Labor Intensive

“It’s hard enough to be a new mom,” Bailey says. “With the pandemic added, it’s really overwhelming.”

In the wake of a statewide lockdown, Bailey found herself more detached than ever. Out of caution, Bailey’s mother stopped coming over to help with the kids, and her only childcare help evaporated. To keep her children safe from Coronavirus exposure, she stopped making the regular trips to the park that normally provided her family with fresh air and temporary relief from the confines of their suburban home. With her six-year-old daughter’s school closed down, Bailey was suddenly saddled with the task of creating a curriculum, too. 

The threat of the virus triggered her anxiety. Bailey had already lost one child to SIDS (sudden infant death syndrome) and a threat to the health of her family felt all too familiar. 

Bailey isn’t alone. Under the best of circumstances, the burdens of birth and early parenthood can bring parents to the brink physically, mentally, and emotionally. Some 12-20 percent of women and 10 percent of men experience prenatal and postpartum mood disorders—an umbrella term that includes depression, anxiety, obsessive compulsive disorder and post-traumatic stress disorder. The pandemic has made things worse. 

With record unemployment, some parents have lost their access to both medical and psychiatric care. Stay-at-home restrictions, lack of contact with the extended network of family and friends, and ever-present threat of contracting a life-threatening virus have forced new parents into further isolation. “It’s an extremely disruptive and difficult time to bring a new baby into the world,” says Dr. Samantha Meltzer-Brody, a lead researcher and Director at the University of North Carolina School of Medicine’s Center for Women’s Mood Disorders. 

Moreover, swathes of pregnant and postpartum parents are seeing their normal care routines interrupted in some way. Some parents are choosing to skip perinatal checkups in order to avoid possible infection. Others are delivering babies without the support of their partner because of delivery room restrictions or considering home births more seriously. 

Meagan Coburn, a mother and marketing executive from Grand Rapids, Michigan, described a dystopian experience of giving birth in a COVID-19-beset hospital on April 22. After arriving at the hospital and encountering entrances blocked off, she and her husband got inside and waited four hours while a room was sanitized for birth. Because of illness and assignment schedules affected by the virus, the doctor and doula who she expected to be present for the birth were not. 

“We get into our room and the nurse tells us that over 30 percent of laboring mothers have been positive for COVID,” she wrote on Instagram (officials at the hospital where she gave birth did not return a request for comment). “I labored, pushed, and delivered my new son in a surgical mask. I was completely hyperventilating and nauseous because I felt suffocated by it—especially in the end when I tore it off. He entered this world to a sea of eyes peering over masks to keep him safe.”

Coburn says that as of this week, she’s doing well and “nervously waiting out the incubation period,” while feeling the pandemic’s emotional impacts. “I’m grieving the loss of freely having our friends and family come gushing through the door with arms outstretched for the baby,” she says. “I have cried at every porch drop off and baby-introduction through our glass front door. It’s not how ‘the village’ is supposed to work.”

Prenatal and postpartum mood disorders are already spottily screened. Some mothers told us that even when given a form at the doctor’s office, they were afraid to fill it out truthfully for fear of being labeled a “bad mother” or having their child taken away. But since the onset of COVID-19, experts say that even fewer women are coming forward to seek mental health support after giving birth. 

“Initially, I think, people literally just hunkered down and were sort of shell-shocked, really in survival mode,” says Meltzer-Brody. 

Mara Watts, the Director of Outreach at Postpartum Support Virginia and a resident in counseling, has also heard numerous new mothers talk about being in that “survival mode.” Some told her that they wanted to ask for help, but when they had an opportunity, they felt as though they couldn’t even form the words to ask for it. When she heard that, Watts recognized a familiar experience from the one she herself had lived through as a new mom battling anxiety.

“Right now we are collectively in a trauma response,” she said, “and weird stuff happens in a moment of trauma. The left side of the brain shuts down, which is the thinking and speaking part, while the right side of the brain activates. That’s why people can usually ‘see’ and feel trauma but not always talk about it.” 

Kim Hawley, a writer and mother living in Lee’s Summit, Missouri, endured a traumatic labor in 2018. About 38 hours in, her baby had to be pulled back out of the birth canal to be born by C-section. The ordeal left her mentally scarred and with a life-threatening blood clot. After seeking help for the depression, anxiety, and PTSD that followed, Hoawley founded Strength Through Story, a postpartum support group based on her own experience writing about her trauma.

But even with the support system and coping mechanisms she now has, Hoawley has felt familiar symptoms returning. “I felt some of that fear come back when the pandemic began,” she said. “Especially because I had this giant health scare during and after my birth, so anxiety about health was already part of it.” 

Dr. Elyse Springer, a Los Angeles-based therapist, says others could be triggered by being confined at home. “Anyone who is a sexual abuse survivor, anyone who has suffered any victimization or has been trapped in some way,” she says. “To have that same kind of situation recreated because of the pandemic can cause an enormous amount of distress.”

Dads are at risk, too, though they’re often left out of the equation. Postpartum depression and anxiety can look different in men, according to Dr. Daniel Singley, psychologist and director of The Center for Men’s Excellence in San Diego. “More like anger or shutting down,” he explains. “And for Native American dads, for Black dads, for people who have experienced generational and historical traumas, racism, and microaggressions, that added level of threat can be really brutal.”

These days, clinicians are trying to adapt their tools to what feels like a new world. “Before the pandemic we could say, ‘You’re safe,’” says Watts. “We could say, ‘You have people who can come and help you if you get overwhelmed’ and ‘If you’re feeling trapped get out of the house and go to Target, walk around the mall, go to a support group, go to a friend’s house.’ But now that’s not the case. So we are having to rework all the coping mechanisms we give people.” 

Today, some of those coping mechanisms include taking walks outside in an area that feels safe, hopping on Zoom calls with supportive friends, and using small moments (like showers or a cup of tea) to be meditative and re-center. Watts also suggests watching a show or listening to podcasts to feel better, as long as the content isn’t COVID-19 related. 

Amidst all the bad, there is some good news. Meltzer-Brody says that the pandemic has led to an explosion in the availability of telemedicine, which is an ideal way for housebound new parents to get medical and psychiatric care.

“We should embrace telemedicine so that we can reach people in the comfort of their homes and provide care there,” she says. “If we do that, we could have all perinatal women involved in routine mental health screenings.” Should that come to pass, she says, all moms would get screened regularly, and access help early on.

Watts adds that postpartum mood disorders, especially depression and anxiety are treatable, something that she hopes makes women feel empowered to reach out. 

“A lot of times, just tapping women into a community of (other) women going through the same thing works wonders,” she says. “And some combination of self care, social support, talk therapy, and medication can get you back on track. All you have to do is reach out, and a good therapist will take it from there.” Of course, as Watts and others mention, it can be hard to find the right resources, so clinicians need to do a better job of reaching out, especially to marginalized women.

The biggest barrier, Watts says, is often simply convincing parents that it’s worth seeking help and care for themselves: that their struggles are worth tending to.

“I tell women, ‘You would take your car to the shop if it was totaled, but you would also take your car to the shop for an oil change so it doesn’t break down later on,” she says. “You still have to do the maintenance for yourself, too.”

New parents who are struggling in the wake of childbirth can check out Postpartum Support International for resources, a helpline, or to be connected with a mental health provider. The Blue Dot Project is a maternal mental health platform with additional resources like suggested reading lists, online events and lectures, and motherhood advocacy campaigns. And to help researchers and nursing schools around the country access more data about early motherhood in the era of COVID-19, women can share their experiences at the New Moms and COVID-19 Survey.