Background: The COVID-19 pandemic affects health of pregnant women and their attitudes and behaviours related to pregnancy and birth. Aim: To explore the impact of pregnant women’s health-seeking behaviour and mode of birth preferences on pregnancy distress during the COVID-19 pandemic. Material and Method: The type of this study is cross-sectional. It was conducted with 351 pregnant women admitted to the pregnancy outpatient clinic. The data were collected using the “Pregnancy Information Form, the Pregnancy Distress Scale, and the Health Seeking Behaviour Scale”. The data were evaluated with Wilcoxon, Binary Logistic, and Linear regression analysis. STROBE checklist guide was followed in the study. Results: The study revealed that the total pregnancy distress score and risky distress levels of pregnant women during the COVID-19 pandemic were higher than before. On average, four out of every five pregnant women (81.2%) stated that they experienced difficulties (decreased social support, finding information suspicious, having to go to the hospital) during the pandemic. During the pandemic, pregnant women mostly wanted to get information about the impacts of COVID-19 on the health of pregnant (59.54%) and foetus (67.81%). Increased health-seeking behaviour in pregnant women decreased the pregnancy distress stemming from inadequate partner involvement. 11.3% of the pregnant women have changed their mode of birth preferences due to the pandemic. The risk of pregnancy distress increased 5.4 times in those who changed their mode of birth due to pandemic compared to those who preferred vaginal birth before and during the pandemic. Conclusion: There is effect of their health-seeking behaviour and mode of birth preference on distress of the pregnant women during pandemic. Health professionals should reduce the distress of the pregnant woman by ensuring the continuity of antenatal care and counseling services during the pandemic. Keywords: COVID-19 pandemic, pregnant women, distress, health-seeking behaviour, mode of birth