She burst into tears the moment she sat down. Although she was due in a few weeks’ time, Esther (not her real name) could not find any reason to enjoy her pregnancy or look forward to her new baby. Esther was just one of the many women I have seen over the last few months who have been experiencing unprecedented stress caused by the COVID-19 pandemic.
All of us face stress during these exceptional times. Firstly, it was the uncertainty of knowing how contagious and dangerous this virus is, then the ambiguity of how long the crisis would last; the economic and financial hardship that would follow and finally the impact that it would have on our work and leisure time. Almost everything that we are familiar with has been changed.
For pregnant and postnatal women, transition is already a given. Changes happen in the body weekly; sleep becomes subject to the baby’s whims, even well before the baby is born. Many routines need changing to accommodate the new arrival. At a time like this, much is disrupted for expectant and new mothers so much so that even with the usual changes, they would still have to manage even more changes and uncertainty that the current crisis brings.
Social support, the key to maintaining optimal coping for mothers and their babies, has been severely disrupted. Mothers have told me that they are now unable to engage confinement ladies to help during their first postnatal month; others worry about not being able to tap on the grandparents for help with infant care. Another mother shared how her domestic helper was set on going home for personal reasons, and her despair in finding another during this time. Fathers, if they work from home, can sometimes help more, but only to a certain extent.
Another issue is that of needing to recharge. A mother told me that being at home constantly with the baby with hardly any respite was, “Draining her battery flat all the time”. The concept of mental load, such as the responsibility of keeping the household functioning, unfortunately still falls largely on women. Even when there is time to rest, one woman said that she felt like there were, “Many apps still running in the background”. Biologically, anxiety disorders can manifest postnatally, leading to what one mother described as, “A very active brain in an exhausted body”.
Finally, in some families, there may be an exacerbation of underlying relationship issues. Having to spend more time with spouses during this circuit breaker period, may increase friction due to differing habits, work preferences and expectations. An increase in family violence in many countries has been reported in the press, and it remains to be seen if we will see higher numbers reported by our family violence specialist centres in the months to come.
We can still find the silver lining during such dreadful times. One woman who suffered from panic attacks and separation anxiety said that having her husband working from home was, “The best thing ever”. A mother said not getting an incessant stream of visitors to see her newborn baby was a godsend. And she added that she had grown closer to her children over the last few weeks.
Sometimes in the midst of such seeming chaos, the ability to find new ways to reconnect takes on an even greater significance.
As the old saying goes, “Never waste a good crisis”.
If you are concerned that you may be suffering from postnatal depression it is important to seek help early, either by speaking with your GP, obstetrician or healthcare provider. Specialist psychiatric services are also widely available and you do not need a referral to see a psychiatrist in Singapore. The Women’s Emotional Health Service at National University Hospital (NUH) has psychiatrists with experience working with pregnant and postnatal women.
You can also learn more via the brochure on Postnatal depression here.
The contributor is Director of the Women’s Emotional Heath Service at the National University Hospital.