Perinatal Mental Health Care for Women With Severe Mental Illness During the COVID-19 Pandemic in India-Challenges and Potential Solutions Based on Two Case Reports.

Sachin Nagendrappa,M Thomas Kishore,Kimneihat Vaiphei,Geetha Desai,Naveen Manohar Pai,Sundarnag Ganjekar,Prabha S Chandra,Pratibha Vinod,Harish Thippeswamy

doi:10.3389/fgwh.2021.648429

Sachin Nagendrappa, M Thomas Kishore + Show 7 more

Open Access

https://doi.org/10.3389/fgwh.2021.648429

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Abstract

The ongoing COVID-19 pandemic in India has created several challenges in the care of women with perinatal mental illness. Access to healthcare has been disrupted by lockdowns, travel restrictions, and the unavailability of outpatient services. This report aims to discuss the challenges faced by women with severe mental illnesses during the perinatal period with the help of two case reports. Accordingly, we have highlighted the role of COVID-19 infection as a traumatic event during childbirth and its role in triggering a psychotic episode in women with vulnerabilities; difficulties faced by women with postpartum psychosis in accessing perinatal psychiatry services; and the challenges of admission into an inpatient Mother-Baby Unit (MBU). Further, we have discussed potential solutions from the perspectives of Lower and Middle-income (LAMI) countries that need to be extended beyond the pandemic. They include offering video consultations, reviewing hospital policies, and evolving strategies to mitigate traumatic experiences for pregnant and postpartum women with severe mental illnesses in both obstetric and psychiatric care.

Highlights

Pregnancy and postpartum in women are vulnerable periods for developing severe mental illness (SMI) or exacerbating pre-existing psychiatric illnesses [1, 2]
Mental health implications of the COVID-19 pandemic for pregnant and postpartum women are comparable to other disasters
The COVID-19 pandemic created a different set of challenges because of the risk of infection, the prolonged nature of the pandemic and inability to access resources due to lockdowns and travel restrictions

Summary

Introduction

Pregnancy and postpartum in women are vulnerable periods for developing severe mental illness (SMI) or exacerbating pre-existing psychiatric illnesses [1, 2]. The COVID-19 pandemic has significantly affected the clinical care of patients with mental illnesses those with severe mental illness. In India, the first case of COVID-19 was detected on 3rd February 2020. At the height of the 1st wave, India had 0.85 deaths per million people. At the time of this report, May 2021, India has the 2nd most active COVID-19 cases globally, with 2.31 deaths per million people due to COVID-19. As per the latest data on 3rd May 2021, India has 2,02,92,331 confirmed cases, among which 34,51,826 were active cases and 2,22,478 deceased due to COVID-19 [6, 7]

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