Perinatal Experiences Research Articles

P2 - Nurturing human potential from the beginning of life. A case report of prenatal bonding

The value of prenatal bonding is so well established in the literature that pregnant women cannot be considered passive incubators anymore. Robust scientific evidence continues to reveal that expectant women significantly influence the health and wellbeing of the unborn baby through the extensive release of hormones and neurotransmitters that will determine different behaviours throughout life. This case report describes a 40-year-old woman’s journey from pre-conception to motherhood and explores how the pre and perinatal psychology paradigm might have influenced the quality of her prenatal bonding and attachment with her unborn baby. In drawing on her story, ways in which health care providers can support expectant parents’ connection with the baby from conception on are highlighted. It is proposed that this unique relationship during pregnancy offers health care providers with a unique opportunity to help create an optimal fetal environment that may echo across their future lifespan. It was concluded that awareness and acknowledgement of the expectant baby’s presence enhances the prenatal bonding and establishes emotional connections between the parents and the expectant baby.

P47 - Practical application of birth psychology principles in a newborn of extreme prematurity. A case report

Even though most Neonatal Intensive Care Unit (NICU) staff members mainly focus on the physical and medical wellbeing of preterm babies; it is generally the parents who recognise and acknowledge that they do respond to their parent’s stimulus in a positive manner. Newborn babies are born with visual, auditory and comfort preferences. They also have the ability to learn and remember. This case report aims to describe parents’ active involvement in the care of their extreme preterm newborn during the hospital stay in the NICU. A 40-year-old pregnant woman Gravida 1, Para 0 had a preterm premature rupture of membranes (PPROM) at 23+4 weeks of gestation. Corticosteroid therapy for fetal lung maturation was provided along with intravenous antibiotics. On ultrasound the cervix was dilated, the birth was imminent, and the fetus was in a footling breech presentation. Instrumental birth (forceps) was performed and the newborn’s birth weight was 770 g, Apgar score at 1, 5 and 10 mins of life were 1/3/5. They were subsequently transferred to a tertiary hospital where the newborn received ongoing intensive care for four months. The Pre and Perinatal Psychology paradigm provided the newborn parents with evidence-based strategies that empowered them to actively care and advocate for the baby’s recovery. This case report highlights practical applications of birth psychology that offer a new perspective for all health care professionals working with babies regardless of the context.

Perspectives on cultural competency and race concordance from perinatal patients and community-based doulas.

As awareness of perinatal health disparities grows, many birthing people of color are seeking racially and/or culturally concordant providers. We described preferences for, and perceptions of, racial and/or cultural concordance and cultural competence in the context of the doula-client relationship. Seven focus group discussions (FGDs) with a total of 27 participants were conducted to investigate the perspectives of patients and doulas across Massachusetts, United States. An interdisciplinary stakeholder group informed the data collection instrument content and design. Two coders achieved 0.89 Kappa for inter-rater reliability prior to coding the remaining transcripts. We used a modified grounded theory approach and Dedoose software for coding. Two major themes emerged. First, cultural competency in doula care is a learning process, with definitions consistent with terms such as "cultural humility" and "structural competency." Doulas discussed listening to clients' needs rather than making assumptions, the importance of understanding privilege and power dynamics, and self-initiating relevant education beyond formal doula training. Second, trust was most frequently cited as an indicator of successful doula-patient relationships. Most study participants specified the importance of cultural humility in doula-client relationships. Doulas approaching the relationship humbly with a willingness to learn and challenge their own assumptions-regardless of the level of concordance-can make a meaningful impact on the perinatal experience.

Patient-centered perinatal palliative care: family birth plans, outcomes, and resource utilization in a diverse cohort

