"What is COVID-19?
COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus. Some people with COVID-19 may have no symptoms or only mild symptoms. 

How does COVID-19 affect pregnant women?
Researchers are still learning how COVID-19 affects pregnant women. A report released in June 2020 looked at whether pregnant women might be at increased risk of getting very sick from COVID-19. This report from the Centers for Disease Control and Prevention (CDC) notes that:

• Pregnant women with COVID-19 may be more likely than nonpregnant women with COVID-19 to need care in an intensive care unit (ICU) or need a ventilator (for breathing support).
• Pregnant women who are Black, Hispanic, or Asian may have a higher risk of severe illness or need ICU care more often than other pregnant women. This is likely caused by social and economic inequity, not biological differences.

Although the risk of needing more care in the hospital and having more severe illness may be increased, the overall risk of these outcomes is still low for pregnant women. Also, it’s important to know that the report suggests the risk of death is not higher for pregnant women with COVID-19 than for nonpregnant women with COVID-19. 

How can COVID-19 affect a fetus?
Remember that researchers are learning more about COVID-19 all the time. Some researchers are looking specifically at COVID-19 and its possible effects on a fetus. Here’s what they know now:

• Some pregnant women with COVID-19 have had preterm births, but it is not clear whether the preterm births were because of COVID-19. 
• Researchers have found a few cases of COVID-19 that may have passed to a fetus during pregnancy, but this seems to be rare.

More research is needed to understand the effects of COVID-19 before birth. After birth, a newborn can get the virus if they are exposed to it. 

 What should pregnant women do to avoid the coronavirus?
Pregnant women should take steps to stay healthy, including:

• keeping your prenatal care visits 
• limiting contact with other people as much as possible
• staying home as much as possible
• staying at least 6 feet away from other people if you need to go out 
• wearing a mask or cloth face covering in public and any other needed protection while at work 
• washing hands often with soap and water for at least 20 seconds
• cleaning hands with a hand sanitizer that contains at least 60 percent alcohol if you can’t wash them (rub until your hands feel dry)
• avoiding touching your eyes, nose, and mouth 
• having a good stock of essential supplies, including at least 30 days of any medications (so you don’t have to go out as often)

Should pregnant women wear a mask or face covering?
As of April 3, the CDC says all people, including pregnant women, can wear a cloth face covering when they are in public to slow the spread of COVID-19. Face coverings are recommended because studies have shown that people can spread the virus before showing any symptoms. See the CDC’s tips on making and wearing a face covering.

Wearing a cloth face covering is most important in places where you may not be able to stay 6 feet away from other people, like a grocery store or pharmacy. It also is important in parts of the country where COVID-19 is spreading quickly. But you should still try to stay at least 6 feet away from others whenever you leave home.

If you have COVID-19 or think you may have it, you should wear a mask while you are around other people. You also should wear a mask if you are taking care of someone who has COVID-19 or has symptoms. You do not need to wear a surgical mask or medical-grade mask (N95 mask). 

How will COVID-19 affect prenatal and postpartum care visits?
It is important to keep your prenatal and postpartum care visits. Call your obstetrician–gynecologist (ob-gyn) or other health care professional to ask how your visits may be changed. Some women may have fewer or more spaced out in-person visits. You also may talk more with your health care team over the phone or through an online video call. This is called telemedicine or telehealth. It is a good way for you to get the care you need while preventing the spread of disease. 
If you have a visit scheduled, your care team’s office may call you ahead of time. They may tell you about telemedicine or make sure you do not have symptoms of COVID-19 if you are going in to the office. You also can call them before your visits if you do not hear from them."

By Cassie Shortsleeve| July 14, 2020

"Six weeks after I gave birth to my first daughter, I found myself in my OB/GYN’s office for my postpartum checkup. After a quick conversation and a physical exam, my doctor told me that I was “cleared.” I could resume all regular pre-pregnancy activity.

I went home, fed my baby and went on a run — and had to stop after a half-mile. My pelvic floor felt like it was going to give out and — although once an avid runner — I felt clumsy. That night, I lay awake, milk-stained and sweaty. Nothing about me felt “cleared.”

