Background The COVID-19 pandemic and related restrictions can adversely impact antenatal maternal well-being and health behaviours. Aim To examine antenatal stress and stress-reduction strategies, social support, and health behaviours between women pregnant before and during the pandemic in Ireland. Methods 210 pregnant women were recruited online and in the antenatal department of a tertiary maternity hospital before the pandemic, and 235 women recruited online during the pandemic. Only women resident in Ireland were included in this study. Women completed measures of stress, social support, health-behaviours, and self-reported stress-reduction strategies. Differences in outcomes were examined between women pregnant before and during the pandemic, and between Phase 2 and Phase 3 of the Irish Government COVID-19 restrictions. Findings Women pregnant during the pandemic reported lower perceived social support, including support from a significant other, friends and family, than women pregnant before the pandemic. There were no significant differences in stress in health behaviours but women reported higher stress and less physical activity during the pandemic. Women reported a range of comparable stress-reduction strategies before and during the pandemic. No differences were observed between phases of pandemic-related restrictions for any outcome. Discussion Our findings highlight negative impacts of the pandemic on social support, stress, and physical activity, which can have implications for maternal and child health. Lack of differences between restriction phases suggests on-going negative effects for antenatal well-being and behaviours. Conclusion . Development of supports for pregnant women during the pandemic should include social-support and stress-reduction components.

Objectives. Prenatal health behaviours have significant implications for maternal and child health. Understanding factors that influence prenatal health behaviours is essential to support women’s prenatal psychological and physical health. Examining strategies women report using during this time also provides insight into acceptable and feasible approaches for support. The aim of this study is to examine the role of prenatal maternal stress (PNMS), social support, and knowledge on health behaviours; and to examine women’s engagement in prenatal stress-reduction support.Methods. A cross-sectional study including 252 pregnant women recruited from an antenatal outpatient department in Ireland, and online. Women completed self-reported measures of sociodemographics, PNMS, social support, knowledge, health-behaviours, and stress-reduction strategies. Correlational analyses and hierarchical multiple regression analyses were conducted to examine associations between PNMS, social support, knowledge, and health behaviours.Results. PNMS predicted unhealthy eating (β= 0.229). Social support predicted physical activity (β= 0.206), sleep (β= 0.186), and taking vitamins (β= 0.200). Age (β= 0.232) and social support (β= 0.228) predicted healthy eating. Women reported good knowledge of PNMS, health behaviours, discomforts of pregnancy, and parenting. Forty-nine stress-reduction strategies were reported; exercise and connecting with others were the most commonly reported strategies.Conclusions. Social support is an important independent predictor of health behaviours. Lack of associations between PNMS and any health-promoting behaviours suggests different mechanisms of effect of positive and negative psychosocial factors. Interventions incorporating both social-support and stress focused strategies may therefore demonstrate greater benefit for prenatal health behaviour change, with significant benefits for women and children.