Perinatal palliative care is an emerging concept in fetal medicine that offers quality-of-life options and anticipatory grief management for families of fetuses with complex conditions. Few perinatal palliative care outcomes are detailed in peer-reviewed literature. This study aimed to describe outcomes of perinatal palliative care at the Fetal Center of the University of Texas Health Science Center at Houston and Women's Center at Children's Memorial Hermann Hospital. This was a retrospective cohort of families receiving perinatal palliative care for life-limiting fetal diagnosis, such as trisomy 13 or 18 and some major structural anomalies between 2016 and 2020. The primary outcome was whether delivery events matched families' birth plans, including fetal/neonatal clinical course matching expectations described by consultant notes. Secondary outcomes included maternal safety outcomes, use of perinatal interventions, delivery outcomes, and resource utilization outcomes. Of 187 perinatal palliative care consults, delivery events matched families' plans and clinicians' expectations in 89% of cases (165/185); 39% (73/187) of families requested some perinatal interventions, 64% of whom planned postnatal comfort care even while choosing antenatal interventions. Demographics and median income were similar between families who chose some interventions and those who chose comfort care. Patients choosing any interventions had more mismatches between their plans and delivery events (19% vs 2%; P<.001), were more likely to change their plans (24% vs 6%; P=.001), and unsurprisingly used more healthcare resources. They were also more likely to have intraamniotic infection or postpartum hemorrhage (9% vs 22%; P=.02), but this was associated with mode of delivery and not choice of interventions. Most families' perinatal experiences matched birth plans and expectations in this perinatal palliative care program. Families who desired interventions used more healthcare resources, but often did so with plans for postnatal comfort care, demonstrating insight into neonatal prognosis but achieving value-consistent goals, such as meeting a live neonate. Perinatal palliative care was safe for maternal patients and equitable across racial, ethnic, and income groups. Perinatal palliative care and some perinatal interventions are options for care of the whole family in complex fetal medicine cases.

'They Sent Me Out to School, and I Came Back with a Baby': Perinatal Women's Experiences of Biographical Disruption and Nonfatal Suicidal Behaviour.

Exploring perinatal women's experience of nonfatal suicidal behaviour (NFSB) could help illuminate the contexts in which perinatal suicide occurs and new ways to conceptualise maternal suicide prevention. Our aim was to explore perinatal women's subjective experience of NFSB in South Africa. Data were collected via in-depth interviews with seven perinatal women hospitalised following NFSB. Thematic analysis showed how poverty and gender norms shape experiences of pregnancy and highlighted the need for eco-systemic interventions for perinatal women in resource scarce environments to increase social support, assist with childcare, improve educational retention, challenge gender norms and increase paternal involvement. Pregnancy can precipitate biographical disruption by disturbing women's view of themselves and their futures. An inability to reconstruct a coherent narrative and re-imagine the future impedes the transition to motherhood and provides a context for suicide. Using the concept of biographical disruption to frame perinatal suicide, could identify novel approaches to suicide prevention.

New Parent Support Needs and Experiences with Pediatric Care During the COVID-19 Pandemic.

ObjectivesDespite evidence for heightened psychiatric risk and unique parenting challenges during the COVID-19 pandemic, no research exists on the specific needs of parents of infants and responsiveness of pediatric care to their needs. We aimed to describe the support needs of new parents and explore their experiences with pediatric care.MethodsIn late 2020 we conducted semi-structured interviews with 30 mothers of babies born or due that year. Interviews addressed perinatal experiences during the pandemic, with an emphasis on experiences related to social support. In an iterative, inductive process, thematic analysis was used to analyze the data.ResultsThis study identifies a set of support needs specific to the context of parenting an infant during the COVID-19 crisis: coping with the compound psychological impacts of the postpartum period and a pandemic; parenting in the absence of expected social support; risk assessment to keep infant and family safe. This study finds that policies implemented by health care providers to reduce risk of COVID-19 transmission came at a cost to new parents and parent-provider relationships. Participants reported mixed experiences with in-person and telehealth pediatric care, including inadequate and/or uncomfortable postpartum mental health screening and breastfeeding support, and identified specific features that constituted responsive care during the pandemic.ConclusionsNormative changes associated with the postpartum period combined with complex adaptations necessitated by the COVID-19 pandemic presented substantial challenges for families with infants, even relatively privileged families. Providers can incorporate these findings to enhance support for families and promote maternal and child health.

Giving Birth in the Early Phases of the COVID-19 Pandemic: The Patient Experience.

