Abstract
BackgroundThis retrospective study aimed to identify possible intensification of mental health difficulties among women seeking support in the postpartum period during the epidemic state in Poland. We assumed that the epidemic crisis, social isolation, and restrictions in hospitals which affect pregnant and postpartum women - lack of family labors, lack of the possibility to be with the newborn when he/she is hospitalized, may increase fear and reduce psychosocial resources of women, hinder their normal process of transition to motherhood and thus contribute to the intensified severity of depressive symptoms.MethodsThe study participants were women seeking support at the on-line platform of the project ‘Next Stop: Mum’, which is a part of the postpartum depression prevention’s program implemented by the Ministry of Health in Poland, and enables remote self-screening for the severity of the postpartum depression symptoms with the Edinburgh Postnatal Depression Scale developed by Cox and collaborators. The analyzed data in this study were obtained from 139 women: 61 filled forms from October 1 - November 10, 2019 (non-epidemic period), and 78 filled forms from February 20–March 30 (beginning of the COVID-19 epidemic), 2020.ResultsA statistically significant difference in the severity of postpartum depression symptoms were observed among women making a self-assessment with EPDS scale at the beginning of the COVID-19 epidemic in Poland (M = 15.71; SD = 6.23), compared to the pre-epidemic neutral period (M = 13.56; SD = 6.46).ConclusionsThe results of this study indicate that the epidemic crisis may be associated with an increased need for additional caution and support of women’s mental health in the postpartum period. We believe that recommendations for medical staff, policy, and families of women struggling with postpartum depression symptoms during crisis should be widespread as the second wave of COVID-19 disease may develop in the autumn-winter 2020 and spring 2021.
Highlights
This retrospective study aimed to identify possible intensification of mental health difficulties among women seeking support in the postpartum period during the epidemic state in Poland
Among women who participated in the study during the non-pandemic period (October 1st - November 10th, 2019) 58.82% were the residents of big cities, 11.74% lived in medium-sized cities, 9.80% lived in small cities and 19.60% lived in the countryside
Among women who participated in the study during the COVID-19 epidemic period (February 20th - March 30th, 2020) 47.69% were the residents of big cities, 23.07% lived in medium-sized cities, 6.15% lived in Variable Woman age, years
Summary
We believe that the COVID-19 epidemic crisis along with a high level of anxiety [1] could contribute to the intensification (or be a trigger) of mental health problems among those people who were at high-risk under normal (nonepidemic) conditions [7, 8] We assumed that such factors as anxiety about the possibility of infection during pregnancy and/or after delivery, restrictions on delivery and hospital stay (limited contact with relatives and friends), limited access to specialist and control treatment (often restricted only to emergencies), a radical change in the postpartum care: midwife-woman relationship, where often the comforting presence, practical help in breastfeeding as the key supportive elements, has been transferred “online” in an attempt to maintain distance and reduce cross-infection, loss of social support due to voluntary quarantine and lockdown, confusion and panic (often increased by fake news) – all may affect the wellbeing and mental health of mothers in the postpartum. It is worth emphasizing that lack of social support is listed as one of the major risk factors for postpartum depression along with high life stress, current or past abuse, prenatal depression, and marital or partner dissatisfaction [8]
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