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    Postpartum depression during a pandemic: what providers should know

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    Welcoming a new baby into the world can be a happy time for new mothers, but postpartum depression is common leading up to and after giving birth. Depression, anxiety, and trauma-related disorders can all be aggravated by stress related to pregnancy and postpartum experiences. Add in a global pandemic, and these scenarios are even more likely. Uncover the research and learn more about what providers can do to help patients impacted by postpartum depression.

    Research shows a connection between postpartum depression and covid concerns

    The CDC estimates about 1 in 8 women experience symptoms of postpartum depression. Additionally, postpartum depression estimates vary by state and can be as high as 1 in 5 women—and this is all before the pandemic. In a new study published in Psychiatry Research, researchers from Brigham and Women's Hospital found that women who had recently given birth had concerning rates of depression, generalized anxiety, and post-traumatic stress disorder (PTSD) symptoms. They also found that these symptoms were exacerbated by COVID-19-related grief and health worries. Research showed that approximately 9 percent of participants felt a strong sense of grief, loss, or disappointment due to the pandemic. These individuals were roughly five times more likely to experience clinically significant mental health symptoms—and up to over four times more likely to experience clinically significant psychiatric symptoms.

    "Obstetric practices weren't able to screen for mental health symptoms as well, all while people's mental health was under the most pressure," said Leena Mittal, MD, of the Department of Psychiatry at Brigham and Women's Hospital. She added, "Mental health supports have persisted and come back in new ways, and the amount of innovation surrounding delivering group and individual care, especially using virtual platforms, is phenomenal. On the psychiatry side of things, we have never been busier, and individuals and families who feel they need mental health care should seek it."

    The impact of postpartum depression symptoms differs for each person. Similar to depression symptoms, these include:

    • Crying more often than usual
    • Feelings of anger
    • Withdrawing from loved ones
    • Feeling numb or disconnected from your baby
    • Worrying that you will hurt the baby
    • Feeling guilty about not being a good mom
    • Doubting your ability to care for the baby

    According to the CDC, the following experiences may put some women at a higher risk for depression:

    • Stressful live events
    • Low social support
    • Previous history of depression
    • Family history of depression
    • Difficulty getting pregnant
    • Being a mom to multiples, like twins, or triplets
    • Being a teen mom
    • Preterm (before 37 weeks) labor and delivery
    • Pregnancy and birth complications
    • Having a baby who has been hospitalized

     

    Resources available for providers to share with patients

    Since COVID-19-related health worries and grief experiences may increase the likelihood of mental health symptoms among those without pre-existing mental health concerns—providers should be aware of these findings so that they can address any related situations with patients. Depression is treatable, and patients look to their providers for guidance. For patients that can't make in-person appointments, there are new ways to continue supporting mental health virtually, as supported by Dr. Mittal above. Our provider network has access to our free telehealth platform: AllWays on Teams, in partnership with Microsoft. You can also visit our Behavior Health Resources to find screening tools such as the Edinburgh Postnatal Depression Scale developed for screening postpartum women in outpatient, home visiting settings, or at the 6 –8 week postpartum examination.

    Providers can also guide patients to resources available through the Massachusetts Child Psychiatry Access Program (MCPAP). MCPAP for Moms provides real-time, perinatal psychiatric consultation to effectively prevent, identify, and manage their pregnant and postpartum patients' mental health and substance use concerns.

    The CDC also offers the following resources: 
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