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Checking in During COVID-19: The Need for Mental Health Screening for Postpartum Patients

 

While the COVID-19 pandemic continues, an increase in associated anxiety can be related to the disruptions to life that have come with it (1). Pregnant patients, a population already at risk for depression and anxiety, are potentially at an even higher risk for postpartum mental health disorders because of the COVID-19 pandemic. While the extent to which the COVID-19 pandemic has affected maternal health is not yet known, it is important to consider the likelihood of increased risk for maternal mental health disorders so that the mental health needs of postpartum patients can be addressed (2). Mental Health America saw a 19% and 12% increase in clinical anxiety screening in February and March, respectively (1); and a Kaiser Family Foundation poll found that 47% of people sheltering in place reported that stress or worry related to the Coronavirus pandemic has had a negative impact on their mental health, while 37% of people not sheltering in place reported the same negative mental health outcomes due to the pandemic (3). With an increase in mental health issues in the United States, it is reasonable to infer that postpartum patients will experience anxiety and depression at higher rates as well. Perinatal mental health morbidity is known to be affected by stress, emergency and conflict situations, and natural disasters (2). A global health pandemic can fit into many of those categories. For some, the pandemic has created job insecurity or joblessness which can cause a stress response, especially for a person with a newborn. Furthermore, the health crisis has created emergent situations for many families and individuals including but not limited to a confirmed diagnosis of COVID-19 for themself or a family member, lack of income, and an inability to access necessities.

The restrictions that have been imposed by public health officials to limit the spread of COVID-19 have been necessary, but the important isolation and social distancing measures are known to have negative psychological effects (2). Therefore, it is even more imperative that health care providers screen postpartum patients for depression. Even though many clinics and health centers are expanding the services they provide, many postpartum visits are still conducted via telemedicine. Therefore, it may be beneficial to add a routine remote 2-week postpartum visit with the intention of screening for postpartum depression. PICCK and Upstream USA have co-created a toolkit to assist practices and providers during the reopening and expansion of services. To learn more about recommendations for postpartum patients during this next phase of COVID-19, please visit our Adapting to the New Normal: Contraceptive Care Services in the Next Phase of COVID-19 Toolkit.

 

References:

  1. Mental Health America. Mental Health and COVID-19 – Information and Resources.https://mhanational.org/covid19. Accessed June 10, 2020. 
  2. Thapa SB, Mainali A, Schwank SE, and Acharya G. Maternal Health in the Time of the COVID-19 Pandemic. AOGS. Doi: 10.1111/AOGS.13896. Accessed June 10, 2020.
  3. Panchal N, Kamal R, Orgera K, et al. The Implications of COVID-19 for Mental Health and Substance Use. Kaiser Family Foundation. https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/. Published April 21, 2020. Accessed July 1, 2020.