The COVID-19 epidemic has impacted significantly on the general population including pregnant women. The psychological impact of COVID-19 among vulnerable population like pregnant women is yet to be estimated. Therefore, the objective of this study was to estimate the prevalence and factors associated with anxiety, depression, and overall psychological problems. A questionnaire-based cross-sectional study was conducted among black pregnant women attending a Primary Health Care facility in South Africa. Logistic regression analysis was performed to determine the significant factors for psychological problems. A total of 346 pregnant women participated in this study. The rates of anxiety, depression and overall psychological problems were 35.7%, 38.2% and 34.3% respectively. Gestational age between 14-26 weeks were 60% (OR=.397, p<0.05), part-time employment 53% (OR=0.47, p<0.05) and pregnant women having adequate funding for monthly expenses were 62% less likely (OR=0.381, p<0.05) to have anxiety problems. Married women were 2.5 times more likely (OR=2.54, p<0.05) and women living together or widowed were 2.9 times more likely (OR=2.91, p<0.05) to have anxiety. Pregnant women aged between 20-29 years were nine times (OR=9.03, p=0.016), women aged 30 to 39 years were 6.3 times (OR=6.3, p=0.032) more likely to have depression. Parity one 91% (OR=0.094, p=0.007), parity two 86% (OR=.143, p=0.027) and part-time employment 65% (OR=0.354, p=0.002) were less likely to have depression. Comparing with women aged >39 years, women who were between 20-29 years were 28 times (OR=27.8, p<0.01) and women aged between 30-39 years were nine times more likely to have overall psychological problems. Respondents with parity one was 83% (OR=0.17, p<0.05) less likely to have psychological problems when compared with other parity groups and women having adequate funding were 65% less likely (OR=0.35, p<0.05) to have overall psychological problems than those did not have adequate funding. Higher rates of anxiety, depression and overall psychological problems are found among black pregnant women. It is therefore imperative that appropriate and timely mental health care supports are provided to reduce adverse health outcomes.
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