Aazh H, Moore BC. Usefulness of self-report questionnaires for psychological assessment of patients with tinnitus and hyperacusis and patients' views of the questionnaires. Int. J. Audiol. 2017; (7)489-498

Alzamora MC, Paredes T, Caceres D, Webb CM, La Rosa Valdez LM Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol. 2020; 37:(8)

Birth in a pandemic: ‘You are stronger than you think’. 2020. (accessed 3 April 2020)

Dashraath P, Wong J, Lim M, Lim M, Li S, Biswas A, Choolani M, Mattar C, Su L. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstetr Gynecol. 2020; 222:(6)521-531

Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, Vecchiet J, Nappi L, Scambia G, Berghella V, D'Antonio F. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. 2020; 2:(2)

García González J, Ventura Miranda MI, Requena Mullor M, Parron Carreño T, Alarcón Rodriguez R. Effects of prenatal music stimulation on state/trait anxiety in full-term pregnancy and its influence on childbirth: a randomized controlled trial. Journal of Maternal-Fetal and Neonatal Medicine. 2018; 31:(8)1058-1065

Gimbel LA, Blue NR, Allshouse AA, Gimbel B, Silver RR. Pregnancy outcomes and anxiety in nulliparous women [30E]. Obstet. Gynecol. 2020; 135:57S-58S

Huizink AC, Mulder EJ, de Medina GPR, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome?. Early Hum Dev. 2004; 79:(2)81-91

Kotabagi P, Fortune L, Essien S, Nauta M, Yoong W. Anxiety and depression levels among pregnant women with COVID-19. Acta Obstetricia et Gynecologica Scandinavica. 2020; 99:(7)953-954

Krusche A, Crane C, Dymond M. An investigation of dispositional mindfulness and mood during pregnancy. BMC Pregnancy Childbirth. 2019; 19:(1)

Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, Lu Y, Wang S, Xia L, Huang L, Wang K. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. 2020;

Madhavanprabhakaran GK, D'Souza MS, Nairy KS. Prevalence of pregnancy anxiety and associated factors. IJANS. 2015; 3:1-7

Mappa I, Distefano FA, Rizzo G. Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study. J Perinat Med. 2020; 48:(6)545-550

Newham JJ, Westwood M, Aplin JD, Wittkowski A. State–trait anxiety inventory (STAI) scores during pregnancy following intervention with complementary therapies. J Affect Disorders. 2012; 142:(1-3)22-30

Prescott J, Mackie L. ‘You sort of go down a rabbit hole … you're just going to keep on searching’: a qualitative study of searching online for pregnancy-related information during pregnancy. J Med Internet Res. 2017; 19:(6)

Rathbone AL, Prescott J. Pregnancy-specific health anxiety: symptom or diagnosis?. Br J Midwifery. 2019; 27:(5)288-293

Royal College of Obstetricians and Gynaecologists. Coronavirus infection and pregnancy. 2020. (accessed 3 April 2020)

Salkovskis PM, Rimes KA, Warwick HMC, Clark DM. The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med. 2002; 32:(5)843-853

Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020; 1:(7)799-805

Shagufta S, Shams S. Prevalence, differences, and predictors of anxiety and depression among pregnant and non-pregnant women in Peshawar Khyber Pakhtunkhwa Pakistan. FWU Journal of Social Sciences. 2019; 13:(1)167-176

Simpson W, Glazer M, Michalski N, Steiner M, Frey BN. Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period. Can J Psychiatry. 2014; 59:(8)434-440

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166:(10)1092-1097

Stoll K, Swift EM, Fairbrother N, Nethery E, Janssen P. A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth. Birth. 2018; 45:(1)7-18

Tendais I, Costa R, Conde A, Figueiredo B. Screening for depression and anxiety disorders from pregnancy to postpartum with the EPDS and STAI. 2014;

UK Government. Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19. 2020a. (accessed 3 April 2020)

UK Government. (COVID-19) Coronavirus restrictions: what you can and cannot do. 2020b. (accessed 12 May 2020)

Pregnancy in a pandemic: generalised anxiety disorder and health anxiety prevalence

02 August 2021
Volume 29 · Issue 8


Anxieties can be typical to pregnancy. At the beginning of the COVID-19 outbreak, pregnant women were classified as at risk and advised to shield. This may have caused increased generalised anxiety disorder and health anxiety across the demographic. This study aimed to explore current, actual and perceived levels of generalised anxiety disorder and health anxiety in pregnant women during the COVID-19 outbreak. A sample of 674 participants completed an online questionnaire consisting of demographic and pregnancy related questions, the GAD-7 and HAI. The COVID-19 outbreak has increased self-reported levels of general anxiety and health anxiety in pregnant women. Of the sample, 633 (94%) agreed that the outbreak had increased their general anxiety; 607 (90.1%) also reported increased health anxiety. Due to the negative effects that anxieties may cause during pregnancy, it is recommended that reintroducing normality to pre- and postnatal healthcare, where safe to do so, will be beneficial.

COVID-19 is the abbreviation for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Primarily documented as ‘pneumonia of an unknown cause’ (World Health Organization, 2020), the COVID-19 outbreak was declared a pandemic in early March 2020. This announcement caused governing bodies to classify those with underlying health issues as being ‘at risk,’ essentially meaning more susceptible to adverse outcomes following infection. Initially in the UK, only ‘women who are pregnant with significant heart disease, congenital or acquired’ (UK Government, 2020a) were considered at risk. Following this, all pregnant women were categorised as being at risk (Alszewski, 2020). This did not mean that there was evidence to suggest that COVID-19 is any more contractible during pregnancy. The decision was made as a precautionary measure as pregnancy can alter the physiological response to severe viral infections (Royal College of Obstetricians and Gynaecologists, 2020).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month