An Integrated Approach to Improve Maternal Mental Health and Well-Being During the COVID-19 Crisis

Abstract

The ongoing COVID-19 pandemic has led to disruption of normal life across the globe, severely affecting the already vulnerable populations such as the pregnant women. Maternal mental health and well-being is a public health priority and the evidence about the impact of COVID-19 on mental health status of pregnant women is gradually emerging. The findings of the recently published studies suggest that increased risk perception about contracting COVID-19, reduced social support, increase in domestic violence, disruption of antenatal care, and economic consequences of COVID-19 mitigation strategies can lead to adverse mental health outcomes in antenatal period. There is a significant increase in antenatal depression and anxiety since the onset of COVID-19 and social determinants of health (e.g., younger age, lower education, lower income) are associated with these poor outcomes. In this paper, we propose an integrated approach to improve the mental health and well-being of pregnant women. Physical activity and/or mind-body interventions like yoga can be practiced as self-care interventions by pregnant women. Despite social distancing being the current norm, efforts should be made to strengthen social support. Evidence-based interventions for perinatal depression should be integrated within the health system and stepped, collaborative care using non-specialist health workers as key human resource be utilized to improve access to mental health services. Use of digital platforms and smartphone enabled delivery of services has huge potential to further improve the access to care. Most importantly, the COVID-19 related policy guidelines should categorically include maternal mental health and well-being as a priority area.

Expected Impacts of COVID-19: Considering Resource-Limited Countries and Vulnerable Population

“…It is therefore advisable to take maximum care of this special category to protect themselves from illness whenever possible ( 28 , 81 ). A further area of concern will be the protection measures for the pandemic, such as social distancing, which may have a bad attribute in isolation and reduced social support, which may lead to mental distress, involving the COVID-19 related policy guidelines, which should categorically include maternal mental health and well-being as a priority area ( 77 , 82 , 83 ).…”

The Aftermath: Post-pandemic Psychiatric Implications of the COVID-19 Pandemic, a South Korean Perspective

“…Notably, adverse childhood events, such as childhood maltreatment, contribute to the development of psychiatric disorders, interfering with a child's brain development ( 61 ). Convincing evidence also suggests that pregnant women were more likely to experience anxiety and depression, and were more vulnerable to domestic violence during the pandemic ( 62 , 63 ), while maternal mental illnesses have well-known adverse consequences for infant and child development ( 64 ). During the Spanish flu in 1918, the birth cohorts in utero displayed reduced educational attainment, increased rates of physical disability, lower income, and lower socioeconomic status in the USA ( 65 ).…”

Role of Ayurveda and Yoga-Based lifestyle in the COVID-19 pandemic – A narrative review

“…Out of 18 articles, 9 were review articles discussing the role of yoga in the pandemic [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], 4 were letters to editor and short communications [ 28 , 29 , 30 , 31 ], 2 were research protocols of randomized controlled trials, first one to study the efficacy of online Sudarshan Kriya Yoga (SKY) for frontline hospital staff [ 32 ] and the other to examine the effect of meditation app on anxiety and wellbeing [ 33 ], 2 were cross-sectional observational studies [ 34 , 35 ], 2 articles were on cancer care during pandemic [ 36 , 37 ], 1 on modifications in tele-training and tele-assessment in alternative therapies for multiple sclerosis during COVID-19 pandemic [ 38 ]. Out of 18 articles, 3 articles exclusively focused on the role of yoga in elderly [ 25 , 29 , 30 ] and 2 were related to maternal health during the pandemic times [ 24 , 26 ]. Only 4 articles discussed specific yoga modules for COVID-19 [ 19 , 20 , 28 , 29 ].…”