Loneliness in pregnant and postpartum people and parents of children aged 5 years or younger: a scoping review

Abstract

Background Despite evidence that loneliness increases during times of transition, and that the incidence of loneliness is highest in young adults, loneliness during pregnancy and new parenthood has not been developed as a program of research. Because loneliness research has primarily focused on older adults and other high-risk populations, the concept of loneliness and its effects on this population are not well understood, leaving a gap in our understanding of the psychosocial needs and health risks of loneliness on pregnant people and new parents. A scoping review has been completed in order to map and synthesize the literature on loneliness experienced during pregnancy and the first 5 years of parenthood prior to the COVID-19 pandemic. Methods To address the aim of this review, a wide net was cast in order to detect experiences of perinatal or parental loneliness and/or instances where loneliness was measured in this population. Among the inclusion criteria were loneliness in people who were pregnant, who were parents in the postpartum period, or who had children aged 5 years or younger. A search for literature was conducted in December 2020 using nine databases: MEDLINE (Ovid), EMBASE (Elsevier), SCOPUS (Elsevier), Cochrane Library including CENTRAL (Wiley), CINAHL (Ebscohost), PsycINFO (Ebscohost), Dissertations & Theses Global (ProQuest) and Sociological Abstracts (ProQuest), and the Web of Science Core Collection (Clarivate). Results Perinatal and parental loneliness studies are limited and have rarely been targeted and developed through a program of research. Loneliness inquiry in this population was frequently studied in relation to other concepts of interest (e.g., postpartum depression). Alternatively, the importance of loneliness emerged from study participants as relevant to the research topic during qualitative inquiry. Across studies, the prevalence of loneliness ranged from 32 to 100%. Loneliness was commonly experienced alongside parenting difficulties, with parents feeling as though they were alone in their struggles. Conclusions As loneliness has been called a sensitive indicator of mental wellbeing, we believe screening will help healthcare professionals identify common difficulties and early signs of depression experienced during pregnancy and parenthood. Systematic review registration The protocol is available on Open Science Framework at DOI 10.17605/OSF.IO/BFVPZ.

Systematic Reviews to Inform Practice, July/August 2023

“…The implications of these findings targeting loneliness as a key factor in mental health are far‐reaching and are consistent with previous studies on loneliness 5 . Other studies demonstrating the impacts of parental loneliness on parenting and child mental health highlight the need for early assessment and intervention 2 , 6 . Health care providers who screen for perinatal depression should develop more effective ways of assessing for loneliness as a contributing factor and avoid equating patients’ reports of adequate physical social support with a low risk for loneliness.…”

“…As the nation witnessed rising rates of depression, anxiety, and other mental health diagnoses during the pandemic, health care providers have had to reassess priorities regarding screening for and guiding patients in managing mental health symptoms. Loneliness, a subjective experience of isolation different from the concept of being physically alone, is a key component of mental health that has received increasing attention 2 . US Surgeon General Dr. Vivek Murthy recently released an advisory recognizing loneliness as a public health crisis and highlighting the urgent need for a national effort to increase social connections 3 .…”

“…Health care providers who screen for perinatal depression should develop more effective ways of assessing for loneliness as a contributing factor and avoid equating patients’ reports of adequate physical social support with a low risk for loneliness. The UCLA Loneliness Scale, Version 3, has been validated for use during the perinatal period and is an effective clinical tool for assessing social and emotional components of loneliness 2 . Assessments that focus on patients’ perceptions of loneliness separately from the presence of a supportive social network would assist health care providers in offering the validation needed to help alleviate loneliness and connecting patients with resources to increase their social connectedness 7 …”

Perinatal mental health and women's lived experience of the COVID-19 pandemic: A scoping review of the qualitative literature 2020-2021

“…Some studies in this review conceptualised this as an exacerbation of the feelings of loneliness and isolation that many new mothers routinely describe( Jackson et al, 2021a ),( Jackson et al, 2021b ). Loneliness has been identified as a sensitive indicator of mental wellbeing in studies from pre-pandemic times( Kent-Marvick et al, 2022 ). Given the strong evidence that social support in pregnancy and postpartum is protective against depression, anxiety and self-harm( Bedaso et al, 2021 ),( Milgrom et al, 2019 ), the impact of increased isolation during the perinatal period is a serious issue to consider.…”

An account of loneliness while living with an eating disorder

“…PPD lasts longer than ‘baby blues’ and has a significant negative impact on the woman's capacity to return to her normal function. Loneliness has been linked to an increased risk of PPD (Kent‐Marvick et al, 2022).…”