The influence of the Covid-19 pandemic on the perinatal mental health of women in North Macedonia

The study aims to explore the influence of the COVID-19 pandemic on mental health of women in North Macedonia during perinatal period

Pregnant woman


In the conducted cross-sectional study, we registered an increase in the prevalence rates of mental health disorders, particularly depression and anxiety, among perinatal women compared to pre-pandemic times which confirms the estimated increase of mental health disorders globally, especially in populations with accentuated risk such as the women in the perinatal period.

The perinatal period, namely the pregnancy and the following year represent a vulnerable period for mental health deterioration in women due to underlying physiological, psychological and sociological factors.

Conditions of crisis additionally aggravate the influence of risk factors on mental health, the COVID-19 pandemic, as an on-going crisis, imposed novel conditions in the functioning of the population world-wide.
The prolonged exposure to stress, social isolation, fear, financial challenges, bereavement and strained health services, reflected in exacerbation of mental health difficulties.

Moreover, for women in the perinatal period the fear of vertical transmission/transmission through
breastfeeding, fear of being separated from the baby after birth, fear of vaccination, reduced availability of health services and social support prevailed as pandemic related worries world-wide. The utilization of a Covid-19 Questionnaire in this study granted us insight into the most common worries and pandemic related risk factors associated with worsened mental health in the population of perinatal women in North Macedonia. It was shown that Covid-19 infection, irregular attendance of OB-GYN visits during pregnancy, fear of vaccination against Covid-19, negative perception of the pandemic influence on their mental health, suffering a loss of employment/financial loss as well as experiencing limiting access to health services during the pandemic were most commonly registered risk factors or worries in correlation to indicators of deteriorated mental health, decreased quality of life and impaired mother-infant bonding among the participants in the study.

The present study highlighted the significant impact of maternal depression and anxiety on mother-infant bonding. Results revealed that clinically severe depression and anxiety were associated with a high prevalence of impairments in mother-infant bonding as evaluated by the Postpartum Bonding Questionnaire (PBQ). These findings underscore the importance of early identification and treatment of maternal mental health disorders to promote healthy mother-infant bonding, which is a crucial factor in the child’s overall health and development.

// This study was conducted by the University Clinic of Psychiatry in Skopje with support from UNICEF and USAID. The authors’ views expressed in this publication do not necessarily reflect the views of UNICEF, the United States Agency for International Development or the United States Government.

University Clinic of Psychiatry - Skopje
Publication date
English, Macedonian