ObjectiveObstetrical patients are at risk of complications from COVID-19 and face increased stress due to the pandemic and changes in hospital birth setting. The objective was to describe the perinatal care experiences of obstetrical patients who gave birth during the early phases of the COVID-19 pandemic.MethodsA descriptive epidemiological survey was administered to consenting patients who gave birth at The Ottawa Hospital (TOH) between March 16th and June 16th, 2020. The participants reported on prenatal, in-hospital, and postpartum care experiences. COVID-19 pandemic related household stress factors were investigated. Frequencies and percentages are presented for categorical variables and median and interquartile range (IQR) for continuous variables.ResultsA total of 216 participants were included in the analyses. Median participants age was 33 years (IQR: 30–36). Collectively, 94 (43.5%) participants felt elevated stress for prenatal appointments and 105 (48.6%) for postpartum appointments because of COVID-19. There were 108 (50.0%) were scared to go to the hospital for delivery, 97 (44.9%) wore a mask during labour and 54 (25.0%) gave birth without a support person. During postpartum care, 125 (57.9%) had phone appointments (not offered prior to COVID-19), and 18 (8.3%) received no postpartum care at all.ConclusionCOVID-19 pandemic and public health protocols created a stressful healthcare environment for the obstetrical population where many were fearful of accessing services, experienced changes to standard care, or no care at all. As the pandemic continues, careful attention should be given to the perinatal population to reduce stress and improve continuity of care.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10995-022-03495-2.

Pregnant and Postpartum Patients' Views of COVID-19 Vaccination.

Perinatal patients were faced with the decision to receive a COVID-19 vaccination in the absence of clinical trial data on COVID-19 vaccine safety and efficacy in pregnant and lactating patients. We used the Coronavirus Perinatal Experiences Impact Survey to explore the impact of the COVID-19 pandemic on the lives of perinatal patients. The mixed-method survey was distributed to all patients ≥ 18 years old who were pregnant between January 1st, 2020 – April 28, 2021 at a large academic health system in the upper Midwest. Open-ended responses were qualitatively analyzed. Of the 1182 respondents who completed the survey, 647 answered at least one open-ended question. Among these 647 participants, 85 discussed COVID-19 vaccination and were secondarily analyzed. The responses illustrated a wide range of perspectives regarding COVID-19 vaccination, with many citing concerns over the consequences of maternal vaccination on their child. Others highlighted the lack of information surrounding COVID-19 vaccination in perinatal women. Respondents also discussed challenges discussing their vaccination status with their healthcare provider and the impact of family member’s vaccination decisions on postpartum support and childcare. The unprompted discussion of concerns about COVID-19 vaccination suggests this decision weighed on many participants, especially in the context of lack of information early in the pandemic. Our findings support the need for open discussion of perinatal patients with their providers on COVID-19 vaccination during the pregnancy and postpartum period.

The Trauma of Perinatal Loss: A Scoping Review

Perinatal loss, the loss of a fetus or neonate between conception and 28 days after birth, is a worldwide phenomenon impacting millions of individuals annually. Whether due to miscarriage, stillbirth, life-limiting fetal diagnoses, or neonatal death, up to 60% of bereaved parents exhibit symptoms of depression, anxiety, and posttraumatic stress disorder. Despite the high prevalence of posttraumatic stress symptoms, perinatal loss is not framed using a trauma lens. The purpose of this scoping review is to gain insight into the trauma within the perinatal loss experience.

Context Matters: A Qualitative Study About the Perinatal Experiences of Latina Immigrant Women.

Although immigrants' health is better compared to their native-born counterparts, their wellbeing starts to deteriorate as they spend more time in the United States. To date, few qualitative studies investigate how migration can influence the perinatal period. This study qualitatively assesses Latina immigrant mothers' perinatal experiences. Thirty Latina women were recruited in 2015 to participate in interviews, all of which were conducted in Spanish. The data were analyzed using thematic analysis. Latina mothers' experiences during the perinatal period were impacted by the cultural expectations that may or may not depend on the context where they are located. Context-independent themes included: (1) Cravings and (2) Body dissatisfaction. Context-dependent themes included: (1) Breastfeeding and (2) Loss of extended social ties. In order to reduce health disparities in the perinatal period among Latina immigrant mothers and their children, it is necessary to provide interventions that promote healthy behaviors and increase social capital and peer support.

Latent class analysis of health, social, and behavioral profiles associated with psychological distress among pregnant and postpartum women during the COVID-19 pandemic in the United States.