Despite the fact that in 2018, the American College of Obstetricians and Gynecologists recommended that, to optimize women’s health, postpartum care should become more of a rolling process rather than a single encounter, for many new moms, the six-week postpartum appointment remains the only touch point with the health-care system that birthed her baby.

If Latin America has la cuarentena — a 40-day period when women take care of a new mom while she rests — and the ancient Indian medical system of ayurveda teaches us that we must nurture women for 42 days postpartum for the health of her next 42 years, the United States, traditionally, has this: one lone appointment that, in many senses, gives a message of closure to the fragile and monumental postpartum period.

"The four- to six-week time frame has historically been thought to be enough time for women to be able to go back to do more physically demanding jobs, like farming, without having any serious medical issues,” explains Heather Irobunda, a board-certified OB/GYN in New York. Your uterus has usually shrunk back to a pre-pregnancy size, lacerations have healed, soreness from birth has resolved.

But physical changes persist for longer — probably six months or so, says Kecia Gaither, director of perinatal services at NYC Health+Hospitals/Lincoln. Around then, pelvic floor and abdominal musculature tone returns, changes in hair normalize, and the menstrual cycle might become more regular (if it’s returned).

Some research even suggests women wait 12 months to conceive again. But how long does it take for the body to recover? It depends on where you look.

The Centers for Disease Control and Prevention, for one, says that a “pregnancy-related” death is a death of a woman while pregnant or within one year of the end of pregnancy, but “maternal mortality” is defined by the World Health Organization as the death of a woman while pregnant or within 42 days of the end of pregnancy.

The Diagnostic and Statistical Manual of Mental Disorders, often called the “bible” of psychiatric health conditions, defines postpartum depression as depression “with postpartum onset: defined as within four weeks of delivering a child.” But, says Cindy-Lee Dennis, a professor at the University of Toronto who studies the postpartum period, “it’s fairly standard in the research literature to consider postpartum depression up to one year postpartum.” (Take a landmark 2013 study published in JAMA Psychiatry of 10,000 mothers: It found that 1 in 7 women develop PPD within the first year postpartum.)

Birdie Gunyon Meyer, a registered nurse and director of certification for Postpartum Support International, a nonprofit group that lobbied to extend the period following delivery in the definition of PPD, says: “I don’t think anybody really believes that the postpartum period is over at four or so weeks, but we give that impression when you come in for your four- or six-week checkup."
​
The truth is, the adjustment to parenthood takes time. It takes more than a couple of weeks and more than a couple of months. Researchers say Year 1 is critical for children and parents alike. “For the child, the brain is growing rapidly and the experiences that happen and the neurological pathways that are developed stay with the child for a lifetime,” says Dennis."

By Charles Feng| July 22, 2020

"Three years ago, my wife, daughter and I took a photo shivering on a beach amid the howling autumnal wind. Last year, for 11 glorious, anticipatory weeks, while my wife was pregnant, I planned to update the picture at the same location with a new baby in tow.

But that plan was abruptly upended when we had a miscarriage. Now that picture that sits on our mantel would still be just the three of us, squinting into the camera, buttressing one another against the cold.
​
The miscarriage itself lasted only a few hours. But the self-recrimination lingered long afterward because I wasn’t sure how to grieve when my wife’s emotional response seemed more important. When I searched online, women’s perspectives abounded on websites, in YouTube videos and in news articles, but men’s perspectives were scarce. Academic research was little better. A pattern emerged: Although there is a spotlight on Mom’s emotions and well-being during a miscarriage, Dad’s experiences are rarely discussed.
​
The pregnancy for our first daughter went smoothly. So, when my wife found out about our second pregnancy, we told family members and friends immediately after finding out, around the two-month mark. This meant that when the miscarriage occurred, we had to backtrack and explain to everyone what had happened, in painful conversations.

My wife’s friends, mostly women, showered her with messages and flowers. On the other hand, for the few friends, all men, I contacted, the comments ranged from the trite (“Sorry, that sucks”) to the callous (“Gotta try again!”) to, well, silence. My best friend, with the best of intentions, emailed my wife his condolences but excluded me.

Eventually, another friend who had recently experienced two miscarriages carved out some time to chat over dinner.
“How are you feeling, buddy?” he asked.

​“Okay,” I said.

