How is the COVID pandemic affecting perinatal mental health?

A recent review published in the journal Advances in Neurology and Psychiatry discusses the adverse effects of the current coronavirus disease 2019 (COVID-19) pandemic on perinatal mental health.

To study: Perinatal mental health during the COVID-19 pandemic. Image credit: Pormezz / Shutterstock.com

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The first few weeks after giving birth are difficult physically, emotionally and mentally. Perinatal depression can occur as early as before conception or as late as about a year after giving birth.

Although women with pre-existing mental disorders are at increased risk of relapse during the perinatal period, these disorders can also emerge for the first time in women with no history of the condition. In fact, mental disorders, which are associated with poor maternal and child outcomes, are considered a major complication experienced by women during the perinatal period and affect nearly one in five pregnant women.

The impact of the COVID-19 pandemic on perinatal mental health

During the COVID-19 pandemic, pregnant women were particularly vulnerable to the psychological effects of lockdowns and other restrictions put in place to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Increased social isolation due to lockdowns and social distancing measures, combined with other socio-economic stressors such as financial difficulties and occupational changes, have contributed to the development of mental health disorders, particularly in the population perinatal

Additional factors were also found to increase the likelihood of mental disorders in perinatal women during the COVID-19 pandemic. Travel restrictions, for example, increased the potential for relationship conflict, controlling behaviors and, in some cases, abuse and domestic violence.

In addition, social distancing limited contact with friends, family, and support from health care providers, which also contributed to anxiety in these individuals. Despite the need for moral and emotional support from their peers, pregnant women often remained isolated from their support systems during the pandemic.

The replacement of in-person maternity care and perinatal mental health services with virtual visits, as well as new policies prohibiting couples from accompanying patients to their in-person visits, also contributed to the isolation of mothers-to-be . The absence of regular childbirth experiences also caused pain for many.

Concerns about exposure of pregnant women and their unborn children to SARS-CoV-2 also increased anxiety in this patient population. In general, pregnant women with COVID-19 are more likely to require intensive care unit (ICU) admission than non-pregnant women with COVID-19 of the same reproductive age.

Because of persistent disparities among various socioeconomic populations, pregnant women from ethnic minority groups are at greater risk of acquiring COVID-19 during the perinatal period compared with pregnant women of other races.

Alcohol consumption has also been found to increase in the general population during the pandemic. Indeed, a US non-perinatal study reported that this increase is more pronounced in women than in men. It should be noted that the potential for domestic violence, abuse and mental illness increases with alcohol abuse.

Global surveys report that health workers working in perinatal mental health settings at the onset of the pandemic identified several barriers to assessing and providing care to perinatal women, as well as their infants and extended families. During consultations and remote follow-ups, staff often reported problems related to their ability to detect early signs of mental illness. Additional concerns about how to assess and foster mother-infant interactions through teleconsultations have also been described.

Guide for improving clinical care

The COVID-19 pandemic has highlighted the importance of improving current perinatal mental health care services. For example, virtual dating is clearly beneficial for some working mothers.

The current pandemic also emphasized the need for collaborative care between mental health professionals and other organizations capable of helping vulnerable perinatal women.

Several organizations have proposed guidelines to improve support for women experiencing mental health problems during the pandemic. These guidelines emphasize the importance of recognizing the unpredictability of today’s political climate and empowering women with information so that they can be equipped to deal with the ever-changing situation.

A better understanding of perinatal women’s experiences during the pandemic could guide the adaptation and formulation of support services aimed at improving perinatal mental health.

Journal reference:

  • Wilson, C. (2022). Perinatal mental health during the COVID-19 pandemic. Advances in Neurology and Psychiatry 26(3); 4-6 doi:10.1002/pnp.751.

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