key: cord-1031057-eyrdy43y
authors: Ranjan Panda, Soumya
title: Maternal psychological health in context with COVID-19 pandemic
date: 2021-01-23
journal: Taiwan J Obstet Gynecol
DOI: 10.1016/j.tjog.2020.12.002
sha: 199a81cdc250a8d84c7ecb48cb3a02c9a11dafce
doc_id: 1031057
cord_uid: eyrdy43y

nan

With the pandemic of Coronavirus disease -19 (COVID -19) creating havoc, every possible way is being adopted by the medical communities and various government agencies around the world to halt the spread. Although pregnancy is a special stage in a woman's life, the journey is not smooth always. Recently few studies have reported a higher prevalence of mental health problems among women compared to men. [1] As such, pregnant women and new mothers could certainly be more vulnerable. Maternal mental health problems can be associated with short -term and long -term risks for the affected mother as well as for their children in terms of physical, cognitive and psychological development. Moreover, certain conditions like extreme stress, emergency situations and natural disasters can inflate the risks of perinatal mental health morbidity. Therefore, it is obvious that pregnant women are vulnerable to mental ill-health during the COVID-19 pandemic.

Strict public health measures directed towards combating the spread of disease, although quite essential, but may lead to negative psychological effects resulting in stress, anger and confusion. [2] In this context concerns regarding the wellbeing of the unborn child, the prolonged pandemic chaos and the related economic consequences etc. are likely to further escalate psychological burden of pregnant women and new mothers. Less studied facts related to the effects of COVID-19 on pregnancy and the foetus is likely to add further to psychological stress. Some individuals may get involved in harmful acts such as alcohol consumption or substance abuse to overcome the crisis stage, thus aggravating existing psychological problems. This may also result in an increase in domestic violence or an increase in suicide rates, especially among low -income families and immigrant communities.

In this critical situation, every community in the world are diverting their health resources to combat an unfamiliar disease. Equally important, even during such a calamity, is the need to scrutinise for any new threats to pregnant women and infants. [3] However, mental health needs are currently overshadowed by other, more pressing issues in healthcare. Hence by reviewing the literature we have listed some essential guidance (table no.1) for the care of maternal psychological health during such a critical time. [4] Hence the psychological health of pregnant women is an important aspect to care for during the current pandemic. Government agencies should be actively involved in developing appropriate strategies to screen for important psychological issues especially stress, depression, domestic violence etc. and to address other issues related to perinatal mental 2) Women should be screened for any pre-existing mental health conditions or substance use disorders and domestic and intimate partner violence early in pregnancy. Referrals should be provided to psychological health or social services as indicated.

3) It should be born in mind that communities affected by systemic racism, housing instability, low socioeconomic status, poor access to health care etc. may be unable to consistently practice infection control measures and social distancing and are at increased risk for poor mental health outcomes and inadequate social support.

4) It should be acknowledged that labor and birth in a pandemic are not according to the mother's expectations or planning and that feelings of anxiety, sadness, grief, fear, or loss are normal. 5) Infant-mother bond should be maintained, and it should be avoided to separate mothers and infants unless required by clinical condition. 6) Skin-to-skin care and breastfeeding should be promoted as long as it's safely possible.

Infants who are separated from mothers should be observed for excessive stress and ensuring that human touch is provided to these infants. 7) For post partum women it's better to reevaluate psychological symptoms (stress, depression, anxiety), support systems and safety upon discharge to assess for community care needs. 8) Women should be made to access to virtual and community mental health resources while maintaining social distancing. Collaborative networks should be created with the community-based organisations to enhance coordination and optimisation of care. 9) For pregnant and postpartum women who are working as health care or other frontline workers, mental health resources and support should be advocated.

Prevalence and predictors of PTSS during COVID -19 outbreak in China hardest-hit areas: Gender differences matter

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Surveillance for Emerging Threats to Pregnant Women and Infants

Promotion of Maternal-Infant Mental Health and Trauma-Informed Care During the COVID-19 Pandemic