UNC Health Talk

Pandemic Pregnancy: 6 Tips for Managing Stress

Being pregnant is never easy, and the coronavirus disease 2019 (COVID-19) pandemic brings new challenges to pregnant mothers, who are considered to be a high-risk group. This means that if infected, pregnant women are more likely to be hospitalized and require ventilation, and their risk of preterm birth increases.

Besides health concerns for mothers and their babies, many pregnant women are also worried about their loved ones, finances, trying to work and help educate their older children without their typical support system. So, it should come as no surprise that stress among pregnant women appears to have spiked since the beginning of the pandemic.

“We are absolutely seeing many more women, both pregnant and not pregnant, reporting anxiety, stress and depression since the pandemic started,” says Brian Brimmage, MD, an obstetrician who delivers babies at UNC REX Healthcare.

While some stress is normal and expected during pregnancy, research in the past decade has shown a relationship between stress in moms and a potential increased risk for both preterm birth and growth restriction for babies (meaning the baby is smaller than expected), Dr. Brimmage says.

“Like many things in pregnancy, we don’t know for sure about the effects of stress on mom and baby, so there is a lot of research in the area still underway,” Dr. Brimmage says. That said, “The vast majority of people who catch COVID do not get really sick, whether they’re pregnant or not. While it is something to be concerned about and something certainly to take very seriously, I think it is more detrimental than beneficial to spend all day worrying about it.”

Also, there is no evidence that COVID-19 infection during pregnancy directly impacts the growing fetus.

While the full effect of stress during pregnancy on the baby is still being explored, here are six things you can do to help manage stress and mitigate its effects on you and your baby during the COVID-19 pandemic.

1. Focus on what you can control.

Although you cannot control when the pandemic will end, you can control some of what goes on in your daily life, says UNC Health clinical psychologist Crystal Schiller, PhD.

This includes following your doctor’s recommendations on eating a healthy diet, drinking plenty of water and getting moderate exercise. Spend some time outside to enjoy fresh air and sunshine every day, which is good for your mental health, Dr. Schiller says.

Also take measures to keep yourself safe. Follow social distancing and hand hygiene guidelines, and wear a mask when leaving home or around anyone who doesn’t live with you.

2. Get a good night’s sleep.

Whether stress manifests itself in your dreams or keeps you from going to sleep in the first place, it can prevent your body and mind from getting the rejuvenating sleep that is so necessary for your whole health—especially when you are pregnant.

“Protect your sleep time,” Dr. Schiller says. “Many times, pregnant women also have other young children or toddlers, and toddlers are notorious for not sleeping well, which means moms often don’t sleep well either.”

Make a plan to help ensure you get proper rest—whether it’s getting some help in the night during toddler wake-ups or allowing yourself to take a daily nap, whenever possible.

3. Practice self-care.

Self-care is often defined as pampering ourselves—and it can be that—but it’s really about identifying and tending to your needs and includes practices that promote your general well-being.

“Self-care can look different for different people, but it’s anything that can make you feel good, such as having that little piece of chocolate after dinner, sipping your favorite tea, lighting a candle that smells really nice, getting a bath or taking a nap,” Dr. Schiller says. “It’s giving yourself permission to do things that maybe feel a little indulgent but could really be important for boosting your mood.”

4. Ask for help.

Another important aspect of self-care, especially during the prenatal period, is asking for help, Dr. Schiller says.

“Many women don’t feel like they have permission to ask for help. I think that a lot of the messages women get from the media and our culture are that they should be completely self-sufficient,” Dr. Schiller says. “Humans have never raised babies solo or in isolation. Humans have always thrived by working together.”

Try to find a way to feel comfortable asking for help and know that you don’t have to do it alone, even during the pandemic.

Identify a friend, neighbor or family member who can run errands for you or who you can call for advice about pregnancy or parenting.

“Having people in your network who are experienced parents can be a really tremendous resource,” Dr. Schiller says.

5. Set limits.

Plan now how to set limits with family members who want to see the newborn, which might not be safe when you give birth.

“Setting boundaries that are direct and clear but also in a way that’s kind and still warm is an important tool for women to have,” Dr. Schiller says. “Trust your own judgment and instincts, and then set limits around what you’re comfortable with in terms of exposure.”

If you have any questions about what is safe, ask your or your baby’s doctor. And then, communicate your boundaries with confidence and without apology—you’re just doing what’s best for your baby.

6. Talk to a mental health professional.

If your stress feels out of control and is interfering with your ability to function in daily life, or if you just could use some support managing your emotions, a mental health professional can help.

Therapy—alone or in combination with medication—can help you uncover the cause of your worries and fears, learn how to relax your body and give you the tools to manage your stress. If your doctor does recommend medication, know that there are options that are safe during pregnancy, Dr. Brimmage says.

“A lot of women are used to pulling themselves up by their bootstraps and doing what needs to be done, and we’re seeing that in mothers all across the country right now, who are being really hard-hit by the pandemic,” Dr. Schiller says. “I think that self-care is really important, but also mental health treatment is available if it just feels so painful or unworkable.”


For the latest information on COVID-19, visit the CDC website and the UNC Health COVID-19 Resources page, and follow UNC Health on Twitter, Facebook, Instagram and YouTube.