Communication Across Maternal Social Networks During England’s First National Lockdown and Its Association With Postnatal Depressive Symptoms

Abstract

Postnatal/postpartum depression (PND/PPD) had a pre-COVID-19 estimated prevalence ranging up to 23% in Europe, 33% in Australia, and 64% in America, and is detrimental to both mothers and their infants. Low social support is a key risk factor for developing PND. From an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers, inherently reliant on social support to raise children. The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is likely to be even more important to new mothers, as it poses risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support. Using data from 162 mothers living in London with infants aged ≤6 months, we explore how communication with members of a mother’s social network related to her experience of postnatal depressive symptoms during the first “lockdown” in England. Levels of depressive symptoms, as assessed via the Edinburgh Postnatal Depression Scale, were high, with 47.5% of the participants meeting a ≥11 cut-off for PND. Quasi-Poisson regression modelling found that the number of network members seen in-person, and remote communication with a higher proportion of those not seen, was negatively associated with depressive symptoms; however, contact with a higher proportion of relatives was positively associated with symptoms, suggesting kin risked seeing mothers in need. Thematic qualitative analysis of open text responses found that mothers experienced a burden of constant mothering, inadequacy of virtual contact, and sadness and worries about lost social opportunities, while support from partners facilitated family bonding. While Western childrearing norms focus on intensive parenting, and fathers are key caregivers, our results highlight that it still “takes a village” to raise children in high-income populations and mothers are struggling in its absence.

Welcoming new life under lockdown: Exploring the experiences of first‐time mothers who gave birth during the COVID‐19 pandemic

“…Given that increased uncertainty and anxiety was often attributed to a lack of supportive presence of both family, peers, and healthcare professionals, ensuring the established option of virtual support is more routinely available would seem to be an important building block in ensuring continuity of anti‐ and postnatal care going forward. Relatedly, Myers and Emmot ( 2021 ) found that mothers during the COVID‐19 pandemic who engaged in remote communication with a higher proportion of their social network experienced fewer depressive symptoms. However, they also found that mothers described virtual support as lacking the ability to respond to unanticipated problems.…”

Mental Health in Obstetric Patients and Providers During the COVID-19 Pandemic

“…Myers and Emmott 28 noted that low levels of social support and social isolation increased a person’s risk for postpartum depression (PPD) among the perinatal population in England. They identified 3 main challenges contributing to higher rates of PPD during lockdown: decrease in support from others contributed to feeling overwhelmed by “constant mothering” and managing domestic tasks on their own.…”

“…Last, women reported sadness based on an inability to establish “mommy friends” due to the closing of classes for new parents. 28 …”

“… 37 Strict lockdowns to prevent further spread of the virus 40 created widespread, previously unmatched, depletion of access to social support for perinatal individuals. 27 , 28 This circumstance was particularly dire for recently postpartum people given the associated lack of practical support available to these new parents, specifically in Western households 28 where it is relatively uncommon to have 3 generations living in the same household. 25 , 28 Yet, when a child is born, grandparents are frequently present.…”

Behavioral Ecology of the Family: Harnessing Theory to Better Understand Variation in Human Families

“…One of the main strengths of HBE is that researchers can focus their areas of inquiry on those that are predicted by theory, which may lead to unexpected insights and reduce data-driven trial-and-error. For instance, HBE predicts that people will produce children even though children are immensely costly (Mace 2014), that people are willing to engage in dangerous or risky behavior if it is needed to attract a mate (Wang 2002), and that mental health will suffer if parents are isolated without help to raise children during a global pandemic (Myers and Emmott 2021). All of these can be empirically tested.…”