Pregnancy and postpartum mental health during covid19

DR KRYSTAL-JANE VERASAMMY

PREGNANCY IS usually a special time marked with joy, excitement and anticipation. However, pregnancy and postpartum during the covid19 pandemic may have additional layers of fear, anxiety, uncertainty, and complexity that need to be talked about.

Research shows that one in seven women experience a perinatal mood or anxiety disorder, such as postpartum depression, postpartum anxiety, PTSD or postpartum psychosis (Postpartum Support International).

Usually, a constellation of risk factors may predispose a person. One such factor may be stress and it is no doubt that the covid19 pandemic inevitably brings additional challenges and limitations for expectant mothers.

Expectant mothers may experience decision fatigue as during times of heighted stress it can be difficult to have the energy and concentration to make effective decisions.

Mothers are being challenged during this time to not only make decisions about their birth process and postpartum experience but to also make decisions about social interaction, weighing constantly changing information and health and safety procedures.

Despite this, there is hope. There are some things that you can do to regain a sense of control during this time. Planning ahead of your recovery and having conversations – that may be difficult – will help alleviate some of the pressure.

Adapting to a new normal involves adjusting your postpartum plan to include realistic support and actionable resources. The following are five tips to help feel less scared and more in control during your pregnancy and postpartum experience:

1. Grieve that your postpartum experience may be different.

Many of us are grieving losses we have experienced due to this pandemic. Pregnant and postpartum women may have lost baby showers, the birth experience they wanted, visitors at hospital or at home postpartum, help/support from family and friends, and access to usual self-care practices.

These are all valid losses that ought to be acknowledged. Allow yourself to feel sad and disappointed at this time. Allow yourself to feel your feelings. Let them be, and acknowledge them when they appear. Give yourself grace and honour your feelings of grief.

2. Setting boundaries with family and friends.

Be mindful that not everyone will be on the same page of what physical distancing actually means and how to keep themselves and others safe. Under the guidance of your baby’s paediatrician and your care provider, decide with your partner what (if any) physical interactions feel okay with you – and communicate those boundaries very clearly to friends and family.

Even without a pandemic as part of the equation, some new parents opt to not have visitors in their home for the first few months of their baby’s life to enhance the bonding experience. Stating your boundaries clearly from the beginning can be helpful, and although Skype/Zoom can never replace your friends and family from coming over and holding your baby, virtual communication is still a great way to stay connected.

3. Reframe this time.

During this period, it can feel very empowering to tune into yourself and envision what you want to feel with your baby at home. This involves shifting thoughts of fear and anxiety into an opportunity on what you want to feel and invite into your sacred space. This gives you more control. Ask yourself: How do you want to feel? What does this look like? How do you want to remember this time? What is important to you? By asking these questions you allow yourself to focus inward as opposed to external, giving yourself more control.

4. Replace “I should” with “I am.”

As humans, sometimes we place self-demands or should/must conditions on ourselves, which feed into a cycle of self-blame and self-criticism. During challenging times like these it may be helpful to let go of the “I should” and focus instead on the “I am.”

“I should” statements are usually defined by outside expectations and external pressures. However, by focusing on all that we are doing in each present moment helps us to have a healthier state of mind. Examples of thought reframing may be:

* I should be trying to sleep when my baby sleeps.

* I am doing the best I can to get rest whenever I am able to.

* I should not go to the paediatrician because I will risk exposing my baby to illness.

* I am listening to my paediatrician’s recommendations and trusting my instincts as a parent.

5. Seek a mental health professional.

Do the legwork now. Even if you may not need professional mental health support at this moment, planning ahead and seeking a therapist who can support you with your pregnancy and postpartum journey can be helpful.

Most mental health providers like myself offer telemental health services (virtual support) so it makes accessibility easier and safer. Your therapist can share postpartum mental health resources and help you to create pregnancy, birth and postpartum recovery plans.

Remember, it’s natural to feel fear, worry and concern during pregnancy and postpartum, especially during a global pandemic, but with the right support and having a flexible postpartum plan you can feel less scared and more in control.

Dr Krystal-Jane Verasammy is a counselling psychologist