BackgroundThere is a growing body of literature documenting negative mental health impacts from the COVID‐19 pandemic. The purpose of this study was to identify risk and protective factors associated with mental health and well‐being among pregnant and postpartum women during the pandemic.MethodsThis was a cross‐sectional, anonymous online survey study distributed to pregnant and postpartum (within 6 months) women identified through electronic health records from two large healthcare systems in the Northeastern and Midwestern United States. Survey questions explored perinatal and postpartum experiences related to the pandemic, including social support, coping, and health care needs and access. Latent class analysis was performed to identify classes among 13 distinct health, social, and behavioral variables. Outcomes of depression, anxiety, and stress were examined using propensity‐weighted regression modeling.ResultsFit indices demonstrated a three‐class solution as the best fitting model. Respondents (N = 616) from both regions comprised three classes, which significantly differed on sleep‐ and exercise‐related health, social behaviors, and mental health: Higher Psychological Distress (31.8%), Moderate Psychological Distress (49.8%), and Lower Psychological Distress (18.4%). The largest discriminatory issue was support from one's social network. Significant differences in depression, anxiety, and stress severity scores were observed across these three classes. Reported need for mental health services was greater than reported access.ConclusionsMental health outcomes were largely predicted by the lack or presence of social support, which can inform public health decisions and measures to buffer the psychological impact of ongoing waves of the COVID‐19 pandemic on pregnant and postpartum women. Targeted early intervention among those in higher distress categories may help improve maternal and child health.

Is There a Need for Trauma-Informed Care in the Perinatal Population?

Research has shown that 20% to 33% of women have endured some form of sexual abuse–assault (SA), and many of these women have given birth later. Some of these women have reported increased anxiety, feelings of loss of control, lack of support, and retraumatization during childbirth. Negative feelings associated with childbirth can lead to increased postpartum depression, lower patient satisfaction scores, and elective changes in providers–birthing centers for future pregnancies. Many obstetric providers are unaware of the negative effect that a history of SA can have on a woman’s perinatal experience.

Perinatal support for couples during COVID-19: A descriptive qualitative study.

To explore the perspectives of parents during the perinatal period amid the COVID-19 pandemic and explore the experiences of Singaporean parents receiving perinatal support via the Supportive Parenting App (SPA). The stressors accompanying parenting responsibilities often affect the overall well-being of the family unit. With the emergence of the COVID-19 pandemic, Singaporean parents are forced to shoulder childcare responsibilities with minimal support due to safety restrictions. The Supportive Parenting Application (SPA) was introduced to parents during the start of the pandemic to offer timely additional support. It is a mobile health application-based educational support for parents across the perinatal period, consisting of features such as peer support, expert advice and discussion forums. Descriptive qualitative study. Semi-structured one-to-one interviews were conducted with 33 parents (16 from the control group, 17 from the intervention group) in an ongoing randomised controlled trial between June 2021 and February 2022. The COREQ checklist was used to guide the reporting of the data. Four themes with 10 subthemes describing the perinatal experiences of parents were identified. The themes include 'Ups and downs' of parenting experiences; Perinatal care from 'best care' to 'flying blind'; What kept couples going and Use of technology-a way forward. Although COVID-19 negatively affected parents' availability of care and support, most could still access other support sources to help them. Additionally, the SPA was found to be a dependable information source for the intervention group parents. Future research could work on improving technology-based support based on the feedback given to offer better quality perinatal care for parents. Technology-based support provided by healthcare professionals helps provide reliable perinatal information and support for parents. More efforts should be directed towards developing quality informational resources and support to improve perinatal care. Patients/members of the public contributed to the data collected and were involved in member checking to ensure the rigour of the study. NHG DSRB: 2019/00875.

P-502 Trans and/or non-binary (TNB) parents’ experiences during the perinatal period

