The pregnancy and postpartum life transitions are known vulnerable times in a woman’s life. We also know that in general, increased life stressors impact the risk of experiencing perinatal mood and anxiety disorders. How has the stress of COVID-19, increased collective anxiety and social isolation impacted current maternal mental health?
1) First, let’s focus on the two most common postpartum mood and anxiety disorders. Both include cumulative sleep deprivation from newborn care cycles. Postpartum anxiety includes nonstop worry, intrusive thoughts, obsessions, compulsions, and a constant need to be doing something / moving around. Postpartum depression includes sadness, tearfulness, low energy, loss of interest, feelings of hopelessness and disconnection.
2) Now let’s add in stressors faced by new moms that have arisen from the current global pandemic:
Lack of support. Recent new moms have less help from family and friends and childcare providers due to social distancing norms.
High levels of stress. Fears from lack of control, uncertainty and overthinking generally occur around infant care and infant health decision-making during the postpartum transition. COVID-19 variants and safety concerns increase these fears and makes even small decisions feel insurmountable.
Grief and loss. New losses occur around not having the idealized / hoped for maternity leave experience, not seeing friends or grandparents regularly, and not easily finding in-person group support to connect with others around the shared experience of new motherhood.
Identity changes. Changes in one’s sense of self naturally occur with new motherhood, but new types of changes arise around trying to fit into a new way of being (telework, social distancing, etc).
Stress of invisible labor. Increased responsibility through invisible labor / the mental load of parenting as chores and household tasks typically fall on women during maternity leave and now through extended remote work from home. For some moms, they are balancing taking care of a newborn and older children without childcare help.
Existential concerns. There is pervasive existential anxiety around us due to COVID-19, droughts, wildfires and polarization. Increased deeper anxiety may arise as moms search for meaning and understanding in the current state of the world / considering the future of our children.
Pregnancy considerations. For pregnant women, the majority of their prenatal OB medical care experience has become virtual. They have lost out on important social preparation traditions like baby showers, meeting expectant parents at in-person group classes for centering or childbirth prep, and enjoying the freedom of their adult lives pre-parenthood. We see more fears around birth as women wonder what their birth experience will be like due to COVID-19 safety protocols
3) Now add in overall risk factors that impact the maternal mental health experience:
Women with a known mental health history. Women with a previous mental health diagnosis including anxiety, depression or bipolar, experience higher mental health risks during pregnancy, postpartum and COVID-19.
Black birthing mothers. There is a disparity in birth experiences and access to care between black and white women, increasing risk for maternal mental health concerns. Black birthing mothers are exposed to structural racism, are less likely to be screened or receive support for maternal mental health concerns, and experience a higher birth trauma and maternal death rate in the U.S. than white women.
Birth trauma and NICU mothers. Experiencing and recovering from birth trauma, and trauma from pre-term birth and NICU stays can increase acute stress disorders and heighten maternal mental health concerns.
Pregnancy/Parenting after Infertility. Infertility is a major life stressor filled with uncertainty and anxiety. Complex feelings related to infertility can transfer to the pregnancy experience and into the postpartum transition.
Can you see that it’s ok to not be ok? The new mom transition is a demanding and challenging experience without being in a global pandemic. Finding a reproductive and maternal mental health professional to work with may sound daunting, but know that we are here to support new moms through this uncertain time.