“Tough as it seems right now, it does get better with time.”

“Good to know.” I felt like a sullen teenager.

“You know, while discussing miscarriages is in general taboo, for men it seems especially so,” he said.

He’s right.

The entire arc of the miscarriage, from conception to loss, occurs within the female body. Aside from contributing sperm, I felt like a bystander. I was traveling when my wife watched the double pink lines appear on the pregnancy test. She occasionally saw the obstetrician on her own and started organizing the baby’s room without my input. I had an ancillary role in the pregnancy, so I wasn’t sure I even had a right to feel devastated.

The event itself is permanently etched in my psyche. Throughout the night, my wife had unremitting abdominal pain. I was asleep when she barged through the door from the bathroom.

​“The baby’s gone,” she said through tears.

“I’m so sorry,” I said. I got up and hugged her. “What should we do now?”

“I don’t know.”

My wife went to the obstetrician, while I stayed home with our 2-year-old daughter.

After a sushi lunch — no longer pregnant, my wife could eat raw fish again — we dropped our daughter off at my parents’ house. To distract ourselves, we caught an animated movie. That evening, we drove to a deserted parking lot at the local elementary school. I shut off the car ignition and let the jazz radio buzz in the background. I held my wife’s hand as we stared into the darkness. We talked about the movie but little else.

The next day I was back at work.

The best thing I could do was to just be with her. I felt like I didn’t have a right to express my despair, so I actively suppressed my emotions. My wife needed to lean on me, so I became a stoic, unperturbable oak tree for her. According to a study published this year, after a miscarriage, men have described themselves, in supporting their wives, as “rocks, guards and repair men.” We adhere to traditional notions of masculinity, of being steady and capable, and never, ever succumbing to emotions."

"Do you ever feel like you’re not doing enough as a parent? Like you might be totally screwing this up and maybe even making things worse for your kids? We’re right there with you. Parenting was already hard, and now we're navigating a pandemic on top of it.

In this webinar, we’ll talk about the self-doubt, anxiety, and uncertainty that has come with pandemic parenting. We’ll also share what the research says about “good enough’ parenting, especially in times of crisis. We’ll be joined by guest, Dr. Sharon Lamb, psychologist and author of The Not Good Enough Mother. Agata Freedle will serve as moderator to guide our conversation and pose questions that you submit.
​
Join us on Zoom at 9 p.m. Eastern Time for this free webinar."

By Josie Cox| July 30, 2020

"As the epicenter of Covid-19 continues to drift around the globe, leaving death and depression in its wake, it’s become increasingly difficult for even the most naive to defend a whimsical assertion favored by the privileged in the early days of the pandemic. Coronavirus is not a great leveller. It never was. 

​Data made available to The New York Times earlier this month shows that Latino and African-American residents of the U.S. are three times as likely to become infected as their white neighbors. Black and Latino people are almost twice as likely to die from it. 

Other figures show that states with the highest level of income inequality have had a larger number of Covid-19-related deaths than states with lower inequality. And the gender divide is marked too.

As the epicenter of Covid-19 continues to drift around the globe, leaving death and depression in its wake, it’s become increasingly difficult for even the most naive to defend a whimsical assertion favored by the privileged in the early days of the pandemic. Coronavirus is not a great leveller. It never was. 

Data made available to The New York Times earlier this month shows that Latino and African-American residents of the U.S. are three times as likely to become infected as their white neighbors. Black and Latino people are almost twice as likely to die from it. 

Other figures show that states with the highest level of income inequality have had a larger number of Covid-19-related deaths than states with lower inequality. And the gender divide is marked too.

​Almost half of all mothers surveyed felt “rushed and pressed for time” more than half of the time during the lockdown, and 46% felt nervous and stressed more than half of the time. Only 15% of mothers said they had managed to set clear boundaries between work and family, largely on account of the closure of schools and childcare facilities. 

“It is clear that parents in particular need more support during school and childcare closures,” says Dr Heejung Chung of Kent’s School of Social Policy, Sociology and Social Research, who led the study.

“There are signs that the increased workload and conflict between work and family has negatively impacted parents’ mental wellbeing, especially mothers,” she adds. “We need a thorough gendered analysis on the economic impact of the lockdown and more resources and policies are needed to support parents especially mothers' labor market attachments.”

