By Pooja Lakshmin|may 27, 2020
"New and expecting moms are facing pandemic-related fears on top of social isolation."
Photo: Mikyung Lee
"After going through a harrowing bout of postpartum depression with her first child, my patient, Emily, had done everything possible to prepare for the postpartum period with her second. She stayed in treatment with me, her perinatal psychiatrist, and together we made the decision for her to continue Zoloft during her pregnancy. With the combination of medication, psychotherapy and a significant amount of planning, she was feeling confident about her delivery in April. And then, the coronavirus hit.
Emily, whose name has been changed for privacy reasons, called me in late-March because she was having trouble sleeping. She was up half the night ruminating about whether she’d be able to have her husband with her for delivery and how to manage taking care of a toddler and a newborn without help. The cloud that we staved off for so long was returning, and Emily felt powerless to stop it.
Postpartum depression and the larger group of maternal mental health conditions called perinatal mood and anxiety disorders are caused by neurobiological factors and environmental stressors. Pregnancy and the postpartum period are already vulnerable times for women due in part to the hormonal fluctuations accompanying pregnancy and delivery, as well as the sleep deprivation of the early postpartum period. Now, fears about the health of an unborn child or an infant and the consequences of preventive measures, like social distancing, have added more stress.
As a psychiatrist who specializes in taking care of pregnant and postpartum women, I’ve seen an increase in intrusive worry, obsessions, compulsions, feelings of hopelessness and insomnia in my patients during the coronavirus pandemic. And I’m not alone in my observations: Worldwide, mental health professionals are concerned. A special editorial in a Scandinavian gynecological journal called attention to the psychological distress that pregnant women and new mothers will experience in a prolonged global pandemic. A report from Zhejiang University in China detailed the case of a woman who contracted Covid-19 late in her pregnancy and developed depressive symptoms. In the United States, maternal mental health experts have also described an increase in patients with clinical anxiety.
In non-pandemic times, as many as 14 percent of women will suffer from pregnancy-related anxiety, which refers to fears that women have about their own health and their baby’s over the course of pregnancy and delivery, and up to 20 percent of women will experience postpartum depression.
Samantha Meltzer-Brody, M.D., M.P.H., who is the chair of the department of psychiatry at the University of North Carolina at Chapel Hill and the director of the Center for Women’s Mood Disorders, said, “The natural vulnerability of this major life transition is exacerbated when you just have sort of global anxiety, and things like going to the grocery store to pick up diapers suddenly become a much more anxiety-producing event than it ever was before.”
In my clinical practice and in a Covid-19 maternal well-being group I co-founded, women have voiced their fears about a number of possible distressing scenarios: delivering without a support person; being one of the 15 percent of pregnant women who is asymptomatic for Covid-19 and facing possible infant separation; and recovering during a postpartum period without the help of family or friends to provide support. There’s also grief about the loss of a hopeful time that was meant to be celebrated with loved ones."
By: Mikaela Kiner
"Pre-pandemic, being a mom meant figuring out the tricky balance between parenting, home, career and self. What that meant in practice was that women in heterosexual relationships took on about two-thirds of domestic responsibilities.
The global coronavirus pandemic has resulted in dramatic shifts for everyone, especially for families, with parents working from home, school and day care closures and a general loss of stability and support. Now moms are homeschooling older kids, caring for little ones, feeding their families three meals a day, and sanitizing everything, all while trying to keep everyone healthy and keep up with their day jobs.
While many partners have stepped up to take on more responsibilities at home during the pandemic, the workload balance has not shifted enough (despite nearly half of men claiming they do "all" the homeschooling, a claim that most women disagree with).
Women are legitimately concerned that they will become the default caregivers and take on most or all of the household chores, leaving little or no time for their careers or their own well-being.
Here's how to keep that from happening by coming to an agreement with your partner about sharing the workload at home.
1. Have the hard conversation.
Many people avoid hard conversations out of a fear that things will become adversarial. But now more than ever, we need to talk about roles and expectations. Remember that your partner also wants what's best for you and the family. View this conversation as a collaborative conflict, one where the two of you are working together toward a win-win solution.
