Abstract
Background/Objective: The COVID-19 pandemic resulted in unprecedented societal changes globally and negatively impacted the psychosocial health of pregnant women. This study aimed to explore how direct, indirect, and unrelated factors associated with the COVID-19 pandemic influenced stress levels among pregnant women. Methods: This interpretivist qualitative study employed open-ended survey questions to capture the lived experiences of 313 pregnant women in the third trimester residing in Florida between January and March 2022, during the Omicron surge. Thematic analysis was conducted, guided by the Stress and Coping Theory and the Stress Buffering Theory. Results: Participants described a range of stressors directly and indirectly related to the COVID-19 pandemic that affected pregnant women. Themes related to increased stress were (1) fear, worry, and anxiety related to COVID-19 infection, (2) fear, worry, and anxiety related to preparedness for birth/baby due to pandemic restrictions, (3) prevention concerns associated with COVID-19, (4) lack of social support, (5) return to normalcy, (6) health-related social needs, (7) physical health issues, and (8) navigating conflict and grief. Conversely, stress-reducing factors were (1) preventive measures during the pandemic, (2) coping strategies, (3) not having to work, and (4) social support. Conclusions: Pregnant women experienced heightened stress due to a complex interplay of factors related directly or indirectly to the COVID-19 pandemic. It is important that maternity care, mental health and health-related social needs screenings and referrals, and tailored interventions are integrated into public health crises preparedness plans to limit the stress that pregnant women experience and support their well-being.