Fear and Pregnancy in the Age of Covid

In spaces where expectant mothers seek fellowship online, panic, frustration, and the predatory nature of anti-vaccine rhetoric are stark.

Over the past few weeks, a thread on TheBump.com, one of the Internet’s largest pregnancy forums, devolved into an impassioned debate. It all began when user kcf19 posted a simple plea: “Just wanted to say, please get your covid vaccine if you haven’t already.”

The results were mixed — to the point of what, on a generally supportive and noncombative forum, might be called a catastrophe. Multiple expectant mothers posted about their vaccine hesitation, explaining that they were afraid of the effects on their fetuses. “I just don't want to take a chance on affecting the baby's development,” one user wrote.

A nurse posted that she was trying to get a medical exemption from her hospital’s vaccine mandate, that she didn’t want the vaccine, “no judgment needed.” One user compared the unvaccinated to drunk drivers: their irresponsibility carried external dangers, she said. While delimited by the forum’s prohibitions on profanity, and even within the prim if anxious environs of expectant motherhood, the sentiments being slung were fiery, the topic urgent.

The fears women expressed on the Bump and in Facebook groups devoted to expectant mothers were chilling, if easily debunked: that babies of vaccinated mothers could develop blood clots from breastfeeding; that vaccination could give rise to miscarriage or permanent infertility; that even being around vaccinated people could cause miscarriage or fetal death. These myths spread in smoothly designed Instagram graphics and intrafamilial anecdotes, and are promoted by organizations, like the medical-scamming outfit America’s Frontline Doctors, that actively stand to profit from vaccine fear-mongering. And these online conversations — driven by the anxiety that accompanies pregnancy, and the desire to connect with other women in the same situation — are unfolding in parallel with a rise in pregnant women whose pregnancies and even lives are imperiled or complicated by covid-19.

Detail of Humana Fragilitas (Human Frailty), circa 1657, by Salvator Rosa. Photograph: DEA/A Dagli Orti/Getty Images/DeAgostini

Dr. Erica Goldblatt Hyatt, acting director of the Rutgers Doctorate in Social Work program and a specialist in counseling women after pregnancy loss, told me that in response to exploding maternal mortality rates, labor and delivery social workers across the country have begun adapting protocols developed for baby loss: making molds of mothers’ hands and feet for their children to remember them by.

“Across the board, loss and trauma cause folks to lose their perspective or objectivity as their nervous systems get hijacked by fear and avoiding it. Then reality and misinformation are hard to tease apart,” Goldblatt Hyatt said in an interview. Labor and delivery social workers, she added, are “overwhelmed, exhausted and terrified,” particularly in the West, South and Upper Midwest. “They feel there is no end in sight.”

Anti-vaccine sentiment cuts across racial and religious lines, across class and political lines, across geographical lines. It’s a complex mix of factors, and a movement that has been growing for decades in the United States, bolstered by a robust system of misinformation working its way through the veins of every major social-media site. Vaccine rejection occurs in right-wing Christian communities as an article of faith; in Black and minority communities as a means of expressing judicious skepticism against governmental intrusion; in the crystals-and-granola set, as a means of embracing “natural” healing. These characterizations are necessarily reductive; the motivations multiply and layer. As the writer Nick Paumgarten put it in a New Yorker article about the anti-vaxx movement and measles in 2019, months before Covid-19 was even on the fringes of awareness: “Suspicion of authority, rejection of expertise, a fracturing of factual consensus, the old question of individual liberty versus the common good, the checkered history of medical experimentation (see: Tuskegee, Henrietta Lacks, Mengele), the cynicism of the pharmaceutical industry, the periodic laxity of its regulators, the overriding power of parental love, the worry and suggestibility it engenders, and the media, both old and new, that feed on it — there are a host of factors and trends that have encouraged the spread of anti-vaccination sentiment.” 

