Abstract
The ongoing COVID-19 pandemic has led to disruption of normal life across the globe, severely affecting the already vulnerable populations such as the pregnant women. Maternal mental health and well-being is a public health priority and the evidence about the impact of COVID-19 on mental health status of pregnant women is gradually emerging. The findings of the recently published studies suggest that increased risk perception about contracting COVID-19, reduced social support, increase in domestic violence, disruption of antenatal care, and economic consequences of COVID-19 mitigation strategies can lead to adverse mental health outcomes in antenatal period. There is a significant increase in antenatal depression and anxiety since the onset of COVID-19 and social determinants of health (e.g., younger age, lower education, lower income) are associated with these poor outcomes. In this paper, we propose an integrated approach to improve the mental health and well-being of pregnant women. Physical activity and/or mind-body interventions like yoga can be practiced as self-care interventions by pregnant women. Despite social distancing being the current norm, efforts should be made to strengthen social support. Evidence-based interventions for perinatal depression should be integrated within the health system and stepped, collaborative care using non-specialist health workers as key human resource be utilized to improve access to mental health services. Use of digital platforms and smartphone enabled delivery of services has huge potential to further improve the access to care. Most importantly, the COVID-19 related policy guidelines should categorically include maternal mental health and well-being as a priority area.
Highlights
In just over 6 months, the COVID-19 pandemic has upended lives across the world
In Japan this practice is called Satogaeri and the restrictions by the Japanese government on the same may lead to adverse maternal mental health outcomes [15]
Cross-sectional survey of 2,740 pregnant women from 47 states in the United States found that younger age, advanced pregnancy, previous history or recent diagnosis of depression/anxiety, and being an essential worker were associated with increase in scores on Pregnancy Related Anxiety Scale (PRAS)
Summary
In just over 6 months, the COVID-19 pandemic has upended lives across the world. Governments in most of the countries have imposed varying levels of “lockdowns” and requested citizens to “stay at home” to contain the spread of the virus and prevent health systems from being overrun. Severe disruption of life due to COVID-19, fear of contracting the disease, and anticipation of negative economic consequences have led to increased symptoms of depression, anxiety, and stress in the general population as well as in the health care providers [4]. A rapid evidence review and two other editorials did not find any studies on the impact of COVID-19 on maternal mental health and wellbeing [5,6,7] Evidence in this domain is gradually emerging and in this perspective paper, we provide a high-level overview of the recently published epidemiological studies assessing the impact of COVID-19 on maternal mental health, and propose an integrated approach to improve mental health and well-being of pregnant women during the current crisis. The details about the search strategy, screening, and selection of published articles are provided in Box 1
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