Over the last couple of years, I have researched the role of communication technologies in the context of mental health and wellbeing for mothers and fathers in the perinatal period (just before and after having a baby). The current Covid-19 pandemic draws my attention to the role of technologies yet again in this context as all offline routes to support and connection have come to an abrupt halt, indefinitely. Having my own 2-month-old as I write this, with my own postnatal plans and expectations significantly altered enables personal insights into strange conditions for us all as the situation plays out with breath-taking rapidity.
Experiencing the perinatal amidst a pandemic
New mothers experience perinatal mental health difficulties unequally in normal circumstances, given the stark differences in their degrees of familial support, relationship conditions, socio-economic status, race and class. Experiences of a pandemic, too, are unequal. Yet, a few specific things tie perinatal experiences together in relation to Covid-19.
First, this particular pandemic has ensured that the peer support and camaraderie derived through quintessential “new mum” activities involving baby-groups, exercise-classes, weigh-in sessions, breastfeeding sessions – all activities involving face-to-face interactions – have ground to an abrupt halt.
Second, outdoor physical activity, including informal meet-ups, catch-ups, group buggy walks, and various other things which are often the go-to for post-natal wellbeing are suddenly significantly curtailed and curbed.
Third, for those with perinatal anxiety, often experienced within the lens and framework of infant well-being, might have a particularly difficult time coping with the notion of a rapidly spreading virus in the world in which they must give birth and raise their infant.
Fourth, new and unprecedented restrictions are cooping people into household units from which there is little to no escape. There could be many cases here, of people in difficult home circumstances, or living in relationships which might range from abusive to unsupportive, with no route for new mums to take distance and breaks from other members of a household.
Fifth, usual routes of support – for instance – conversations with a counsellor, calls to a helpline, or chats with a sympathetic health visitor – are now jeopardised because of the significant lack of privacy at home, even when such things are rearranged to occur by phone or online.
And sixth, whilst new mothers would be on maternity leave, or just out of it, since any pre-existing children are also now at home, and an increased amount of feeding, cooking, cleaning, tidying is happening now that everyone is at home, it would not be unusual if traditionally gendered patterns of domestic labour got starker at home, meaning increased pressures on women.
These particularities of the impact of a pandemic on the perinatal period are experienced over and above pre-existing circumstances, inequalities, divides and conditions, often exacerbating them. Covid-19, or indeed any epidemic or catastrophe, does not replace existing divides and inequalities, it overlays them.
Pandemics, the perinatal, and the digital pivot
In fact, NHS resources for the perinatal mental health support have been reduced over time, leading to significant gaps in care and pressures on those providing support for new mothers. But at a time when a pandemic is raging through the world and the UK, resources are even more unimaginably stretched and many usual walk-in avenues no longer available.
Peer support groups, charities and the third sector have been rapidly re-arranging their priorities, re-assessing needs and moulding their services to offer support to new mothers in such challenging conditions.
The NCT have moved its suite of ante-natal classes online, after pregnant women were advised particularly to distance themselves socially, also beginning to consider moderated WhatsApp groups and phone support. The Institute of Health Visiting are beginning to work on resourcing virtual visits for Health Visitors and ways in which these could become effective. The Perinatal Mental Health Partnership have postponed Maternal Mental Health Week to dedicate themselves towards better supporting new mothers at this time. Cocoon Family Support have started online groups to offer support at a time when face to face groups cannot go on. Bluebell Care have started offering phone-call ‘buddy visits’ and are open to requests for online and phone support in such times. Baby Café – infant feeding support network is offering online baby ‘cafes’. Mothers for Mothers are offering online engagement and phone-based support in the absence of face to face groups. The Smile Group are engaging with their virtual community to reassure mothers of their presence amidst these strange times. Mum’s Aid’s Online Journaling Group is yet another, creative option for new mothers to connect to others, and to express themselves.
This is by no means even close to an exhaustive list of perinatal mental health support or organisations, and as the weeks progress and the pandemic peaks, more will become evident. We will also begin to learn more about the utility, efficacy and challenges associated with this move online.
Amidst the numerous opportunities and relief offered amidst times of great turmoil, such a digital pivot draws our attention, once again, to the many nuances and challenges involved in such a turn:
First, digital alternatives to any largely face to face sources of support have had to come about in a very short period of time, involving huge amounts of energy and effort of people experiencing the pandemic in often demanding ways. Perinatal mental health is an area, where the third sector – charities and peer support groups – are, even in normal circumstances – under pressure owing to a paucity of NHS resources. But the conditions of a pandemic, and the heightened need from new mothers, ramps up the pressures on self-help groups and charities. Once again, we are reminded of the gaps in care which, over time, often fall on to the shoulders of independent groups, small or large, to fill. People behind such a rapid, and impressive move to offer alternative support sources are stretched, working extremely hard, and dealing with their own challenges amidst a crisis.
Equally, digital technologies are not always an easy go-to. Such a swift digital pivot involves a learning curve to adapt and employ these technologies usefully in a crisis. Training with such things is often scarce.
Questions of privacy are often unanswered in relation to popular online platforms which are now our top collaboration avenues, and the use of tech-tools is not an easy straightforward magic bullet in crises, or otherwise, and a complex thing embedded in everyday life, as broader research in media and communications have often showed.
Also, after panic-striking, but often evidence-poor, headlines warning people, but sometimes unfairly blaming parents, and mothers particularly, of “too much tech-time”, here we are, again, hoping that those in need will be able to fully access and engage with these things to support themselves, and their families, in a crisis. We must be cautious, more so than ever, that we do not ascribe to technology itself either the role of a villain, or that of a saviour.
Also, as we know, digital divides and inequalities in access, use and literacies, do not disappear in a crisis, and we must be cautious about the highly individualised expectations we might begin to hold of everyone, that they will all be able to access and make the most of things available to cope with the crisis.
In sum, a crisis such as this, exacerbates conditions for the most vulnerable, for those struggling with existing physical and mental health difficulties, and does so, unequally. In the context of the perinatal, a very admirable effort is being made, at breath-taking speed, by charities and peer support groups to offer connection, camaraderie and support to perinatal mothers at a time of intense public anxiety. Once this is behind us, we will do well to remember the gaps in perinatal support and care within the NHS, which need filling urgently, and the need, as I have argued recently, to develop a balanced, context-sensitive plan and approach to digital support-sources for perinatal wellbeing.
Ranjana Das is Reader in Media and Communications at the University of Surrey. Ranjana notes that in writing this post I have found very useful various inputs from organisations and individuals on Twitter, alerting me to the range of efforts being made amidst the pandemic.