On Facebook, groups for expectant mothers abound, often sorted by due date; most have members numbering in the thousands or tens of thousands. There, discussions of vaccines are even more heated — in “Pregnant Moms Due 2022,” a 23-thousand-member public group, a query from one user about whether she should get a Covid-19 vaccine devolved into the online equivalent of a shouting match, with some urging mothers to “follow the science,” and others deriding their fellow pregnant women as “sheep” who obeyed without question, or lab rats exposing their unborn children to danger. Between September 22 and 25, no fewer than 10 women posted separately in the group concerning the Covid-19 vaccine, expressing deep fear, and turning to the other “mommies,” as group members called each other, for consultation about the decision. The comments filled with conflicting exhortations — to follow God, to save your child and your life by getting the vaccine — or avoiding it.

“Pregnant people are already vulnerable to misinformation about vaccines and anything medical in normal times because you're bombarded with advice from everyone, much of it fear-based, and you're told that anything and everything might harm your baby,” says Melissa Ryan, a disinformation researcher and CEO of CARD Strategies. Ryan, who was recently pregnant, told me that the experience gave her a new insight into how anti-vaxxers target women. “Many women and trans folk have been failed by the medical system and might not trust that their doctors and care providers are actually giving them good information. They go online seeking social interaction and validation from other pregnant people, and the anti-vaxxers are there waiting to pounce. Covid only makes this worse because we're all even more isolated and more vulnerable.”

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Fear and pregnancy are intermingled — fear of loss, fear of pain, and a fierce need to protect the fragile life growing within. In spaces where pregnant women seek fellowship online, panic, frustration, and the predatory nature of anti-vaccine rhetoric, with its sowing of insidious doubt, are particularly stark. The United States is a country with astonishing maternal mortality rates exacerbated by medical racism, and a rapacious healthcare system in which it is both expensive and precarious to give birth. It’s no wonder that women turn to each other for wisdom and advice in a time fraught with disease — but it’s wrenching to see the ways in which misinformation turns women away from a lifesaving medical intervention.

The conclusions drawn by the scientific community are clear: pregnancy is a risk factor for severe Covid-19 illness, with complications, according to the American College of Obstetrics and Gynecology (ACOG) including preeclampsia, a potentially fatal condition. “Data have shown that COVID-19 infection puts pregnant people at increased risk of severe complications and even death, yet only about 22% of pregnant individuals have received one or more doses of the COVID-19 vaccine,” the U.S. Centers for Disease Control and Prevention wrote in a press release urging pregnant people to get vaccinated. Expectant mothers with Covid also are at higher risk of preterm labor, fetal distress, and other conditions endangering newborns. Meanwhile, vaccination is safe for pregnant women — full stop — before, during, and after pregnancy.

ICU nurses, obstetricians, and Labor and Delivery social workers have reported a sharp uptick in expectant mothers delivering their babies from the ICU; in infants born to dying mothers; in babies lost in utero to the disease. A study published in JAMA Pediatrics encompassing women in 18 countries found significant increases in morbidity and mortality for both mothers and neonates with Covid-19 diagnoses. 

The story of Patricia Jackson, who died of Covid-19 at age 31 in Mississippi immediately after giving birth to a daughter, is indicative of the ways in which fiercely protective maternal instincts, combined with pervasive misinformation, can lead to calamity. Jackson had determined not to get vaccinated until after the baby was born, for fear of risk to her unborn child, she told family. After an emergency C-section, her 4-pound and 7-ounce daughter was placed in the NICU, struggling for oxygen. Jackson was placed in an induced coma after her lung collapsed; she never held her daughter Kara, who survived her. And in this tragedy, she is not alone.

Since the pandemic started, more than 120,000 children in the United States have lost a parent or primary caregiver to Covid-19 — a new flood of orphans, minors navigating a world that whirls now on an axis of grief. Globally, the number of these children expands to 2 million. That number is likely an undercount – as all the numbers are — but even in those bare six figures, there are incalculable constellations of loss. The loss of a parent at any age is painful — and so many have lost their parents this year and last — but to stand at the threshold of the world without a guide, knowing that guide drowned on dry land in the antiseptic and terrible confines of a plague ward in a hospital, is its own unique horror. It’s one that will affect a generation of children who will grow up without their mothers — mothers who died because they wanted to protect their children too much to save their own lives, mothers pushed by fear, by lies, by faux studies and real profiteering into a fatal indecision.