August 19, 2020
Emerging in Wuhan, China, in 2019, a new strain of coronavirus known as COVID-19 was identified and characterized by the World Health Organization (WHO) as a pandemic in early 2020. COVID-19 is a global public health threat to all individuals, but pregnant women and new mothers are more prone to infection. The presence of limited and inaccurate information concerning vertical transmission, assessment, and management of pregnant women and new mothers infected with COVID-19, has induced an increased level of stress, anxiety, and depression among them.
Depression and anxiety affect one in seven women during the antenatal period in regular times. They are associated with increased risk of preterm delivery, reduced mother-infant attachment, and impediments in the health of the mother and the physical, cognitive, and psychological development of the fetus. These issues could be aggravated by strict preventive health measures to prevent the spread of COVID-19, such as physical distancing, quarantine, home isolation, restrictions to healthcare systems - specifically mental health services - and limited support during the pregnancy cycle.
WHO and professional societies of obstetricians and gynecologists have set guidelines to manage COVID-19 before, during, and after pregnancy. However, these have not diminished anxiety and panic among pregnant women, making them more at risk of mental health problems as well as medical-related issues.
The imposed physical distancing, quarantine, and home isolation have decreased social support to pregnant women and new mothers. In addition, the underutilization of the healthcare system due to COVID-19 has led to a lot of health problems, including maternal mental health issues. In a survey conducted on pregnant women in their second and third trimester, almost 35% of them were self-isolating as a preventive measure. Many women also chose home deliveries, which might lead to increased complications during and after birth. To avoid the risk of COVID-19 infection, many women decided not to breastfeed, which is a contributing factor to ill health among them and their infants. Exacerbating this is women’s anxiety about their wellbeing, that of their unborn/newly born child, as well as their other children.
This long-lasting chaos, along with its health, economic, and financial consequences and uncertainties, will certainly escalate further maternal mental health issues. Some may resort to substance abuse and alcohol consumption, while others may commit suicide. Gender-based intimate partner violence may rise.
In conclusion, the psychological repercussions of this pandemic on maternal health necessitate the urgent need for healthcare support. Innovative approaches, such as teleconsultation services for medical and psychological assistance, integration of internet-based screening tools for anxiety and depression in prenatal programs, and online therapeutic interventions by medical professionals, should be introduced. It is worth mentioning that physical activity (of at least 150 minutes per week) remains one of the most helpful tools to reduce stress and depression in pregnant and postpartum women.
Nations worldwide need to join forces during these exceptional times to overcome the challenges arising and address the gaps in information and research regarding COVID-19 and its impact on maternal mental health and the health of the infant. Let us stand together to support these extraordinary women in their maternal journey during this testing period.
References:
- Davenport, M. H., Meyer, S., Meah, V. L., Strynadka, M. C., & Khurana, R. (2020). Moms Are Not OK: COVID-19 and Maternal Mental Health. Frontiers in Global Women’s Health, 1, 1-6. https://doi.org/10.3389/fgwh.2020.00001
- Thapa, S. B., Mainali, A., Schwank, S. E., & Acharya, G. (2020). Maternal Mental Health in the Time of the COVID-19 Pandemic. Acta Obstetricia et Gynecologica Scandinavica, 99(7), 817-818. https://doi.org/10.1111/aogs.13894
- Akber Ali, N., & Shahil Feroz, A. (2020). Maternal Mental Health amidst the COVID-19 Pandemic. Asian Journal of Psychiatry, 54, 102261. https://doi.org/10.1016/j.ajp.2020.102261
Nisreen Alwan, PhD
College of Health Sciences
Abu Dhabi University
