Trigger warning: this article may be upsetting to read if you have recently given birth. Please take care when reading and refer to our Urgent Warning.
As if giving birth isn’t challenging enough, women who welcomed babies during the COVID-19 pandemic did so under difficult circumstances, and often without the support of their family and friends due to social distancing measures. So it comes as no surprise that new mothers in the UK experienced worryingly high rates of depression and anxiety during the first lockdown. That’s according to new research published in the Journal of Psychiatric Research, the latest of many studies into the impact of COVID-19 on perinatal mental health. (‘Perinatal’ means the time from conception through to when baby is 12 months old).
A UK-wide research team examined the psychological and social experiences of over 600 women with babies between birth and 12 weeks old during the first lockdown. Based on the completion of mental health questionnaires, the researchers found that 43% of the women met the criteria for clinically relevant depression, and 61% met the criteria for anxiety. To put this into perspective, the usual rates of depression and anxiety after birth in the UK are around 15%.
43% of the women met the criteria for clinically relevant depression, and 61% met the criteria for anxiety.journal of psychiatric research
‘We are already aware that the postnatal period can be a time during which mothers are vulnerable to the development or worsening of mental health related concerns,’ Dr Victoria Fallon, a lecturer in health psychology at University of Liverpool and the lead author of this research, tells Motherdom. ‘The lockdown restrictions included reduced access to care and services, absence of birth partners, and limited or no social contact with family and friends. This was something we hypothesised would be associated with an increase in mental health problems for new mothers.’
Dr Fallon says that while they did expect to see a negative impact of social distancing measures on new mothers, they didn’t expect such a high proportion of women reporting clinically relevant depression and anxiety without a formal diagnosis.
Perinatal psychologist Julianne Boutaleb, the clinical director and founder of Parenthood in Mind, explains, ‘in the last year, women have been pregnant and birthing without the sort of support they can usually rely on, eg rapid access to mental health services, emotional support of friends and family, birthing and receiving antenatal care without their partner, and in hospitals where health professionals are gowned up and masked.’
Julianne points to The Royal Foundation research published in November, which reported that 1 in 3 parents who felt the pandemic had negatively impacted their mental health said the main reason was a lack of support. She refers to it as a ‘supporting matrix,’ a group of other experienced parents, grandparents and health professionals who can guide them through the first few months of parenting.
‘Coming home from hospital with a new baby can be an overwhelming experience anyway, never mind in a pandemic,’ Julianne adds. ‘There is so much to learn about your new baby, and all this is more difficult if you don’t have the support of experienced others around you. Every cough or missed feed can very quickly become a source of worry and panic for new parents.’
‘Coming home from hospital with a new baby can be an overwhelming experience anyway, never mind in a pandemic.’Julianne boutaleb
As a perinatal psychologist, Julianne has seen first-hand how the pandemic has impacted parents and their families, including an increase in referrals for birth trauma and anxiety, and more new parents seeking support for infant feeding, sleeping and attachment. ‘For some women who have already had a difficult birth, the changes in birthing, such as having their partner present only for established labour, or cancelled home births, were catastrophic,’ she says. Make Birth Better, an organisation that campaigns for better awareness of birth trauma, carried out a poll in September as the first lockdown restrictions eased and found that more than 50% of women who were already impacted by birth trauma had to change their birth plans. This resulted in the women feeling unsupported and out of control, and in some cases re-traumatised. And half of the women who had needed mental health support said this support stopped during lockdown. (Dr Emma Svanberg, who is co-founder of Make Birth Better, wrote this article for Motherdom on how to move on from birth trauma).
Hopefully, the growing body of research into the impact of COVID-19 on perinatal mental health leads to improved access to care, not only during the pandemic but beyond.
‘It’s really important that mental health interventions are timely and meet mothers’ needs to prevent the escalation of symptoms and additional burden on the NHS,’ Dr Fallon explains. ‘Interventions must be developed with flexibility to ensure they work in both this and any future health crises.’
Julianne hopes the research impresses on government and other stakeholders the need for rapid and effective mental health support pathways for mothers, and families, once pandemic restrictions are finally lifted.
‘What I would like to see is a well funded, longitudinal study into maternal mental health and the impact of COVID-19 and related aspects, eg mother-baby attachment, by a world-recognised body,’ she says. ‘This should look at the impact of what happened during the pandemic, e.g. birthing alone, maternity restrictions, lack of parenting support and the impact on maternal mental health – and fuel funding in perinatal mental health and children’s services in the coming years.’
Hear, hear. Motherdom would love to see that too.