“It was a lot to deal with,” he said. “I didn’t have an active partner, there was all this rejection at work; I mean, being alone every day of your pregnancy is extremely depressing.”
Depression during and after pregnancy affects many people, and the pandemic has only made this mental health problem worse, health professionals say. These types of depression can include deep sadness, heightened anxiety, and relentless exhaustion that make it hard for sufferers to take care of themselves and their families.
“Even before Covid happened, we knew there was an increase in the number of women who had postpartum depression, so the pandemic added to that,” she said. Clayton J. Shuman, assistant professor at the University of Michigan School of Nursing.
Shuman is lead author of a pair of studies from the University of Michigan Michigan School of Nursing and Medicine, which found that a third of people who had babies in early to mid-2020 experienced postpartum depression. That’s triple pre-pandemic levels.
A fifth of the 670 respondents in one of the studies said they thought about harming themselves. The results, published in BMC Research Notes, showed that formula feeding, neonatal intensive care unit admission and concern about coronavirus infection increased risks of depression.
“We weren’t surprised that there were more, but we were surprised that there were so many people suffering,” Shuman said.
For Shuman, the pandemic highlighted existing flaws in the nation’s response to maternal psychological health. “The main problem,” he said, “is that, systemically, I don’t think we evaluate very well” perinatal and postpartum mental health care. “And we also don’t provide customized resources for needs that we identify,” he said. “It’s a one-size-fits-all approach.”
Addressing those flaws, he said, would require public health departments to work more closely with perinatal patients and create more robust and effective screening tools and treatments. It would also require a greater investment in education, such as free classes at affordable prices for new and expectant mothers and their families.
The pandemic, with its lockdowns, visitation limits and political divisions, has made having a baby more isolated than usual for many people.
By removing many social supports for people with perinatal and postpartum depression and anxiety, experts say, the pandemic has underscored how vital they are for treating mood disorders. They are even more necessary for patients of color, who are several times more likely to suffer perinatal mental illness but less likely to get treatment than other people.
With mental health issues driving maternal mortality in some states, including California, where Stanford University researchers in 2019 identified it as the leading cause of death among new moms, experts say the stakes are too high to let it persist.
People suffering from perinatal and postpartum depression need support and coping strategies that go beyond medication, experts say. Research, including a new Northwestern University study, shows that medications are not always effective in treating postpartum depression.
For Gorey, her pregnancy, marked by fatigue and fluctuating hormones, brought latent trauma to the surface. “I was constantly battling bouts of depression trying to break through,” she says, “and realized that every little mental issue you hold on to is going to be there throughout your pregnancy. She didn’t have all the joy that a lot of new moms normally have.”
From spring to fall, she endured anxiety, isolation, and fear of abandonment. Then came what felt like a blessing: Shyana Broughton, who founded Our Mommie Village a few years earlier to provide doula and lactation support to black mothers like Gorey.
“One of the biggest things I needed was for Shyana to help me process everything,” says Gorey, “not just saying, ‘Oh, you’re doing great, you’re doing good,’ but really talking about things, to confront all those emotions, all those feelings that you know are going to become big postpartum triggers.”
With Broughton’s encouragement, Gorey, 33, says he learned to cry when he felt like crying and to rest when he felt like resting.
With perinatal and postpartum depression, “a lot of it comes from not having a community,” says Broughton. “When I felt like freaking out, I knew where to go. When he cried, when he was sad, when he said: ‘I don’t know what else to do’, I would say: ‘Come and have some tea or coffee’ or ‘Come dance and eat some mango because that’s what I happen to be. cutting right now. ”
Lack of community, supports
The problem is that perinatal supports that most people could benefit from aren’t available to many people, pandemic or not, says Amber Parden, who oversees perinatal psychiatric services at Woman’s Hospital in Baton Rouge. “Or, if they do exist, they are very limited,” she added. “So when you subtract from that in a pandemic, you end up with sicker people. It strains the system.”
That’s the case in Bayou State, where a weak safety net and rampant poverty make it especially difficult for many people to access health care.
“We just don’t have enough treatment providers,” Parden said. “There just aren’t enough therapists. When the pandemic hit, we were trying to find enough help for these people, but the impact was so intense – everyone was overwhelmed.”
Parden found herself helping others overcome many of the same issues she was dealing with. “I had a covid baby myself,” she said, “a covid pregnancy, with complications.”
Parden had a family to turn to, having moved back to Louisiana after a several-year stay in upstate New York so her children could be with their cousins, grandparents, aunts and uncles.
“We are not meant to be independent, to deal with these things alone,” he said. And being within driving distance of so many loved ones, she said, helped her get through an otherwise alienating pandemic.
She knew the isolation many of her patients experienced: the anxiety of not having her husband by her side even during routine appointments, not being able to hold his hand, having to tell him after the fact.
“Pregnancy changed a lot to a lonely experience,” Parden said. “And that hit moms hard, they’re going to find some way to feel guilty no matter what’s going on in the world. Mom’s guilt is a very real thing.”
As the pandemic forced millions more people to simultaneously become stay-at-home parents and employees, Parden said she saw an influx of clients struggling to remain emotionally and mentally present to their families. Parden began collaborating with other perinatal care providers to ensure that new moms had “more than just a psychiatrist who prescribes medication.” She said she started doing a lot more parent training with new moms because of increased demand from families trying to manage behavioral issues in children who spend a lot more time at home.
It didn’t help, she added, that many of the lactation support groups and services that would overcome that isolation have been suspended or gone virtual during the pandemic.
Stressful and lonely childbirth
Anslye Chatham, a 24-year-old public school teacher in rural Mississippi, had Covid-19 just before giving birth to her first child, as did her husband. When the couple arrived at the nearest hospital, 90 minutes from home, for a scheduled C-section, they were both in quarantine and neither had symptoms.
“But when I got to the labor unit, I was met with a lot of animosity from the nurses,” she said. “They told me that my husband could not be there.”
She had an extremely stressful and lonely birth, she said. There was no immediate skin-to-skin contact, no swaddling to bond with dad, no nursery time, she said. Had it not been for a nurse who took it upon herself to take some photos, Chatham says she would have no way of visually remembering the first moments of her daughter’s life. Two hours passed before he came to hug her.
“At the time, I didn’t realize how much it affected me,” he says, “but it has affected me a lot.”
As someone diagnosed with anxiety years earlier, Chatham says she anticipated the mood disorder to be a challenge before and after pregnancy. But after a few blissful weeks as a new mom, she says the hospital experience began to send her into a spiral of postpartum angst, of deep guilt that she and her daughter had been deprived of something from the start.
“Most of all, I feel guilty that I didn’t have that time with her, or that I didn’t fight for that time with her,” he says.
Amplifying those concerns were stressors with her job at a small-town public high school in the Deep South and living in a state that doesn’t offer paid maternity leave.
Although her psychiatrist gave her half her usual dose of Zoloft during pregnancy, Chatham said that breastfeeding became one of the most effective ways to deal with her clinical anxiety.
Nell Blakely, a 66-year-old leader of the La Leche League grassroots breastfeeding support network, guided her through the process. Although the pandemic forced La Leche League to bring its support groups online, Blakely’s closeness became a source of comfort.
“She lives near me,” Chatham said, “and would give me great advice on things like hitch problems.”
Breastfeeding has not only eased her worry, but also some of the lingering trauma of a stressful birth.
“It also lessened some of the guilt,” she said, “and that really helped me heal.”
