Hi everyone! This is Hunter Marcus, an MPH student at the OHSU/PSU school of public health. My area of interest is sex and reproductive education and, and today I’m going to give you a quick run down on perinatal mental health during the COVID-19 lockdown.

For those of you who don’t know, “perinatal” means someone who is about to give birth or who has just given birth. And “just” and “about to” are definitely squishy, relative terms. The perinatal time is around the time of birth.

Now, for context—the perinatal time, for many people, is happy and exhilarating. But COVID-19 has put a big damper on that. And it’s mostly because pregnant people have been shown to be at a higher risk for a more severe course of the disease if they contract COVID-19. Pregnant people have been shown in multiple studies to have a higher risk of needing to be admitted to the ICU, and here is an increased risk of miscarriage, stillbirth, or preterm birth when it comes to baby.

So because a COVID-19 infection has such a risk of bad outcomes for pregnant people, the CDC recommends that pregnant people and their households completely isolate—don’t see anyone, don’t go anywhere—to get their chance of contracting COVID-19 down to the lowest it can possibly be. This has forced a lot of new parents to sink or swim on their own where before COVID they would have had physical help from friends or family—doing the laundry, cooking dinner, watching the baby—or just providing in-person support.

Now, we have found over the last year that social isolation is extraordinarily hard on human beings. We are a social species, and we feel almost a magnetic need to be with other people and interact. We’ve seen all sorts of increased need for mental health support services in the general public. We’ve also found that, while video chatting services like Zoom are good, they just don’t cut it for our brains. We don’t get that same level of dopamine we get from an in-person interaction, and some studies have actually found that that kind of interaction is more harmful than good.

So add on top of that a pregnancy or a new little person you’re just learning to care for, with severely decreased or no additional support, and you have an absolute recipe for mental health crises. And we’ve seen this throughout the birthing population all over the world over the course of COVID-19. Perinatal people are already at risk for pregnancy-related depression or anxiety, and in a time when they would normally get more support, they’re getting less.

And this isn’t just a lowered amount of support with friends and family, it’s medical support, too. In the United States, people giving birth in hospitals are being discharged as quickly as is safe for them to go back home—usually around 1 day instead of 2 or 3—to try and minimize the risk of contracting COVID-19 in the hospital. And with that, you lose—again—the in person, hands-on support from medical staff. And telehealth services can only replace so much of that.

We also see, too, that perinatal people are at an increased risk—because of this huge amount of stress and the lowered amount of support, of becoming victims of domestic or intimate partner violence. This is incredibly serious, and it has everything to do with perinatal people not being able to leave their homes, even when their homes become dangerous for them to be. And the resources they could normally turn to, like shelters, are often full, and full of strangers, which is a huge red flag for a susceptible population in the COVID-19 pandemic!

However—is that the sun on the horizon? We have a vaccine coming! However…and this was and continues to be extraordinarily frustrating to many, many experts in the field, pregnant people were completely excluded from the safety trials, and breastfeeding people were excluded from most of them. As a result of that, we now have almost no information on the safety of this vaccine for pregnant and breast or chest feeding people. But we can make an educated guess, comparing this new vaccine to similar vaccines that also use dead virus as opposed to a live virus (which is not safe in pregnancy), that the benefits to the pregnant person of not contracting COVID-19 likely outweigh the risks to the fetus, which are currently unknown. But again, we need the research to back this up and will likely have it in the next 6-12 months as pregnant people elect to get the vaccine and are studied for bad side effects. If you are pregnant and are considering getting the vaccine when it becomes available to you, talk to your doctor about your specific pregnancy and your specific medical history so you can make an informed decision together.

Thank you so much for listening. If you or someone you know needs mental health resources, please visit the links farther down on the site. Wear your mask, stay home, and stay sane.