Midwife and lecturer Billie Bradford explains the impact stress can have on pregnant women and why support for low-income families is so important right now.
OPINION:The COVID-19 pandemic has turned our society upside down. It's a stressful time for everyone, and this stress and change is likely to impact pregnant women in New Zealand in many ways.
We know from research conducted during natural disasters that the resulting stress pregnant women experience can impact the foetus. It's unclear exactly what mechanism causes a foetus to be affected by stress, but it's believed to be caused by foetal programming.
In other words, exposure to stress during pregnancy leads to changes in foetal metabolism during development that can increase the risk of preterm birth, babies being small for gestational age, stillbirth, and developing obesity later in life.
Another possible mechanism contributing to these effects is behavioural changes in response to stress. For example, it's been shown that some pregnant women increase risk behaviours such as overeating, smoking, and alcohol or drug use in response to stress.
The social factors that contribute to stress for pregnant women during an event like this are often under-appreciated. Exposure to domestic violence, food insecurity, financial stress and relationship stress can all be harmful for pregnant women and their babies. Women are more likely to be victims of domestic abuse during pregnancy than at any other time in their lives and Women's Refuge has already reported more women seeking its support since the COVID-19 lockdown began.
As is often the case in healthcare, interventions can bring unwanted side effects. In the case of the current pandemic response in New Zealand, controlling the spread of the virus has meant pregnant women have been spared large-scale exposure to COVID-19 and the stress and grief of losing loved ones to the disease. However, the economic and social impact of the lockdown and economic downturn will have other effects, including increased exposure to financial hardship.
Some agencies supporting low-income families have reported access to food being a problem for many since the lockdown started. Low-income families will not have had the means to put aside extra groceries in the lead-up to the lockdown and are now more likely to be dealing with impacted jobs and income. Affordable sources of healthy food such as vegetable markets, hunting, fishing and sharing gathered and harvested food between family groups have all disappeared.
This will impact pregnant women and young families disproportionately. The Ministry of Health's report on maternity in 2017 showed that half of women giving birth in New Zealand that year were living in some of our poorest neighbourhoods.
As a society, any effort we can make to mitigate these financial pressures on low-income families will pay dividends in protecting the health and wellbeing of future generations. The government's efforts to reduce financial pressure on families are likely to prove essential in holding together the fabric of our society as we come through this pandemic.
For women who are pregnant at this time, maintaining a healthy diet and exercising are really important both for physical and mental wellbeing. Keeping up with regular antenatal appointments, routine blood tests and scans, as well as having a flu vaccination, are also important.
Those with a pregnant woman in their whānau or bubble, your support can help to reduce the effects of stress during this time. Try to use the time at home to prepare healthy meals, get your hapū māmā out for regular walks or other exercise, and help keep her space smoke-free.
The good news is international research has also shown good social support can reduce the harmful effects of stress on pregnant women. So to use the words of our prime minister, "be kind", especially to pregnant women. Your support makes a difference.
Billie Bradford is a midwife and a lecturer in the School of Nursing, Midwifery and Health Practice at Te Herenga Waka - Victoria University of Wellington.