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Raising concerns about pandemic pregnancy, motherhood and mental health

Opinion

The pandemic and its restrictions have added another layer of stress for many new or expectant mothers, and it’s important that they be offered and be able to access services to address mental as well as physical health, argues Marielle Smith.

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2020 has been a challenging year for so many South Australians, but especially so for women and their partners who have brought babies into the world, or who are still preparing to, for the very first time.

Becoming a mum for the first time is a wondrous, incredible experience. But as most women who’ve done it will tell you, it can also be bloody tough, and that starts in pregnancy.

The magazines full of women cradling a perfect baby bump tell you that you’re meant to love every minute of pregnancy: that it’s a magical experience and to expect that pregnancy ‘glow’. Except, for many women, not every part of pregnancy is lovely.

I count my own pregnancies here – hyperemesis gravidarum really shattered any hopes I had to ‘glow’ or even enjoy the first two trimesters. Pain, insomnia, complications, nausea, reflux – there’s a long list of things that can take the edge off the elation of bringing a new baby into the world. High among that list, although too rarely discussed, is the spectrum of peri-natal anxiety and depression that affects far too many pregnant women and new mothers.

Even prior to the pandemic, we know that peri-natal anxiety affected up to one in five mums in our community. The signs and symptoms include panic attacks, persistent, generalised worry, often focused on fears for the health or wellbeing of the baby, development of obsessive or compulsive behaviours, abrupt mood swings and feeling constantly sad or low. The development of depression and anxiety during pregnancy can not only be debilitating to the day-to-day life of a mother, but also detrimental to the overall health of mother and unborn baby. It can also lead to a greater likelihood of developing further mental health difficulties once the baby is born.

Peri-natal anxiety and depression are serious maternal health issues that can be very dangerous for both mother and child. That’s why it should alarm us all that during this pandemic too many of the mechanisms that allow for the early identification of these conditions fell by the wayside, with pregnant women and new mums suffering as a result.

The push towards telehealth during the pandemic has meant that pregnant women have had access to fewer face-to-face appointments with their maternal health care providers than they otherwise would have.

These early contacts are often the first opportunity for healthcare workers to identify and offer support to pregnant women struggling with their mental health. South Australian mums have told me that not only have they found it extremely difficult to get face-to-face appointments with midwives throughout their pregnancies, other hospital services like birth ward tours, which can help relieve anxiety, were also cancelled.

For mums with new babies, one in seven of whom are at risk each year of post-natal depression and anxiety, there have been further challenges. COVID forced many new mothers’ groups to cease entirely, or at best to move to an online format. These groups often provide a vital lifeline to new mothers struggling with their mental health after having a baby: they provide a path through the isolation, and provide an important opportunity for first time mums to meet with a trained nurse, and connect women with other first-time mothers who might be experiencing similar challenges.

Women struggling with their mental health who miss this opportunity therefore also miss an opportunity for early intervention and support.

House visits from specialist nurses were also affected. Another young mum who gave birth to her first child mere weeks before we went into lockdown told me that she only received one house visit from a child and family health nurse, as COVID restrictions prevented further visits. Her isolation was compounded by not being able to see family and friends or join a mothers’ group. When her newborn baby suffered allergic reactions and only one parent was permitted in the emergency room, this mother’s mental health unsurprisingly tumbled even further.

The consequences of this type of disconnection are already being revealed in the data: since the COVID-19 crisis began in March, the number of calls to the PANDA National Helpline increased by 20 percent. Of course, this data only reveals the women who are reaching out for help. The women I am most concerned about are the ones who have been suffering in silence.

I am urging everyone in our community: if you know a woman who has become, or is soon to become, a first-time mum this year, please pick up the phone and make sure they are coping okay. Don’t assume a maternal health care worker has been able to do that to the extent they normally would.

The reality is, whilst our state health system has largely done an exceptional job of keeping us safe in South Australia during this pandemic, many policy decisions haven’t been without cost: there have been serious and potentially dangerous consequences for first time mothers in our community.

And at a federal level, while the shift to telehealth has obviously been a welcome development in terms of managing the COVID-19 pandemic, in considering any long-term change to its availability we need to be absolutely certain that there are not going to be adverse impacts for first-time mums, or others in our community whose mental health may depend on a face-to-face interaction with their health care provider.

No pregnant woman or first-time mum in our community should be made to suffer from depression or anxiety in silence. It’s incumbent upon all of us to do everything in our power to make sure their mental health and wellbeing isn’t cast aside.

Marielle Smith is a Labor Senator for South Australia. She is a mother of one and expecting her second child in coming weeks.

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