TL;DR: A systematic review of 16 studies found that psychological interventions, particularly those delivered digitally or in hybrid formats, reduced depression, anxiety, and stress in pregnant women during COVID-19, though study quality was modest and standardized long-term data remain limited.
The COVID-19 pandemic created a convergence of two problems for pregnant women: heightened psychological distress and reduced access to routine mental health care. This systematic review, published in the Journal of Psychosomatic Obstetrics and Gynaecology, examined 16 studies evaluating psychological interventions specifically designed for pregnant women during the pandemic period. The researchers wanted to understand which approaches worked and whether they could feasibly support maternal mental health when traditional healthcare systems were disrupted.
The interventions studied fell into several categories. Cognitive behavioral therapy (CBT) appeared most frequently, alongside mindfulness-based interventions, psychoeducation programs, and other psychological approaches. Delivery methods varied significantly: some were conducted individually, others in groups, and notably, many were adapted for digital or hybrid (in-person plus remote) formats. This variation in delivery method turned out to be important, as the review identified digital and hybrid interventions as particularly promising for reaching pregnant women when clinic access was limited or when safety concerns made in-person visits difficult.
The reported outcomes were largely positive, though with important caveats about evidence quality. Most studies documented reductions in depression, anxiety, or stress symptoms among participants. Some interventions also showed improvements in resilience-related factors, suggesting potential benefits beyond symptom reduction. However, the reviewers were explicit about limitations: methodological quality across the studies was modest. Outcome measures varied considerably between studies, making direct comparisons difficult. Follow-up periods were often short, raising questions about whether improvements persisted after the intervention ended or in the longer term.
The overall conclusion was cautiously optimistic: psychological interventions adapted for digital or hybrid delivery show promise as a scalable strategy for supporting maternal emotional well-being during crisis periods. The authors noted this finding matters because crises, whether pandemics or other disruptions, tend to simultaneously increase psychological burden while limiting access to routine mental health infrastructure. However, they emphasized that future research needs larger sample sizes, more rigorous methodological designs, standardized outcome measures, and extended follow-up periods to establish stronger evidence.
If you are pregnant or planning pregnancy, this review suggests several practical considerations. First, psychological interventions, particularly those delivered through digital platforms, appear capable of meaningfully reducing anxiety and depression during stressful periods. You should not assume that access disruptions to traditional mental health care mean those interventions are unavailable. Second, multiple modalities showed benefit, so if one approach does not resonate with you, others exist. CBT and mindfulness-based approaches both appeared in the literature with positive outcomes. Third, the delivery method matters: digital and hybrid formats proved effective, meaning you may have options even if in-person appointments are difficult to access.
Beyond formal interventions, the underlying mechanisms suggest broader strategies. Psychological interventions work by helping individuals develop coping skills, process stress, and build resilience. Supporting these processes during pregnancy can involve structured approaches like those studied here, but also complementary habits: practices like journaling, breathwork, social connection, and nature exposure operate through similar pathways and may augment formal interventions.
From a healthcare system perspective, this review strengthens the case for investing in accessible, digitally-delivered psychological support for pregnant women, particularly during times of crisis or system disruption. The evidence suggests this is not a luxury add-on but a practical tool for maintaining maternal mental health when routine care is compromised.
| Parameter | Details |
|---|---|
| Study type | Systematic review |
| Number of included studies | 16 |
| Databases searched | 4 (specific databases not provided in abstract) |
| Search date | Up to September 3, 2025 |
| Study designs included | Randomized and non-randomized controlled studies |
| Intervention types | Cognitive behavioral therapy, mindfulness-based interventions, psychoeducation, other psychological approaches |
| Delivery formats | Individual, group, digital, hybrid |
| Primary outcomes | Depression, anxiety, stress, resilience-related factors |
| Journal | Journal of Psychosomatic Obstetrics and Gynaecology |
| PubMed ID | 42578412 |
| Evidence quality noted by authors | Modest methodological quality, heterogeneous outcomes, limited follow-up |
Psychological interventions to improve maternal mental health and resilience during pregnancy in the COVID-19 pandemic: a systematic review. PubMed: https://pubmed.ncbi.nlm.nih.gov/42578412/
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