Perinatal mental health: supporting the family during COVID-19
For people who are pregnant or who have recently given birth, it’s understandable that the current coronavirus outbreak is likely to be causing them to experience an increased level of stress and worry.
Dr Leanne Hayward, Consultant Psychiatrist at Priory Hospital Bristol, has put together information on how to support your mental health - and that of your family – if you are going through the perinatal period during the COVID-19 pandemic.
Understanding perinatal mental health
Perinatal mental health refers to a person’s mental health from the point of conception, throughout the pregnancy and until their baby is one year of age.
Approximately one in five women experiences a mental health problem during pregnancy or in the year after giving birth. This can be a new mental health condition or the reoccurrence of one that they have previously experienced.
Partners can also experience mental health problems during this period. Some studies, particularly around depression, suggest that 1 in 10 new fathers experience a mental health condition after their partner has given birth.
Pregnancy and giving birth during the coronavirus outbreak
If you are pregnant, remember that it’s completely normal to be concerned about your unborn baby and experiencing a heightened state of worry is also to be expected given the COVID-19 outbreak.
At this time, it’s important that you continue to attend your routine care if possible when you are well. And, it is crucial to follow the advice that has been laid out by your maternity team, which may have changed slightly as a result of coronavirus.
For valuable advice and guidance on areas such as antenatal care, childbirth choices and birth partners, The Royal College of Midwives, The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Paediatrics and Child Health recently co-published information on coronavirus for pregnant women and their families to help you navigate through this unprecedented time.
If you are particularly worried about the birth of your baby, maternity sites recognise the importance of partners being there during the delivery. Where possible, providing that your partner is well and doesn’t have any symptoms of coronavirus, you’ll be supported to have them present at the birth. It is important to remember that at some sites, this may only be during active labour.
Whatever your concerns, it’s really important that you share them with your family so you can support one another.
Being a new parent during COVID-19
If you have already given birth, remember there’s no right way for a person to feel after having a baby. Allow yourself the time to adjust and be self-compassionate. Having a baby is a life-changing event and it’s likely to be even more challenging in coronavirus lockdown.
With the arrival of a new born, there’s often an expectation for you to have visitors or a celebration. For some, the delay of these events will leave them feeling saddened, but for others, the lockdown restrictions may be providing a welcome relief from unwanted intrusion in the early days.
However you feel, it’s really important to talk. And remember, it’s ok not to be ok. It can be really difficult to discuss how you’re feeling, especially in the early days when emotions are changeable and sleep is limited. Sometimes, people believe that they should be happy, excited and on top of everything, when actually they feel something different. A lot of new parents have this experience, so it’s really important to share these feelings with a trusted person and ask for extra support from professionals if you need it.
Recognising signs of mental health conditions in the perinatal period
If you, a partner or a family member spots any sign of change in your mental health or that of someone close to you, please seek help early.
It’s important to know how to spot signs of depression or more serious mental health conditions in the perinatal period and when to access help.
We’ve probably all heard of the ‘baby blues’, which is a brief period of feeling emotional and tearful that often occurs three to ten days after giving birth. This affects many new mothers, usually lasting only a few days and is generally quite manageable.
However, for 10 to 15 percent of new mothers, symptoms of a longer term depression or another mental health condition can occur. Often, symptoms present within the first six weeks of having a baby, though this is not always the case. Symptoms can come on gradually or very suddenly, and can be mild, moderate, or severe.
Common signs and symptoms of depression to look out for include the following:
- Sad or low, and tearful for no obvious reason
- A sense of hopelessness or worthlessness
- Extreme tiredness
- Expressing being unable to cope
- Extreme guilt
- Irritable, angry or hostile
- Indifferent or hostile towards the baby
- Losing concentration
- Disturbed sleep
- A reduced appetite
- Less interest in sexual relations
- Thoughts about death or wanting to harm themselves
If you or your partner notices any of the following symptoms, these are signs that you should seek urgent help from a health professional:
- A recent significant change in mental state or emergence of new symptoms
- New thoughts or acts of violent self-harm
- New and persistent expressions of incompetency as a mother or estrangement from your baby
- A sudden change in activity levels such as becoming excessively busy, overactive or talkative
- Fluctuations in your presentation (i.e. repeated change in your state over minutes to hours)
- Confusion, disorientation and/or perplexity
Research tells us that 7 in 10 women will underplay how they really feel because they’re fearful of what will happen or what will be said if they tell somebody. That is why it’s so important for partners, friends and family members to be alert for these signs and to encourage new mothers to speak openly and honestly about how they are feeling.
Staying well during the perinatal period
Here are a few key things to remember when you are going through the perinatal period during the coronavirus:
- Remember it’s ok not to be ok; be kind to yourself
- Talk and ask one another regularly: “How are you? Are you really ok?”
- Focus on the positives; recognise, value, and celebrate what you can do at a time of lockdown
- Stay connected with your family, friends and healthcare providers
- Manage how you follow the coronavirus outbreak in the media. Restrict the amount of time that you go online to check and when you do, make sure that you’re seeking information from reliable sources
- If you have a partner, allow one another to have some ‘me time’ when you have a new baby
- If you are on your own, try and build some ‘me time’ into your day at any point that you can
- Just make loose plans, recognising that things are likely to change. Babies don’t follow our timetables so we can be better prepared if we can build flexibility into our own expectations
- If you haven’t already, try to link with online support networks. There are a number of reputable online groups for mothers, fathers and families
Mental health support at Priory Group
Priory continues to offer mental health support during the COVID-19 outbreak. To find out more, please visit our perinatal mental health page.
The Royal College of Psychiatrists Perinatal faculty have produced a patient guidance document for women and their families who are pregnant or in the postnatal period in the context of the COVID-19 pandemic, which can be found at: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/perinatal-care-and-covid-19