The ongoing pandemic of coronavirus disease 2019 (COVID-19) has severely disrupted social and economic interactions, impacting health services and other important aspects of human life. Until the start of the Omicron (B.1.1.529) wave, COVID-19 had already had a staggering impact on the world, by more than 40% of the world population had already been infected once in mid-November 2021. COVID-19 has wreaked havoc on mental health, with cases of anxiety and depression rising by more than 25 percent worldwide, the WHO said. In addition, statistical evidence shows that COVID-19 has had a more severe effect on women’s mental health than men, according to data from Global Burden of Disease.
Writing in the journal Reproductive Health, two researchers are investigating the unexpected impact of the virus on mothers’ mental health. The contributing factors to such tensions include the implementation of non-pharmaceutical interventions (NPIs) such as lockdowns and social distancing, which robbed many important resources for interacting with other people; loss of family or loved ones with consequent mental, emotional and often financial difficulties; the infection itself resulting in loss of physical and mental health; and loss of employment. Coupled with the ongoing lack of clarity about what the future might look like, it’s not hard to see why this pandemic has led to psychological distress in many people.
Study: Uncovering the side effects of COVID-19 on maternal mental healthh. Image credit: fizkes/Shutterstock
It is already known that the perinatal period is a high-risk period for depression, anxiety and psychosis or the reactivation of mental health problems. In fact, new mothers have 22 times the risk of hospitalization for psychiatric conditions compared to the same pre-pregnancy cohort. Furthermore, mental illness increases the risk of preterm birth, poor bonding between mother and child and delayed cognitive development in infants.
Tendencies to self-harm are also common in women who are depressed during this time, affecting at least one in five. Overall, perinatal mental illness is the most common condition of the peripartum period, affecting mothers and babies in up to one-fifth of pregnancies. According to recent research from both Asian and Western countries, this has probably doubled.
It appears that some NPIs have been responsible for a significant amount of mental illness, especially among those at risk. Because people already living on the outskirts experienced mobility limitations, job loss and a reduced ability to seek support from family or friends, financial stress played an additional role in the pre-existing fear of becoming infected, ill, or to die.
Add to that the stress of grief and loneliness, along with burnout in many professions that interact directly with people, and you’re looking at a recipe for anxiety and depression. Domestic violence occurred because many families spent all their time together in conditions of uncertainty and stress. At the same time, mental health services were less available than before, while people under stress were unable to seek help through the usual options, such as going out to spend time with family, friends or neighbors.
Virtual interactions were increased, but could not compensate for all these hardships. Many scientists have pointed out that pregnant women at risk and women already suffering from mental stress and ill health suffered from the lack of mental health services, while online consultations did not always yield beneficial results. In addition, pregnant women are often reluctant to take antidepressants, even without a prescription.
The stigma of mental illness is another powerful factor disrupting access to care. Meanwhile, reproductive services were severely curtailed during the pandemic, leading to increased stress in infertile women. Women of low socioeconomic status, including the poor, the uneducated, the unemployed and the unmarried, were hardest hit.
Particularly in low- and middle-income countries (LMICs), 85% of people in need of mental health care, including those with substance abuse, mental illness or neurological disorders, were cut off from required care due to the lack of mental health care. health professionals, with an estimated deficit of nearly 1.2 million. In many of these countries, there is less than one worker for every 100,000 people.
The study authors emphasize the need for governments to work closely with volunteer, community and health care organizations to improve mental health care for expectant mothers. Since mental health care only receives about 2% of the already meager health budget, a larger investment is needed.
More workers need to be recruited and trained in this area, especially in LMICs. Virtual consultations can help reduce employee shortages in the meantime, although a hybrid model may work best. Better laws and programs are needed to increase mental health rankings, among other needs in times of health crisis, such as the Comprehensive Mental Health Action Plan 2013-2030.
Efforts to reduce the stigma of mental illness should leverage the acceptability and reach of social media, such as developed by Facemums, a Facebook service moderated by midwives, to support pregnant women during the start of the UK lockdown .
International efforts are being made by the WHO, other non-governmental organizations and voluntary organizations such as the Red Cross or Red Crescent, to integrate mental health support into the mainstream of COVID-19 healthcare. Again, the Maternal Mental Health Alliance (MMHA) in the UK includes over 100 organizations that came together to provide quality mental health care on a reliable basis to many women during the peripartum period.
Healthcare workers who are pregnant need further support as burnout is a common problem in this area and can lead to suicidal thoughts. Such personnel may need to be reassigned to less traumatic roles, and working remotely may be the best solution in such cases. They should also have priority access to professionals who can support their mental health.
†Social vulnerabilities in society are closely linked to social determinants of health. Practical measures that promote equality, social justice and a shift in the balance of power and resources could improve the abysmal state of maternal mental health worldwide†
In short, there is an urgent need for action to address the significant decline in maternal mental health observed since the start of the COVID-19 pandemic. It is essential to increase mental health funding, reduce social vulnerabilities and promote a greater presence of civil society organizations to combat this formidable threat.
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