Maternal mental health shouldn’t be ignored now

Pandemic putting stress on moms, Tanya Nayler says.

Welcoming a child into the world is a lifealtering experience that usually involves a mix of excitement, fear, joy and exhaustion. Doing so during an unprecedented global pandemic, however, adds a level of stress that has the potential for serious consequences for moms and babies.

In ordinary times, perinatal mood and anxiety disorders are a significant public health issue affecting upwards of 20 per cent of Canadian women during pregnancy and the year after birth. They are the most common pregnancy complications, and sadly suicide is a leading cause of maternal mortality in Ontario.

Several of the risk factors for postpartum depression — prenatal anxiety, recent stressful life events, and a lack of social support — are likely to be exacerbated by the pandemic. Women expecting during this time are facing significant stress and uncertainty. As a pregnant mother with a rapidly approaching due date, I worry if it will be safe to deliver at my local hospital, where a COVID -19 outbreak involving staff was reported earlier this month.

Another question weighing on many pregnant women’s minds is whether hospital policies will force them to endure childbirth alone. The World Health Organization has stated women have the right to a safe and positive childbirth experience during the pandemic, including “having a companion of choice present during delivery.”

However, The Ottawa Hospital’s current policies do not allow a support person to be present during triage, inductions prior to active labour (which can last for hours or days), multiple births (because they occur in operating rooms), or caesarean deliveries. If a labouring woman has any signs of possible COVID-19, her support person cannot be someone who lives with her or who she has seen in 14 days, likely excluding partners in most cases. These policies are causing significant mental distress for

I worry if it will be safe to deliver at my local hospital ...

pregnant women and leading some to consider birthing at home without medical assistance.

New and expectant mothers have also lost many sources of support. In-person prenatal classes that help women prepare for birth and parenthood, and make connections with each other, have been cancelled. The same is true for groups new moms are normally encouraged to participate in to avoid isolation. At home, most no longer have the help of family or friends while they adjust to life with a newborn.

Care providers are seeing pregnant women less frequently during the pandemic, so both physical and mental health issues may be missed. Mothers are trying their best to protect their families and communities from COVID-19, but in turn are having to navigate without the “village” we would otherwise be told to lean upon.

Unfortunately, the impact of this added stress is likely to extend beyond mothers themselves. When the 1998 ice storm left millions without power, some for nearly six weeks, researchers at McGill University embarked on a longterm study dubbed “Project Ice Storm” about the impacts of maternal stress in utero. They recruited 200 women who were pregnant during this event and followed their children at regular intervals. Over 20 years of study, researchers found persistent effects on the children’s physical, cognitive and behavioural development. As the pandemic stretches on, I worry about the long-term impact on the son I have yet to hold in my arms.

While the federal and provincial governments have recently announced funding for mental health initiatives to support vulnerable groups, pregnant and postpartum women have been forgotten so far. World Maternal Mental Health Day went unacknowledged this month by both our prime minister and premier, while advocates highlighted that #NowMoreThanEver, a national perinatal mental health strategy, is needed to ensure universal screening and timely access to treatment.

Our leaders did remember to issue messages for Mother’s Day a few days later, but mothers deserve more than praise for what they do for their families. They deserve help when they are struggling, and it’s time our governments took action to support maternal mental wellness during this time of crisis.

Tanya Nayler is an Ottawa mother expecting her second child in June.