In the advent of the Coronavirus pandemic, new and expecting mothers are facing increased levels of fear, anxiety, and stress on top of overwhelming social isolation. Postpartum depression cases, in particular, are rising globally as mothers are now navigating unanticipated challenges of delivering without a support person, being physically separated from loved ones (including newborns), managing their newborns without help, and grieving loss during a moment that was meant to be cherished.
Postpartum depression is a perinatal mood disorder that develops within four to six weeks of delivering a newborn due to neurobiological factors and environmental stressors. The disorder is characterized by at least two weeks of severe depressive symptoms and must be differentiated from postpartum blues, which is known to self-resolve. Unlike postpartum blues, postpartum depression requires a combination of antidepressant medication, psychotherapy, and a significant amount of planning. Postpartum depression is associated with an increased risk of preterm delivery, reduced mother-infant bonding, and delays in cognitive development of the infant; it is crucial to recognize and manage symptoms early on. These symptoms include depressed mood, excessive crying, difficulty bonding with the newborn, withdrawing from family and friends, fatigue, insomnia or hypersomnia, irritability, hopelessness, or feelings of worthlessness, shame, guilt, or inadequacy.
Prior to the recent pandemic, approximately 14 percent of women have suffered from pregnancy-related anxiety and 20 percent of women are said to experience postpartum depression. Those most at risk are women who have a history of depression, bipolar disorder, postpartum depression from a previous pregnancy, difficulty breastfeeding, weak support systems, or financial troubles. Unfortunately, despite the prevalence, postpartum depression cases are often underdiagnosed and undertreated – especially in the African American patient population who are more likely to be infected or die from the virus compared to the Caucasian population.
Perinatal psychiatrists are working towards creating COVID-19
maternal well-being groups, which allow patients to share their concerns, seek
support, and grieve together. These groups are particularly helpful as affected
women are forced to also think about specific scenarios that may not have
medical guidelines. For instance, if a patient or her partner is a health care
worker, what precautions should she take? If she is balancing other kids at
home, can she send them to day care? If she has a limited support system, can
she rely on help from her own parent who is at high risk? These decisions can
cause added stress for mothers and are difficult to make without the guidance
of medical professionals and the availability of social support. Additionally,
a public health intervention to battle postpartum depression includes reaching
out to families with prior mental health concerns to address issues
proactively.
The pandemic unveils a new mental health crisis and has been shown to disproportionately impact women. For this reason, it is crucial for new mothers to monitor symptoms and seek medical support during these challenging and uncertain times.
