Levels of distress high in postpartum mothers

By: Dr Prabha S Chandra

BENGALURU: Priya had never imagined having a baby would be such a lonely experience. She had not planned on becoming pregnant during a pandemic, but it happened. All her obstetric consultations were brief, sometimes only over the phone. She would panic about getting Covid-19 while in the waiting room with other expectant mums.

After the delivery, things were better for a while but then her mother contracted Covid. She could not get a nanny for fear of contracting the infection, and she struggled without support. Lack of sleep and doomscrolling heightened her anxiety, till one day exhausted and crying, she spoke to her husband about getting mental health advice. Priya is among many who experience anxiety while pregnant during the pandemic.

There is now global data, indicating high levels of psychological distress among postpartum mothers during the pandemic. Rates of anxiety and depression have almost doubled compared to non-Covid times. Women report feeling intensely lonely at a time when normally they would be surrounded by visitors including family and friends.

Among pregnant and postpartum women, who faced the trauma of getting infected with Covid or had a close family member dying or in the ICU, symptoms of post-traumatic stress such as nightmares, flashbacks and a heightened sense of vigilance have been high. These mothers report feeling extremely overcautious and preoccupied that their vulnerable baby might get infected — to the point of not allowing others to help with infant care.

Overwhelmed by anxiety, some mothers even relinquish care to others. Social support has a buffering effect in stressful conditions and is a known protective factor for postpartum depression. Also, living in proximity with each other at a time when you are isolated from others has led to an increase in interpersonal conflicts without having a place to diffuse tensions.

Nimhans perinatal helpline number 81057 11277

The longstanding nature of the pandemic is another factor overwhelming young mothers. Mothers have felt in tense loneliness having to stay indoor s for months on end with their infants. Factors increasing vulnerability t o mental health problems in postpartum mothers during the pandemic are: Excessive Covid anxiety during pregnancy, loss or serious illness of a clos e family member due to Covid or other conditions, doomscrolling and excessive use of social media and other s sources for Covid related news an d conflicting information about the impact of vaccination on pregnancy and breastfeeding. An other major factor contributing to poor mental health has bee n a loss of job and income at a time when family expenses actu ally increase because of de livery costs and infant care.

Practices for perinatal mental health

Providing clear information about the impact of Covid-19 and vaccination, especially on pregnancy. Impact of Covid–related stress o n mental health in new mother s must be discussed. Educating the mother and partner about expected reactions of new mothers in a pandemic such as excessive anxiety, fears or distress. The mother and husband must be taught method s of self-care. Actively involving the husband or the main support person in sharing the work of infant care and also providing emotional comfort Enabling early access to a mental health professional – through a tele-mental health or online consultation if a face-to-face meeting is unsafe Encouraging the mother to create he r own ‘listening circle’ of friends, family Finding ways of continuous contact with women who have had a previous episode of depression or other mental health problem (The writer is a senior professor o f psychiatry and in-charge o f perinatal psychiatry service s at Nimhans, Bengaluru )