Abstract Study question What are the experiences of trans and/or non-binary (TNB) parents during the perinatal period (defined here as conception, pregnancy, birth and infant feeding)? Summary answer TNB parents often experience extensive cisgenderist discrimination at a structural level (via inappropriate legislation and bureaucracy) and an interactional level (from other parents/healthcare professionals). What is known already Although TNB people have always parented, it is only recently that their experiences are becoming more socially visible. Some research has explored the pregnancy experiences of trans men, finding that men report feelings of isolation and find it difficult to integrate pregnancy with a male identity. However, little research has explored the perinatal experiences of non-binary parents and TNB non-birth parents. Additionally, preliminary research in the US suggests that TNB parents report negative experiences within fertility clinics, and that some parents deliberately avoid clinics for fear of discrimination, pointing to the importance of studying parents’ experiences in the UK. Study design, size, duration This presentation will focus on interview data collected in a study of UK TNB parents, all of whom had identified as TNB since before having their child. Participants were recruited via social media/snowballing. 13 TNB parents were interviewed in total. This presentation will focus on the experiences of the 10 parents who had become parents via assisted conception at a fertility clinic (n = 5), unassisted conception (n = 4) and known donation (n = 1). Participants/materials, setting, methods Participants had a range of gender identities, including trans women, trans men and non-binary. Six participants had experienced pregnancy. The sample is diverse in terms of SES, family structure, and four parents were experiencing disabilities. Participants took part in a semi-structured interview. The data were analysed using reflexive thematic analysis, and a structural symbolic interactionist framework was employed. Main results and the role of chance Cisnormative understandings of bodies (i.e. men producing sperm and women being pregnant) were found to impact participants in both fertility clinics and pregnancy spaces. Parents with different gender identities (e.g. trans men, non binary people and trans women) had different experiences, pointing to the importance of including all parents under the TNB umbrella within research. In terms of conception, some participants reported avoiding fertility clinics due to fear of discrimination, and one participant described being denied treatment due to their gender identity, disability and being in a multi-parent family. Negative experiences within fertility clinics included clinicians’ lack of knowledge about TNB identities, and more positive experiences were reported when participants conceived outside of a clinical setting. With regards to pregnancy, birth parents reported that pregnancy/birth was assumed to be a female activity, and that services were often exclusively for cis women. Birth parents used the strategy of detachment to navigate pregnancy and infant feeding. The trans women in the study, as non-birth parents, were often assumed to be fathers, and reported feeling excluded in pregnancy spaces. One trans female participant found breastfeeding to be a gender-affirming experience, pointing to the importance of supporting TNB parents to explore all available options. Limitations, reasons for caution The small sample size and qualitative nature of the research limits the generalisability of the findings. Although diverse in other ways, the sample was majority white and more research is needed on the experiences of ethnic minority parents. Wider implications of the findings Findings show the importance of including TNB parents with diverse gender identities within research, and demonstrate the necessity of education about trans-inclusive language and family diversity within fertility clinics and pregnancy spaces. Trial registration number n/a

A Trauma-informed Approach to Postpartum Care.

Distressing or traumatic perinatal experiences and adverse health outcomes can lead to particularly challenging postpartum experiences for patients and families. By adopting a trauma-informed care approach, the health care team can provide much-needed support, prevent additional harm, and promote healing. We propose practical communication, behavioral, and procedural considerations for integrating trauma-informed care principles into routine postpartum care, with attention to populations that have been marginalized. We see postpartum care as a critical component of holistic patient recovery and an opportunity to facilitate posttraumatic growth so that all families can thrive.

American Indian Motherhood and Historical Trauma: Keetoowah Experiences of Becoming Mothers.

Background: American Indian/Alaskan Native (AI/AN) women disproportionally experience postpartum depression in the United States as compared to the rest of the population. Despite being disproportionately represented, the current body of knowledge lacks research on depression in this particular population. Specifically, the current literature lacks research pertaining to the experiences of postpartum AI/AN women, their culture, birthing and mothering expectations, and trauma. This qualitative study used the theories of becoming a mother, historical-trauma framework, and reproductive justice as they relate to Indigenous women’s personal and historical trauma to assess their lived experiences of becoming a mother. Methods: Keetoowah mothers (N = 8) were interviewed by using a story inquiry method to understand the perinatal experiences of members of one Indigenous tribe in the US. Findings: The story inquiry coding resulted in two main themes, namely maternal mental health challenges and inadequacies of perinatal care. Conclusion: The subthemes illuminate the intersection of historical trauma and the perinatal experience, continued colonization of mothering, and the resilience of tribal culture during the postpartum period. Implications include advocacy for increasing culturally derived perinatal interventions, increased healthcare coverage of culturally appropriate birthing practices, and future research evaluating the correlation between historical trauma and maternal mental health challenges.

Experiences With Antenatal Care, Breastfeeding Education, and Employment During the COVID-19 Pandemic: Perspectives From Mothers and Healthcare Workers in Kenya