Phrase to try: "Let's sit down for half an hour this evening and review both of our to-do lists," or "Can we find a time in the next day or two to go over everything we're both trying to get done?"
2. Start with your goals in mind.Your goal is to come up with a plan that works for both of you. The focus is you both teaming up against the problem.
Phrase to try: "I'd like to talk about how we can both find a good balance between work and helping the kids," or, "So much has changed. Let's talk about how we're going to make this work for us both."
3. Share your hopes + fears.
Tell your partner what you're worried about, and what's been most challenging. Be honest about your experience and what you're afraid of. You'll notice there are no assumptions, personal attacks, shaming or blaming, which is important. My friend Melissa Strawn was in the middle of launching a business when the virus hit. Her husband works full-time and they're raising five boys. Melissa suggests, "Communicate openly and honestly about what's working and not working. Sometimes, I am just looking to feel validated given how much I actually juggle with five kids and a startup. Other times, I need him to just #getitdone."
Phrase to try: "I'm concerned that I've taken on all of the homeschooling and I don't have time to do my work," or, "I realize I'm trying to cook, clean and watch the baby. When I sit down to focus on my job, I'm already exhausted."
By: Megan Richardson, LMFT, NCC
"There is no doubt that COVID is putting a strain on a lot of aspects of our life, one of them being our relationships. While some couples may find that spending extra time with their spouse is creating additional problems in the relationship that once did not exist, many couples are also finding prior relationship concerns are now being placed into a spotlight that may have been easy to avoid or ignore before.I am a strong believer in the fact that the goal of relationships is surprisingly not to feel happy all the time, as it can be easy to blame unhappiness on a partner when there may be other contributing factors. Instead, it is important to acknowledge what you may be feeling in your relationship so that you can take action to address your emotional reactions.
Aside from being in a relationship where you or your children’s safety is at risk, unhappiness may not actually be a good reason to end a relationship. Our partners were not created to make us happy, just like we should not be expected to make our partners happy. Couples often find relief in learning most relationships go through seasons where they do not necessarily feel happy but can still have a satisfying experience in the long term if they remain committed and work on their relationship concerns. Happiness can be worked on. Couples who end relationships because they are unhappy often continue to find themselves unhappy outside of the relationship, as well.
So while it can be easy to blame your unhappiness on your partner, it may not be all of their fault.
If you find yourself feeling especially irritated with your spouse since the start of the quarantine, you are not alone. But it also may not be their fault."
By Meghan Holohan| April 20, 2020
"After experiencing infertility for almost four years, Sarah and Brian Piett felt thrilled to welcome their new son, Brooks, on February 26. Soon after, the COVID-19 pandemic dramatically changed life. Now friends and family can’t meet the baby or offer to babysit. As the quarantine lingers, Sarah feels more listless, worried and frustrated.
“Our whole family has really been waiting for Brooks forever and have been on this journey with us. We finally have our baby and nobody can even see him,” the 29-year-old recovery room nurse from Canonsburg, Pennsylvania, told TODAY Parents. “I’ve cried a lot.”
"After facing infertility for almost four years, the Pietts were excited to finally welcome a baby. But that feeling lessened as stay-at-home orders means Sarah feels isolated." -- Courtesy of the Piett family
"Sarah struggled to breastfeed and a phone call with the lactation consultant made her feel guilty about pumping and supplementing with formula. She wishes she had a little more help around the house or could even go to a moms group or walk around a mall.
“I love my baby and I love holding him,” she said. “Sometimes you wish that somebody was here just to hold him for like five minutes to give you a break.”
At her six-week follow up appointment, she scored high on a diagnostic test for postpartum depression. Her doctor gave her a prescription and a therapist recommendation. She feels like being isolated is making her depression and anxiety more severe.
“It sounds so selfish but I keep thinking this isn’t the maternity leave I envisioned. I thought I’d be able to see friends and they’d be able to see my baby and enjoy him,” Piett said. “It just totally all around completely sucks.”
Postpartum is already changing. What about during COVID-19?
