Being pregnant leaves women at risk of increased anxiety and other mental health complications, but this has become more common as a result of the impacts of the coronavirus pandemic.
Pregnant women have reported a range of anxious concerns including fear of infection, the impact of the virus on the foetus, possible birth complications such as preterm delivery and importantly, their own mental health and capacity to manage the stress of the pandemic situation. For some women, there is also a fear of the future state of the world and concerns that this is not the time to have a new baby.
Work and financial insecurity concerns are also impacting families, which can lead to increased situational anxiety as well.
Isolation due to social restrictions, combined with less access to in-person support from family and friends, can allow mental health concerns to grow and worsen. The sense of community with others going through pregnancy is also lessened when in-person visiting is not possible.
Accessing medical care during pregnancy looks different during a health crisis
Many maternity and hospital-based services have had to reduce face-to-face care for pregnancy, meaning some women don’t feel as connected to their midwife or doctor. The lack of connected, strong relationships with healthcare providers can be stressful, especially for isolated or single parents.
In the absence of face-to-face care, phone services have reported increased numbers of calls – and increased levels of distress among callers.
Health practitioners not being able to see pregnant patients face-to-face also means it can be harder to identify signs of mental health concerns, which can be particularly challenging in people who have pre-existing conditions like depression and anxiety, which can be made more serious by both pregnancy and the COVID-19 crisis.
Providing safe care to women giving birth, and infants needing special care, has been a particular challenge for hospitals during the pandemic.
One of the key ways hospitals limit infection spread is by limiting the amount of people allowed in the hospital, which has meant few or no visitors for women giving birth and directly after.
This has contributed to psychological distress, feelings of isolation and abandonment with some women developing depressive symptoms and concerns that they will not be able to parent effectively as the birth experience has been negative and traumatic.
Birth is usually a time of celebration and has a lot of cultural significance in many communities, which has unfortunately been disrupted by the threat of infection and the rules in place to prevent the spread of the virus.
Overall, the experience of pregnancy and birth in the pandemic has a major stressor for many families, which has the potential to significantly impact the early bonding between parents, families and their new babies.
Early parenthood is an intense time under normal circumstances, and is even more so during a pandemic. Support from healthcare professionals, family and friends is limited in the same way it is during pregnancy: in-person visits are less frequent.
Phone contact has been used as an alternative but many women report needing the reassurance of having their baby checked, weighed and measured by an experienced professional who can also support some of the issues that can arise in early care, feeding and settling. These checks are important for the parents as well, as mental health issues are often picked up by practitioners such as Maternal and Child Health Nurses.
Parents who do not have access to direct support from family and other parents and can become increasingly anxious that they are not parenting well. If parents in these situations become depressed, these feelings of inadequacy and guilt can be overwhelming.
Responding to the needs of families and infants in the pandemic is complex. Public health measures are definitely needed in order to limit the spread of COVID-19, but side effects of isolation can cause issues that negatively affect pregnant women and new parents.
Services and professionals to support new parents with the feelings of disappointment and grief that their birth experience was impacted and their real concerns that they are having a new child in a changed and uncertain world.
Mental health services also play a critical role in supporting parents in the early days of their baby’s life, establishing a strong attachment relationship and gaining confidence in their capacity to care for and emotionally support their baby.
Confidence is critical in parenting, and parents need to feel assured that their baby can thrive even in times of pandemic. Community helps with this a lot and, for isolated parents, rebuilding a sense of connection and relationships with other new parents can happen through social media and other distance platforms.
Connecting with families is vital when stress can play a major role in escalating family conflict and in increasing risk to infants. Protecting the most vulnerable families and infants should be placed high on the post-pandemic recovery list of actions.
If you’re an expecting or new parent and you’re struggling with isolation or anxiety due to the coronavirus pandemic, there are a range of options available:
Professor Louise Newman AM is a specialist in Perinatal and Infant Mental Health and early life Psychological Interventions at the Albert Road Clinic. Professor Newman focuses on Women’s Mental Health, support for early parenting and developmental difficulties of infants and young children. She is trained in Infant and Parent Psychodynamic Therapy.