Cited by 46Maternal Mental Health During Pregnancy and PostpartumCOVID-19 and Mental HealthCOVID-19 Impact on Reproduction

Postpartum stress and protective factors in women who gave birth in the United States during the COVID-19 pandemic

Open access
Mollard, Elizabeth, Kupzyk, Kevin, Moore, Tiffany·2021·Women's Health
DOI 10.1177/17455065211042190PMC PMC8414615
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Abstract

Objectives: The COVID-19 pandemic has caused considerable stress throughout the world. Little is known about how postpartum women who gave birth during the early months of the pandemic were impacted. The purpose of this study was to explore and describe the associations between potential risk, protective factors, and psychological distress among postpartum women who gave birth during the early months of the COVID-19 pandemic. Methods: Postpartum women over the age of 18 years who gave birth in the US hospitals between March and July of 2020 and spoke English completed a survey about their experiences. Demographic and health variables were measured via self-report. Stress was measured using the Perceived Stress Scale-10. Mastery was measured with the Pearlin Mastery Scale. Resilience was measured with the Connor–Davidson Resilience Scale-2. Results: This study included 885 women. Participants had higher stress and lower resilience relative to pre-pandemic norms. Participants had high levels of depression, anxiety, and stress. Women who had an infant admitted to the neonatal intensive care unit had more stress. Income, full-time employment, and partnered relationships were associated with lower stress. Resilience and mastery were related to lower stress, depression, and anxiety. Black, Indigenous, or People of Color women showed higher stress and lower resiliency. Single women were likely to report lower levels of mastery than partnered women. Conclusion: Stress, depression, and anxiety were high in postpartum women in this study. Income, partnered relationships, and employment security, along with protective traits such as mastery and resilience, may reduce the impact of stress on postpartum women in a pandemic. Care models should be modified to support women during a pandemic. Health disparities exist in postpartum stress. Future interventions should focus on building resiliency and mastery and ensuring appropriate resources are available to postpartum women in a pandemic.

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  • The incidence of postpartum depression increases with the number of children, particularly when the number of children in the household is elevated.

    “The extant literature documents that the incidence of postpartum depression increases with the number of children, particularly when the number of children in the household is elevated [38–40].”

    From Understanding mothers’ lived experiences of postpartum depression: a qualitative phenomenological study (2025) · cites this paper as [39]

    The Results report high levels of self-reported depression and an association with preterm birth, but do not relate depression to the number of children. Searches for household size, number of children, and parity found no passage addressing the claimed increase in postpartum depression. (LLM, conf=0.74)

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Authors
Mollard, E., Kupzyk, K., & Moore, T.
Affiliations
University of Nebraska Medical Center (US)
Corresponding author
Mollard, Elizabeth
ORCID
Venue
Women's Health
Publisher
SAGE Publications
Published
2021-01
Volume
17
Pages
17455065211042190-17455065211042190
ISSN
  • 1745-5057 (ISSN-L)
  • 1745-5065
DOI
10.1177/17455065211042190
PMC
PMC8414615
OpenAlex
W3196841448
Cited by
46
References
16
Citations by year
2026: 3 · 2025: 9 · 2024: 6 · 2023: 13 · 2022: 13 · 2021: 2
FWCI
7.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Women s Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Sigma Theta Tau International (Gamma Pi Chapter, Sister Patricia Miller Award)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
Keywords
postpartum stress, COVID-19 pandemic, postpartum depression, postpartum anxiety, resilience, mastery, protective factors, neonatal intensive care admission, income, employment status, BIPOC, health disparities, Perceived Stress Scale, Connor-Davidson Resilience Scale
MeSH terms
Psychological Distress, COVID-19, SARS-CoV-2, Adult, Anxiety, Cross-Sectional Studies, Female, Humans, Pregnancy, Surveys and Questionnaires, Risk Factors, Socioeconomic Factors, Stress, Psychological, United States, Depression, Postpartum, Postpartum Period, Resilience, Psychological, Pandemics, Protective Factors

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