Biggest Setback in a Decade 

​This research adds to reams of existing evidence underscoring the extent to which the pandemic has chipped away at hard-earned progress towards both greater gender equality and women’s economic rights, while exacerbating an already terrifying mental health crisis.

Sofia Sprechmann, Secretary-General of humanitarian agency Care International, recently described Covid-19 as the biggest setback to gender equality in a decade. Research conducted by McKinsey has revealed that women’s jobs are 1.8 times more vulnerable to this crisis than men’s. The consultancy concluded that because of Coronavirus’ “regressive effect on gender equality”, global GDP growth could be $1 trillion lower in 2030 than it would be if women’s unemployment simply tracked that of men in each sector."

By: Catherine Pearson| July 14, 2020

"We're facing a year without precedent in modern parenthood. So why do we feel...so detached?"

"When the pandemic first hit New York City in March, abruptly closing my boys’ school and daycare, I was a wreck.

I was terrified of my kids getting sick. I was so anxious sitting in bed at night, listening to sirens scream past my window down the Brooklyn-Queens Expressway, I’d lose my breath. Then sometimes, I’d have moments of delirious happiness: My family was safe and hanging out together at, like, 11 a.m. on a Tuesday. We never do that! It was emotional and logistical chaos all day, every day.

Now, months into this mess, I move through my days feeling basically ... nothing. When I see friends and family (from a safe distance, outdoors, usually wearing a mask) and they ask how I’m doing, I say something like: “We’re good! We’ve kept our jobs, and no one’s been sick. Also, I’m dead inside.”

This is only a partial joke.

The everyday stresses parents are facing now are arguably worse than they were when the virus first emerged. Where I live in New York City, public schools recently announced they’ll likely open for in-person learning between one and three days a week — as though those are remotely similar. I have no idea if my husband and I are sending our older son in. I have zero idea what we’re doing for childcare for our younger kiddo, because I do not see a solution that feels relatively safe and is one we can actually afford. I have no idea how we are going to get through the fall or winter or any part of next year.

But I’m not freaking out; I’m numb.

And I’m not alone.

“After being on high alert for so long, it’s entirely understandable that numbness would set in. No one can sustain a state of emergency for any length of time. We weren’t built that way,” said Olivia Bergeron, who runs Mommy Groove Therapy & Parent Coaching in New York City. “Fight or flight is supposed to be a temporary state to ensure survival, not a permanent way of living.”

"​While parents may be feeling unsure about school options this fall, there are ways to feel better as you make the tough decision."

"A combination of dread, panic and sheer exhaustion. This is what I see on the faces of patients (and friends and colleagues) when the conversation turns to the most pressing topic on every parent’s mind: what to do about school in the fall. I’m a psychiatrist specializing in women’s mental health, and I have yet to speak to anyone who feels satisfied with the options presented to them, or who feels particularly confident in the choices they’ve made.

The information on children and the coronavirus has been evolving since March, with the most recent data suggesting that children are less likely to become infected by the virus and less likely to have a severe course when infected. But, those words “less likely” suggest that children are at some, albeit smaller, risk. And, the United States still has not come up with an adequate solution to protect teachers, many of whom are high risk.

As I see it, school stress for parents boils down to two main points: Deciding what to do, and then what to do with the uncomfortable feelings that could arise after that decision. As a psychiatrist, I’m admittedly not so helpful when it comes to the decision of whether or not to send your kids to in-classroom learning this fall. Where I can help is how to deal with the uncertainty and difficult feelings that accompany this process.

A risk assessment system, like the one described by Emily Oster, Ph.D., a professor of economics and public policy at Brown University, can be a useful guide when making decisions with scarce data. Instead of focusing on the illusion of “one right answer,” this framework can give you a reliable process for making hard parenting decisions by focusing on evaluating and mitigating risks, and assessing benefits. While no parent is feeling particularly confident about the school options available to them, it is possible to feel good about the process you use to make those decisions.

In an interview, Dr. Oster wrote, “By making clear the choices, the costs and benefits, we can reason our way to better decisions. But I really think even more important is the fact that we can make our way to more confidence in these decisions by articulating a good process.”