By Margaret M. Quinlan, Ph.D., Bethany Johnson, MPhil, M.A.| April 22,2020
"Maggie and I are both fascinated by social media discourse, and particularly any conversations that center around bodies and health crises. We've researched the infertility community on Instagram (Bethany never thought to turn to Instagram during treatment), and then we had to make an account for work. This was a very awkward endeavor for us (trained academics who don't have experience marketing our research), but the upside is we've met some incredible people.
Today we are interviewing Chelsea Skaggs of Postpartum Together. Not only does she have an excellent Instagram account with relatable, vulnerable images, but she fosters necessary dialogue about the difficulties of the postpartum period, and she runs an online group for newly postpartum folks. We began by discussing COVID-19 and the postpartum experience, then we asked about her work.
As someone who works with postpartum women, how do you think COVID-19 is changing postpartum experiences right now?
We are seeing a lot of changes for women who are entering postpartum during this season. First of all, many women are grieving the loss of a picture they had in their mind—from the birth experience to bringing baby home to meet the family to have more in-person support. We must have permission and space to grieve that loss while also holding the gratitude women have for this time of their lives. (I remind people that grief and gratitude are not mutually exclusive!)
We have to get more creative with support—how do we stay connected to friends and family and other aspects that make women feel like themselves? Postpartum can be an isolating time already, so adding on social distancing means women need, more than ever, more access to virtual supports and resources to keep them connected. On the flip side, some women have the chance to embrace the slow-down of postpartum. So many other cultures prioritize a slow transition, and in America, we are typically more fast-paced. With COVID-19, many women have the chance to step back, slow down, and have that time to rest and restore while having intimate time with the immediate family."
"How are you and your family doing in all this?
Every day is different for us. I know personally having things I can't control is an anxiety trigger, so I have been extra mindful to carve out time for joy and being present. I am also tempted to measure my value in how productive I am, and right now, my brain needs a lot more time to restore (more sleep and downtime), and I've had to challenge the belief I've held all my life about productivity.
It has been very introspective. Some days feel heavy—seeing the impact on our family, our friends, and extended family, but it also feels so refreshing to be living with fewer complications. The pandemic allows us to remove some of the stressors our family was falling into that aren't part of our values; ultimately, we have "sifted out" things, and I appreciate that. I wish it weren't because of such tough circumstances."
By Karen Kleima| April 28,2020
l"What if I get sick and can't take care of my baby?
What if my baby gets sick?
What if my partner gets sick?
How do I do this all alone?
Being a new mother is hard.
Being a new mother during a pandemic is almost unimaginable. One of the things we have learned-thanks to the increased awareness and circulation of good, accurate information about maternal mental health-is scary, negative intrusive thoughts about harm coming to the baby are a stressful but common expression of normal anxiety. Almost every single new mother and most new fathers experience the presence of scary thoughts that can range from mildly annoying to excruciatingly painful and debilitating.
It may be hard to distinguish between "normal and scary thoughts" and those triggered by the current extraordinary stressors associated with sheltering in, isolation, quarantining, social distancing and all the other mandates that are imposing gut-wrenching restrictions. It stands to reason new mothers today are bombarded on a moment-to-moment basis with negative thoughts that may feel out of control, never-ending and often shame-inducing. After all, we often hear, "How can a good mother think these thoughts?"
But good mothers do have these scary thoughts. Awful thoughts. Terrifying thoughts. Indescribable and unfathomable thoughts. And if these moms do not find the support and validation they need, the thoughts can swirl around in their heads, gaining momentum from fear. Anxiety is at an all time high right now, for good reason. It's scary outside and some new moms understandably feel out of control with anxiety.
When the anxiety emerges within the context of having a new baby, it often manifests as specific thoughts about something horrible happening to the baby. By accident, or by intent. The guilt and worry can be excruciating."
By Al Donato| 4/15/2020 6:48pm EDT
"If you’re an exhausted parent at home right now, you have a friend in Elmo’s dad, Louie. In the latest pandemic programming from “Sesame Street,” the children’s series has released a PSA for parents starring the famous Muppet’s father.
In the PSA, Louie reveals that, like many kids cooped up at home, Elmo won’t leave his parents alone.
“It is wonderful to spend so much time with our children, but it can also be a bit ...” the older Muppet pauses, before letting out the world’s most relatable sigh. “Overwhelming.”