Balancing Mom’s Mental Wellness During COVID-19 

Marcia Williams

PhD Student, College of Nursing

University of Utah 

Moms and Pregnant Women

1 in 5 pregnant women and new mothers experience perinatal depression and anxiety (PDA).  Is it hormones, lack of sleep, lack of support, genetics, or a traumatic delivery that makes this condition problematic?  Yes, very likely all of these factors interact although scientists are still trying to understand why prevalence remains unchanged despite available resources.  Most of the time these symptoms resolve on their own; however, mothers giving birth during the COVID19 pandemic are at greater risk for complications from this commonly experienced condition.  Any mom can see if have PDA by taking this short quiz here (it takes less than 5 minutes).  If you or a friend take this test, print a copy to take to your provider’s office.  Simply taking the test has been effective in eradicating PDA, even without any additional interventions.

COVID19 and Mom’s Mental Health

The country is adjusting to a new normal that includes social distancing, change in plans, heightened anxiety, and increased childcare at home since March 2020.  Pregnant mothers and new moms absorb all of those problems and have other stressors as well.  Mom’s wonder if they can pass COVID19 on to their unborn babies during birth or breastfeeding.  Some scheduled office visits with providers may be completed by telehealth. The long-awaited anatomy ultrasound may now be completed with only the mother and not a partner.  During birth, the number of support persons is limited, and visitors may not be allowed to see the newest member of the family.  COVID19 changes exacerbates a commonly experienced problem with potentially devastating results and limited resources.

Sunshine Wellness Tool

Pregnant and new moms benefit from a tool created in collaboration with the Postpartum Support International Utah and the Utah Department of Health.  These tips contain advise for sleep, diet, support, activity, and personal development that combat PDA and can be used during COVID19.  A proactive approach to caring for mental health during pregnancy and postpartum can curb anxiety experienced by COVID19 and new parenting. 

Supportive actions

Family and friends need to know the difference between “Baby Blues” (normal hormonal fluctuations that leave after two weeks) and PDA.  Additionally, having helpline or telehealth resources that mothers can use right change outcomes for a family.  Mild to moderate PDA responds well to cognitive behavioral therapy and mindfulness training (and many of these are now offered in online groups).  Severe PDA may require medication prescribed by mom’s provider.  Providers of groups and prescribers across the country are listed on the Postpartum Support International website.

COVID19 Impact on Maternal Mental Health

Normally a time for showers, baby shopping, provider visits, and finding childcare, a new era is now in place that changes the trajectory for pregnant and new mothers.  Environmental and personal stressors may increase a mom’s susceptibility to PDA during COVID19. 

Maternal mental health can be challenged in another manner during COVID19.  Underreported, the true impact of Intimate Partner Violence (IPV) cannot be quantified but is suspected to effect 1 in 6 pregnant women and is more prevalent during pregnancy.  Stressors of job losses, children at home, and unrest is suspected to increase violence among pregnant and new mothers.  Without regularly scheduled in-person visits, women are less likely to be screened for IPV.  The outcome of IPV to mothers and infants include perinatal death, small for gestational age, and preterm labor (Alhusen et al, 2015)

We do not know when COVID19 restrictions and way of life will be erased from our daily routines, but we do know that mothers and their babies are currently at significant risk maladaptive mental wellness.  Screening for PDA, connecting with providers and family (digitally or in person), working on steps contained in the Sunshine wellness plan, and checking out supportive resources can change the course of a family.  It is hoped that adhering to these recommendations, mothers and infants can be appropriately screened and cared for during this is unprecedented time. 

References:
Alhusen, J. L., Ray, E., Sharps, P., & Bullock, L. (2015). Intimate partner violence during pregnancy: maternal and neonatal outcomes. Journal of women's health (2002), 24(1), 100–106. https://doi.org/10.1089/jwh.2014.4872

Brownridge, D. A., Taillieu, T. L., Tyler, K. A., Tiwari, A., Ko Ling Chan, & Santos, S. C. (2011). Pregnancy and intimate partner violence: risk factors, severity, and health effects. Violence against women, 17(7), 858–881. https://doi.org/10.1177/1077801211412547

Edinburgh Postnatal Depression Scale (2014).  Retrieved July 17, 2020.  http://perinatology.com/calculators/Edinburgh%20Depression%20Scale.htm

Hollier, L. (2020).  Coronavirus (COVID-19), Pregnancy, and breastfeeding, a message for patients. 

Intimate Partner Violence Screening. Content last reviewed May 2015. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/ncepcr/tools/healthier-pregnancy/fact-sheets/partner-violence.html

Perinatal depression.  U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (2020). NIMH Strategic Plan for Research Retrieved from https://www.nimh.nih.gov/health/publications/perinatal-depression/index.shtml

Thapa et al. (2020). Maternal mental health in the time of COVID-19 pandemic.  AOGS.
Useful links.  Postpartum Support International, Retrieved July 17, 2020.  https://www.postpartum.net/learn-more/useful-links/