Once you’ve delineated a plan, then you’re faced with the task of coping with the onslaught of feelings, like worry, guilt, fear and uncertainty. For this, here are some strategies, many of which come from acceptance and commitment therapy, a form of behavioral therapy that teaches people to accept their difficult thoughts and feelings as opposed to struggling against them, and to prioritize taking actions that are in line with their values."

Elliot Aronson and Carol Tavris|Social Psychologists| July 12, 2020

"​The minute we make any decision--I think COVID-19 is serious; no, I’m sure it is a hoax—we begin to justify the wisdom of our choice and find reasons to dismiss the alternative."

By: LULU GARCIA-NAVARRO

​"So many of us do it: You get into bed, turn off the lights, and look at your phone to check Twitter one more time.

You see that coronavirus infections are up. Maybe your kids can't go back to school. The economy is cratering.

Still, you incessantly scroll though bottomless doom-and-gloom news for hours as you sink into a pool of despair.

This self-destructive behavior has become so common that a new word for it has entered our lexicon: "doomscrolling."

The recent onslaught of dystopian stories related to the coronavirus pandemic, combined with stay-at-home orders, have enabled our penchant for binging on bad news. But the habit is eroding our mental health, experts say.

Karen Ho, a finance reporter for Quartz, has been tweeting about doomscrolling every day over the past few months, often alongside a gentle nudge to stop and engage in healthier alternatives.

Ho first saw the term in a Twitter post from October 2018, although the word may very well have much earlier origins.

"The practice of doomscrolling is almost a normalized behavior for a lot of journalists, so once I saw the term I was like, 'Oh, this is a behavior I've been doing for several years,' " she says.

​If Ho's daily reminders aren't enough to break the habit, clinical psychologist Dr. Amelia Aldao warns that doomscrolling traps us in a "vicious cycle of negativity" that fuels our anxiety.

​"Our minds are wired to look out for threats," she says. "The more time we spend scrolling, the more we find those dangers, the more we get sucked into them, the more anxious we get."

By: Cassie Shortsleeve| July 07, 2020

"​Black maternal health providers share the advice they give their own patients that any Black expectant or new mom can learn from."

"Pregnancy is a life-changing event. But for Black women, this time in their lives comes with uniquely concerning health issues and added layers of struggle.

In the U.S., Black women are two to three times more likely to die from pregnancy-related causes than white women. That figure is even larger in metro areas such as New York City where Black women are up to 12 times more likely to die during pregnancy and childbirth. And while about one in seven women in this country experience a perinatal mood and anxiety disorder (PMAD), Black women suffer at higher rates—and are less likely to receive treatment.

Black moms and moms-to-be also face the biases of a mostly-white medical field, not to mention systemic racism, and stigma in and out of doctors' offices, say experts. But there are ways to prioritize yourself and protect your mental wellness (or help an expectant friend) in the journey to motherhood.

Here, Black doctors, therapists, doulas, and other maternal health experts share the words of wisdom they'd give to Black moms everywhere.

1. Prioritize emotional wellness.
"Given that Black women are at higher risk for pregnancy-associated mortality when compared to non-Black pregnant women, it is important that Black women empower themselves with knowledge about the importance of maintaining emotional wellness so that they take the steps necessary to advocate for their mental health needs during their pregnancy. If you're experiencing significant anxiety, disclose your distress to friends and family. If social support is not sufficient, talk to your healthcare provider about different treatment options."—Christine Crawford, M.D., M.P.H., an assistant professor of psychiatry at Boston University School of Medicine and an adult, child, and adolescent psychiatrist at Boston Medical Center.

2. Find the mental health support you need (even if it's virtual).
​"Mental health support during the prenatal period is important especially during a time like this when women have the extra stress of the consequences of COVID-19 and racial injustice and protests. Black women are less likely to receive care for depressive symptoms and are often under-diagnosed. If you have symptoms, find a provider that you feel comfortable with, whether on a mental health app, one-to-one talk-therapy, or group therapy. Another great tool I love for moms is meditation apps. They can help with grounding during times of great stress. If the new mother has access to mental health support during the prenatal period, the risks for postpartum depression decrease."—Latham Thomas, founder Mama"