ObjectivesThe impact of the COVID-19 pandemic on breastfeeding practices in low and middle-income countries is not well understood. Modifications in breastfeeding guidelines and delivery platforms for breastfeeding education are hypothesized to have affected breastfeeding practices during the COVID-19 pandemic. We aimed to understand the experiences with perinatal care, breastfeeding education and practice among mothers who delivered infants during the COVID-19 pandemic. MethodsWe conducted key informant interviews among 35 mothers with deliveries since March 2020 and 10 healthcare workers (HCW) from two public health facilities in Naivasha, Kenya. ResultsMothers described COVID-related income loss and lack of support from family and friends as a worse challenge to practicing EBF as they wished or planned. While mothers noted that HCWs provided quality care and breastfeeding messaging, one-on-one perinatal breastfeeding education was cited to be less frequent than before the pandemic due to altered conditions in health facilities and COVID safety protocols. Knowledge among mothers about the safety of breastfeeding in the context of COVID was limited, with few key informants reporting of specific receipt of information such as COVID transmission through human milk and the safety of nursing during a COVID infection. Mothers stated that some HCW messages emphasized the immunologic importance of BF. COVID restrictions limited or prevented familial support at facilities and home, causing stress and fatigue for mothers. In some cases, mothers noted income loss due to furloughs and layoffs, time spent seeking new means of employment, and food insecurity as causes for perceived milk insufficiency, which was, in turn, connected to introducing weaning foods and liquids before six months. ConclusionsThe COVID-19 pandemic created changes to the perinatal experience for mothers. While messages the importance of practicing exclusive breastfeeding were provided, altered HCW education delivery methods, social support and food insecurity limit EBF practices in for mothers in this context. Mothers lacked consistent knowledge about the safety of breastfeeding in the context of COVID-19. Funding SourcesNational Institutes of Health Fogarty International Center.

New life, new feelings of loss: Journaling new motherhood during Covid-19

In this article we analyze the longitudinal journals of 32 Pandemic Journaling Project (PJP) participants who were pregnant, planned a pregnancy, or gave birth between January 2020 and July 2021. Employing a grounded theory approach, we coded journals in NVivo for emerging themes related to the influence of the Covid-19 pandemic on perinatal experiences in North America and Europe. In the paper we first provide some brief background on perinatal mental health and on the particular conditions for pregnancy and birth during Covid-19, before introducing major themes that emerged from the data, along with three in-depth case studies. We argue that the new mothers and prospective mothers in our sample associated new life with new feelings of loss during Covid-19. New motherhood during Covid-19 has meant for PJP participants a loss of seemingly irretrievable opportunities and moments that they see as necessary for establishing themselves as mothers and integrating their babies into their families through a process of “kinning” (Howell, 2003). Feelings of loss associated with disruptions to kinning may be partially responsible for the increase in perinatal mental distress observed during the pandemic.

Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk Implications.

While pregnancy presents a strong motivation to seek and comply with treatment for opioid use disorder (OUD), many women relapse within the first year of childbirth. Addressing relapse risk, we examined the perinatal experiences of mothers with OUD through 6 months postpartum. We recruited mothers (N = 42) with a history of OUD into the Newborn Attachment and Wellness study, all of whom met with a child welfare worker immediately after giving birth. In qualitative interviews, mothers described their social, physical, emotional, and psychological perinatal experiences. Seven themes categorically informed relapse risk (i.e., related to childhood bond, mother-infant attachment, birth support, child protective services, breastfeeding, mental health, and recovery planning). In conclusion, we noted a critical window in which clinical social workers and other health/behavioral health providers have the opportunity to capitalize on mothers' desire not to “ever want to touch it again." We outline specific avenues for directed support in the perinatal and postpartum period associated with reduced risk for relapse, and we make recommendations to enhance risk assessment practices.

Subjective social status, COVID-19 health worries, and mental health symptoms in perinatal women

Pregnant women and those who have recently given birth are considered an at-risk population during the COVID-19 pandemic with regards to the impact of both general stress and pandemic-related stressors. The extent to which subjective social status (SSS), one's perception of relative standing compared to others in a social hierarchy, might mitigate the effects of COVID-19-related health worries on mental health has not yet been reported, despite SSS often outperforming socioeconomic status as a predictor of various health outcomes including depression. This cross-sectional survey study tested the moderating effect of SSS on association between COVID-19- related health worries and mental health symptoms (depressive and generalized anxiety) among a sample of 1,637 perinatal women from the United States who took part in the Perinatal Experiences and COVID-19 Effects (PEACE) Study between May 2020 and June 2021. We found that high subjective social status was protective against depressive symptoms when self-reported COVID-19-related worry was low. When COVID-19-related worry was high, subjective social status was no longer influential. Higher levels of COVID-19-related health worries were associated with more anxiety symptoms, and higher subjective social status did not moderate anxiety symptomatology at either level of COVID-19-related worry. Although higher SSS has historically been protective against mental health decline, in the context of the COVID-19 pandemic it may not be sufficiently protective against anxiety, or against depression for those who experience high levels of worry regarding the effects of COVID-19 on health.