Why Addressing COVID-19 and Maternal Health Is Important
The COVID-19 pandemic is a historic and unprecedented public health crisis. COVID-19, short for “coronavirus disease 2019,” is caused by a novel (new) coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).  It is not yet well understood how this novel virus might affect women’s fertility, time during pregnancy, postpartum period, and life course. Therefore, the influence of factors such as sex, gender, race, ethnicity, and age on the virus requires great attention. In addition, the interaction between these factors and social determinants of health—conditions in environments where people are born, live, learn, work, play, worship, and age —must be considered. Recognizing the influence of these interactions on women’s health is necessary to ensure a holistic understanding of the disease and its effects. For example, not only should we seek to understand how women’s physical health is affected by the implementation of recommended public health guidelines for reducing viral transmission during this pandemic. We also should increase awareness about the effects of this pandemic on women’s mental health and the unintended consequences of adopting certain behavioral change techniques, particularly among the most vulnerable populations. As we continue to learn more about the nuances of this disease, it is critical for the scientific community and public to understand how the virus that causes it uniquely affects maternal health across the life course.
Understanding mental health needs during the pregnancy and postpartum periods is essential to the health of women. Researchers and clinicians should remain vigilant in addressing these same needs in the COVID-19 pandemic. Studies are being conducted to determine how public health guidelines recommended to help reduce transmission of the virus, such as social distancing and quarantining, have produced unintended mental health consequences among pregnant women. One study used the Pandemic-Related Pregnancy Stress Scale (PREPS) to assess COVID-19-related concerns among pregnant women by measuring three factors: (1) preparedness stress, (2) perinatal infection stress, and (3) positive appraisal.  Findings showed that nearly 22% of the surveyed population reported severe symptoms of anxiety, underscoring the need for increased focus on the stress levels of pregnant women during this pandemic.
In addition to increasing focus on mental health care and health outcomes, we must also continue to address and combat health inequities among our most vulnerable populations as we navigate this pandemic. Rampant health disparities across maternal health care and health outcomes already exist and are well documented. , ,  This disproportionate impact on underserved populations has prompted scientists and researchers to focus on how the COVID-19 pandemic may exacerbate these existing health disparities. Many are providing resources and developing materials that are necessary to address the reverberating effects of this pandemic.
This webpage provides current science-based information on COVID-19 and maternal health, highlighting research and key Federal resources; the National Institutes of Health (NIH) Office of Research on Women’s Health’s (ORWH) role in addressing the pandemic’s effects on maternal health; and NIH-wide efforts that incorporate consideration for maternal health in the pandemic response.
What We Currently Know
Below are links to a few key resources that share evidence-based insights and findings on pressing aspects of the COVID-19 pandemic.
- Adapting to the Pandemic: Protocol of a Web-Based Perinatal Health Study to Improve Maternal and Infant Outcomes
- How COVID-19 Affects Pregnancy
- ACOG and SMFM Recommend COVID-19 Vaccination for Pregnant Individuals
- Use of Electronic Medical Records to Estimate Changes in Pregnancy and Birth Rates During the COVID-19 Pandemic
- COVID-19 Vaccines While Pregnant or Breastfeeding
- NIH begins study of COVID-19 vaccination during pregnancy and postpartum
- Journal of National Medical Association, Pregnant in the United States in the COVID19 pandemic: a collision of crises we cannot ignore
- COVID-19 Vaccine Response in Pregnant and Lactating Women: A Cohort Study
- Prenatal Stress, Health, and Health Behaviours During the COVID-19 Pandemic: An International Survey
- Involving Pregnant Individuals in Clinical Research on COVID-19 Vaccines
- NIH Director’s Blog: Vast Majority of Pregnant Women with COVID-19 Won’t Have Complications, Study Finds
- NIH News Release: Severe COVID-19 in pregnancy associated with preterm birth, other complications
- JAMA Network Viewpoint: Involving Pregnant Individuals in Clinical Research on COVID-19 Vaccines
- Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report: Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020
- Journal of Maternal-Fetal and Neonatal Medicine: COVID-19 pandemic and maternal mental health: a systematic review and meta-analysis
The NIH Office of Research on Women’s Health’s Role
ORWH is committed to advocating for research that addresses the health of women across the life course and promoting research on underserved populations. Ensuring maternal health concerns are included in efforts responding to the COVID-19 pandemic is one of ORWH’s top priorities. ORWH is participating in the Rapid Acceleration of Diagnostics (RADx) initiative, one of the many NIH-wide efforts addressing the pandemic. RADx Underserved Populations (RADx-UP) is a two-phase, $500 million program focused on understanding factors associated with disparities in COVID-19 morbidity and mortality. Within this program, ORWH is co-funding projects such as “Social Stressors and Inflammation: A Mixed Methods Approach to Preterm Birth.” Another COVID-19 maternal health–related project co-funded by ORWH—though not a part of the RADx initiative—is a study titled “Availability, Accessibility, and Structure of Opioid Use Disorder Treatment and Maternal and Child Health Outcomes.” As our understanding of the effects of the disease grows, ORWH will continue to support community-engaged research projects, strengthen available data on disparities in infection rates, and identify strategies to reduce these disparities in COVID-19 diagnostics in underserved and vulnerable populations, such as pregnant women and postpartum women.
The National Institutes of Health’s Role
For a broader understanding of how NIH is responding to the COVID-19 pandemic—including treatments, vaccines, funding opportunities, and the NIH-Wide Strategic Plan for COVID-19 Research—visit the “NIH COVID-19 Research” website. This site contains up-to-date information about the agency’s key pandemic initiatives, such as RADx, Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV), and the Community Engagement Alliance (CEAL) Against COVID-19 Disparities. Also visit this page, which details NIH’s COVID-19 treatment guidelines for pregnant women, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s COVID-19 research webpage.
Additional Federal Resources on COVID-19 and Maternal Health
We’ve compiled a list of additional Federal resources that provide science-based information regarding COVID-19’s impact on maternal health.
- Federal COVID-19 Website
- Federal COVID-19 and Pregnancy FAQ
- CDC COVID-19 Webpage for Pregnant Women and Mothers of Young Children
- CDC’s “Investigating the Impact of COVID-19 during Pregnancy” Webpage
- The Health Resources and Services Administration’s Coronavirus Disease (COVID-19) Maternal and Child Health Bureau FAQ
 Centers for Disease Control and Prevention. (2020, September 1). About COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/about-COVID-19.html
 U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. Social determinants of health. Retrieved January 4, 2021, from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health.
 Preis, H., et al. (2020). Social Science & Medicine. PMID: 32927382.
 Petersen, E. E. et al. (2019). Morbidity and Mortality Weekly Report. PMID: 31487273.
 Agrawl, P. (2015). Bulletin of the World Health Organization. PMID: 25838608.
 Centers for Disease Control and Prevention. (2019, May). Pregnancy-related deaths: saving women’s lives before, during and after delivery. https://www.cdc.gov/vitalsigns/maternal-deaths/index.html