Women with COVID-19 Report Higher Levels of Pain During Delivery

Women who gave birth during the pandemic and were positive for COVID-19 at the time of delivery were more likely to have a traumatic birth experience and higher levels of pain than those who did not have COVID-19, a recent study found. Traumatic birth can lead to post traumatic stress disorder, depression and trouble with early mother-infant bonding. In the United States, an estimated 3.7 million women gave birth in 2020, and a portion of those women had the coronavirus during delivery. In the early months of the pandemic in New York City, for example, an estimated 9-15% of birthing mothers were infected. 

As hospitals canceled non-essential procedures and dedicated more resources and space to COVID-19 treatment, pregnant women continued to access medical care. Often, they were alone at appointments and, in some cases, during delivery. The multi-institutional study sought to understand the physical and psychological impacts of giving birth with a highly transmissible virus and the unique stressors that will impact this generation of mothers and babies. The study included 2,344 women who were an average of two months postpartum, most of whom had given birth during April or May 2020. Sixty-eight had a suspected or confirmed positive COVID-19 infection during pregnancy and/or birth with varying symptom severity, and the remaining 2,276 were negative. The study accounted for various background factors including demographic information, prior births, prior birth-related trauma and complications, and mental health history. The women completed an anonymous survey and answered questions about their labor, birth and postpartum experiences. The survey included a Peritraumatic Distress Inventory, or PDI, which is a questionnaire used to measure distress during or shortly after a traumatic event. The results found that COVID-19 positive women were twice as likely to experience acute, clinical levels of stress and higher pain levels during birth than COVID-19 negative women. Their babies were also more likely to be admitted to the neonatal intensive care unit. 

The researchers theorize that the increased stress response, pain and NICU admissions could be from a number of factors, including fear of transmitting the virus to the infant, a lack of support during labor and delivery due to visitor restrictions, or being separated from their newborn after birth. The research to understand maternal and neonatal outcomes during the pandemic is ongoing.