(PS1-A1) The Unexpected Outcome of Expecting: First Time Motherhood in the covid-19 Pandemic

The COVID-19 pandemic has placed many expectant first-time mothers at risk for adverse mental and physical health outcomes through increased social isolation, and by exacerbating stress, anxiety and depression (Caparros-Gonzalez & Alderderdice, 2020; Berthelot et al., 2021). Even pregnant women without pre-existing mental health conditions are at increased risk of developing mental health symptoms during the COVID-19 pandemic (Liu et al., 2021). The current study sought to understand expectant first time mothers COVID-19 related fears, as well as the role of negative emotional states on maladaptive attitudes toward motherhood. Pregnant first time mothers (n = 56) were recruited in the early stages of the pandemic (June 2020) via Amazon MTurk. More than half of the sample 55.4%) reported being 20 weeks gestation or less and expectant first-time mothers were on average 28.8 years (SD =3.2) old. Expectant first-time mothers provided qualitative and quantitative reports on their experience of COVID-19, anxiety, depression and stress symptoms, as well as their attitudes towards motherhood. Inductive thematic analysis of open-ended responses to a prompt inquiring about an important and worrisome problem related to being pregnant during the COVID-19 pandemic revealed difficulties accessing healthcare services when needed (18%), worries about the impact of COVID-19 on self and fetus (18%), and isolation (12.5%) as prominent fears. Linear regression analyses indicated that higher levels of anxiety in the past seven days predicted more maladaptive attitudes towards motherhood (b = 1.12, p = .001). Surprisingly, higher levels of depressive symptoms predicted more adaptive attitudes toward motherhood (b = -.55, p = .048), which may be indicative of depressive realism (i.e. more accurately interpreting reality on account of being depressed). Taken together, our results indicate that expectant first time mothers have specific COVID-19 related fears. Their symptoms of maternal anxiety are associated with maladaptive maternal cognitions, possibly exacerbating perinatal and postpartum distress. Given the uncertainty of the pandemic and its ever evolving trajectory, it is imperative that clinicians are attuned to and address pregnant first time mothers’ existential anxieties and their associations with maladaptive cognitions about motherhood (e.g. “If I fail at motherhood, then I am a failure as a person”). Clinicians should encourage first time mothers to develop tolerance for the uncertainty, as well as help clients reframe adverse thoughts or experiences relating to pregnancy during the pandemic.