How is the covid epidemic affecting perinatal mental health?

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

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

Background

The first few weeks after childbirth can be physically, emotionally and mentally taxing. Perinatal depression can occur before conception or about a year after delivery.

Although women with pre-existing mental disorders have an increased risk of recurrence during pregnancy, these disorders can also appear for the first time in women with no prior history of the condition. In fact, mental disorders, which are associated with poor maternal and child outcomes, are considered a major complication that women endure during the perinatal period and affect one in five pregnant women.

Impact of the COVID-19 pandemic on pregnancy mental health

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

Additional factors were also found to increase the likelihood of mental disorders in antenatal women during the COVID-19 pandemic. Travel restrictions, for example, have increased the likelihood of relationship conflict, behavioral control, and, in some instances, domestic abuse and violence.

Furthermore, social distancing limited contact with support from friends, family and healthcare providers, which contributed to anxiety in these individuals. Despite needing moral and emotional support from their peers, pregnant women are often 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 partners from accompanying patients on their in-person visits, contributed to the isolation of expectant mothers. The absence of traditional birth experiences also caused grief for many.

Concerns about the risk of pregnant women and their unborn babies to SARS-CoV-2 have also raised concerns 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.

Due to disparities between different socioeconomic populations, pregnant women from minority ethnic groups are at higher risk of acquiring COVID-19 during pregnancy than pregnant women from other ethnicities.

Even during the epidemic, it has been found that the consumption of alcohol among the general public has increased. In fact, a non-perinatal US study reported that this increase was more pronounced in women than in men. It should be noted that the likelihood of domestic violence, abuse, and mental illness increases with alcohol abuse.

Global surveys identified many barriers to providing assessment and care to antenatal women, as well as their infants and extended families, by health workers working in perinatal mental health settings at the onset of the epidemic. During remote counseling and follow-up, staff often reported challenges regarding their ability to detect early signs of mental illness. Additional concerns about how to assess and encourage interaction between mother and infant through teleconsultation are also described.

Guidelines for improving clinical care

The Covid-19 pandemic has highlighted the importance of improving existing perinatal mental health services. For example, it’s clear that virtual appointments are beneficial for some working mothers.

The current pandemic also underscores the need for collaborative care between mental health professionals and other organizations capable of supporting vulnerable prenatal women.

Several organizations have proposed guidelines to improve support for women suffering from mental health problems during the pandemic. These guidelines emphasize the importance of recognizing the unpredictability of the current political environment and empowering women with information so that they are able to handle the ever-changing situation.

A better understanding of prenatal women’s experiences during the pandemic can guide the adaptation and structuring of services to provide support 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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